Dysmenorrhoea is the medical term used to refer to period pain, which affects most women at some point. It Is characterised by stomach cramps caused by contractions in the uterus wall which compress the blood vessels. Period pain is treatable but there is stigma surrounding it, particularly regarding taking time off work when the pain is at its most disabling. Up to 10% of women in the UK experience period pain to this degree.
What are the signs and symptoms of dysmenorrhoea?
Dysmenorrhoea is predominantly characterised by pain in the stomach, however this pain can spread to other areas of the body, such as the back.
The pain can be dull and constant, or present as spasms.
Other related symptoms include nausea and difficulty sleeping and concentrating as a result of the intense pelvic or abdominal pain.
How is dysmenorrhoea diagnosed and treated?
Dysmenorrhoea is usually mild enough to be treated using over-the-counter painkillers such as paracetamol or ibuprofen. Some people use heat packs or hot water bottles and some find that exercise or relaxation activities such as yoga or massage can help.
Contraception is sometimes recommended – such as the contraceptive pill – if the person’s period pain cannot be managed easily with painkillers. This method works by maintaining a thinner uterus lining, which reduces the severity of contractions.
Period pain can also be linked to underlying conditions, in which case treatment is more complex.
These conditions include endometriosis (when the cells that line the uterus are also found in the fallopian tubes and ovaries and cause extreme period pain). There is no cure for endometriosis.
Fibroids (non-cancerous growths around the uterus) and pelvic inflammatory disease (caused by bacterial infection) can be treated with surgical removal and antibiotics respectively.
Pelvic ultrasounds and vaginal examinations can help diagnose such underlying gynaecological conditions.
There are a few ways to confirm what sort of reasonable adjustments could be made for an employee with dysmenorrhoea (although employers are not obliged to under the Equality Act 2010) :
An employee may not disclose their dysmenorrhoea upfront, but if they do, questions regarding the nature of an employee’s dysmenorrhoea and what extra support they may need can be broached sensitively. For example:
- Have they required adjustments in the past? For example, extra breaks to prepare a hot water bottle during their monthly period.
- Even if the employee does not wish to disclose their dysmenorrhoea – or they have not even received a precise diagnosis – an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.
What reasonable adjustments are possible for employees with dysmenorrhoea?
Dysmenorrhoea is not a disability according to the Equality Act 2010 as its effects typically only last for a few days per month, which is not typically classified as ‘long-term’ – one of the criteria for a disability under the Act.
An employer could still decide to make adjustments for an employee who experiences dysmenorrhoea.
If the employee does not disclose a health issue or disability which may affect their performance upfront, an employer should broach the subject sensitively if they suspect that there may be a health condition behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of dysmenorrhoea if the employer sees fit:
- Flexible working hours to accommodate periods of increased absence or decreased productivity following a flare-up in dysmenorrhea – it often improves with age or after a woman has a child.
- Additional breaks if the person’s pain medication causes their concentration to lapse, or to prepare a heat pack which helps them manage their pain.
- Adjustments to duties depending on the severity of their symptoms, which may be variable and improve or deteriorate from one month to the next. This may also be dependent on when they take their medication if they are required to operate machinery, for example.
- Raising awareness so that colleagues understand the employee’s dysmenorrhoea and can help ensure the employee feels comfortable at work, for example, when taking additional breaks. This is also particularly important in the case of period pain, as periods still have stigma attached to them and many women will feel the need to keep quiet about their period-related symptoms, even if they are interfering with their ability to perform their usual duties at work, etc.
Bloody Good Period – charity working to combat period poverty and destigmatise periods in the UK by encouraging everyone to talk more about menstruation and access the information they need to understand theirs or a loved one’s biology better.
Pelvic Pain Support Network – charity providing support and information regarding all types of pelvic pain, including dysmenorrhoea and other gynaecological conditions.
Women’s Health Concern – organisation which is part of the British Menopause Society and provides information and support to women of all ages regarding their menstrual cycle and issues relating to it, such as period pain.