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Pain Drawings Show Multisite Pain in Women with Primary Dysmenorrhea


Often when you make a doctor’s appointment for your pain, you’re asked multiple questions. How long have you had the pain? Where does it hurt? What type of pain is it? What have you been doing to try and ease the pain? It’s difficult to answer these questions because we’re doing the best we can - dealing with pain while also juggling various activities. Journaling or using health trackers can be helpful (and I highly recommend it), but we’re simply not doctor’s. Sometimes we need a doctor or medical professional to see what we can’t see and help us find steps towards managing our conditions.


That’s why I love the idea of using pain drawings to evaluate pain. In a study conducted in 2020 and published online in September of 2022, researchers used pain drawings to “assess multisite pain in women with primary dysmenorrhea.”


Participants were women from ages 18 to 45, with self reported period pain in their last three periods. Unfortunately women who had a previous history of secondary conditions, such as endometriosis or fibroids, were excluded from the study. Participants completed a questionnaire where they gave information about their menstrual cycle, medications they take, and non-medication methods they use. The study took place during the course of two consecutive menstrual cycles. In addition to filling out the pain drawing, women also completed a Numerical Rating Scale, where they rated the intensity of their menstrual pain.


For the pain drawings, women were given a diagram or sketch of a body and were told to fill in the areas where they felt pain during the first three days of their period. The diagram was then read and analyzed by computer software which could “...provide real world dimensional measurements in centimeters or millimeters.”



Screenshot of pain drawing. Image taken from article published by BMC Women’s Health in the National Institutes of Health (NIH). Click here for reference to the image.


Through the pain drawing, researchers found that:

  • As already noted in other studies, women with primary dysmenorrhea (PD) had pain in the lower abdomen.

  • Most of them also had pain in other areas such as the low back, head, and lower limbs.


What I found significant was the confirmation that PD is not just period pain, but can involve other parts of the body as well. Primary dysmenorrhea is said to be part of the central sensations syndromes, and one of the characteristics of those syndromes is multisite pain, which is shown in this study.


Centralization sensations syndromes are a group of disorders in which something goes wrong in the central nervous system and results in pain, fatigue, brain fog, and sleep problems.


“What I found significant was the confirmation that PD is not just period pain…”


Researchers also noted that:

  • Women may experience more or less pain on different parts of the body depending on the cycle. For example, in one cycle a woman may feel less pain in her lower abdomen, and in the next cycle she may feel intense pain in other parts of the body (e.g the lower back and head). How period pain affects the body is not exactly the same from cycle to cycle.


According to researchers, using pain drawings can help doctors have a better understanding of the patient’s pain and find the best option for them. On the other hand, it seems that patients may have a better way to express their own pain and understand the changes that may occur with each cycle. Pain drawings are often used in other painful conditions, and this study shows that it can be a helpful tool for primary dysmenorrhea as well.


What are your thoughts? Do you think pain drawings would be helpful for your doctor appointments? Do you think it would lead to greater findings, or a more accurate diagnosis? Let me know in the comments section. If you have secondary dysmenorrhea, I’d love to hear how you think pain drawings could be helpful.


Disclaimer: Amber’s Care should not replace medical advice. If you have questions about the following statements, please consult a doctor.


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