Dysmenorrhea (Painful Periods)

Period pain or dysmenorrhea is a condition of painful menstrual periods. Menstrual cramps or pain is felt in the abdominal areas and can occur before the menstrual cycle begins and can continue for 2 to 3 days.

Primary dysmenorrhea is the common painful condition in women with no abnormalities in the pelvic region. Women may experience severe pain before or at the onset of menstrual periods and the pain persists for 2–3 days. Primary dysmenorrhea is caused by the elevated levels of the hormone prostaglandin produced by the tissues lining the uterus (womb). Prostaglandin triggers the uterine muscles to contract and push the uterus lining (endometrium) out of the body through the vagina. Women who have a high level of prostaglandin will experience intense pain and contractions.

Secondary dysmenorrhea is the painful condition that may be caused because of other gynecological problems. This kind of pain begins early in the menstrual cycle and lasts longer than primary dysmenorrhea. Conditions that may cause secondary dysmenorrhea include endometriosis, fibroids, infection, ovarian cysts, narrow cervix, abnormal pregnancy, and intrauterine device for birth control.

Some of the commonly observed symptoms are back pain, leg pain, nausea, vomiting, diarrhea, headache, irritability, weakness and fainting. Your doctor will perform a pelvic examination to identify if there are any other problems associated with menstrual cramps. Blood tests and cervical cultures will confirm if there is any sign of infection. Other diagnostic tests may be required which include MRI scan and ultrasound scan.

If the menstrual cramps are because of the underlying medical conditions, then treating the conditions will help to relieve pain. The conservative approach includes non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and contraceptive pills which decrease the production of prostaglandins by preventing ovulation. However, these medicines are taken before the menstruation begins.

NSAIDs are contraindicated if you have a history of kidney and stomach problems. The other home remedies such as a heating pad to the pelvic area, regular exercises, massage to the back and abdomen, low-fat diet, and intake of calcium and thiamine tablets may help to treat period pain.

  • ACOG
  • AIUM
  • American Association of Gynecologic Laparoscopists
  • NYU langone Medical center
  • American Association for Accreditation of Ambulatory Surgery Facilities
  • UpToDate