Dear Dr Mitchell,

I used to have painful periods in my teens and 20s, but nowadays there is no pain at all, and I hardly notice that it’s there. It still lasts between two to three days, with the same flow as I’ve always had. I’m just wondering why the pain and discomfort would have stopped, and if there’s anything to be concerned about. I am 45, mother of two, and had my tubes tied.

The absence of pain with your monthly period may be an early sign that you do not ovulate as you used to when you were younger. Women who ovulate tend to have some amount of painful discomfort on the first one to two days of the period. This can range from mild cramping discomfort which can usually warn you that the period is about to start, but can be severe enough to warrant the need for pain medication.

The change in your monthly cycle from painful to painless could also be a sign that you are entering the perimenopausal phase of life. These changes can start at any time after 40 years old. The pain associated with the menstrual period is caused by prostaglandin which is increased in production when you ovulate. This causes the muscles of the uterus to contract and results in the pain during the menstrual period.

There are other factors that can cause or change your ovulation pattern and result in painless menstrual periods. These include changes in your body weight, strenuous excessive exercise, and stressful factors.

In some women there can be changes in ovulation and menstrual period after a tubal ligation. This can result in less painful periods because the ovulation pattern changes and is less frequent. The fact that you did a tubal ligation suggests that you have completed your childbearing desires.

The absence of pain with the menstrual period is really nothing to be worried about. You could consult your doctor and have your hormone profile including a test of your thyroid function, as thyroid problems can sometimes result in changes in your ovulation and absence of the period or painless periods. But the fact that your period is still regular makes this less likely to be the cause. Other symptoms of the perimenopause include hot flashes, mood swings, irritability and sleep disturbances.

Experiencing an absence of pain with the menstrual cycles is a welcome change accepted by most women with previously disabling painful periods, as it is seen as a significant improvement in their quality of life.

Best regards.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5 or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.

DISCLAIMER:

The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.