Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Painful menstrual periods (also called dysmenorrhea) may include pain in the abdomen, back and legs; abdominal cramps; headache; and fatigue. Most women have painful periods at some time in their lives. In some women, the pain is severe enough to interfere with normal activities.

There are two types of dysmenorrhea:

Menstrual Flow

Copyright © Nucleus Medical Media, Inc.

Causes

Primary dysmenorrhea is caused by high levels of prostaglandins in the uterus. Prostaglandins are hormone-like substances normally found throughout the body.

Secondary dysmenorrhea can be caused by:

Risk Factors

Risk factors include:

You are also at risk if you have a related condition, such as endometriosis or ovarian cysts.

Symptoms

The pain associated with either primary or secondary dysmenorrhea may be sharp and throbbing or dull and aching. It is most typically located in the lower abdomen and may radiate to the low back or thighs. Other symptoms may include:

Call your doctor if you have:

  • Severe or unusual cramps
  • Cramps that last for more than a few days
  • Signs of infection, such as fever or chills
  • Cramps with heavy menstrual bleeding
  • Abdominal or pelvic tenderness
  • Vaginal discharge (other than menstrual bleeding)

Also, call you doctor if you are having vaginal bleeding or pain and are unsure if it is related to menstruation.

Diagnosis

Your doctor will ask detailed questions about your symptoms and medical history, and perform a pelvic examination.

Tests that may be done to look for causes of secondary dysmenorrhea include:

  • Pelvic ultrasound —a test that uses sound waves to examine structures in the pelvis
  • Hysteroscopy —a test that uses a long, thin telescope with a camera on one end to view the inner uterus
  • Hysterosalpingogram —a test that uses x-rays to view the uterus and fallopian tubes
  • Pelvic laparoscopy —a test that uses a thin, lighted tube to view structures in the pelvis

Treatment

Primary dysmenorrhea is usually treated with medicines and lifestyle changes.

The treatment of secondary dysmenorrhea varies depending on the underlying condition (for example, antibiotics for an infection, surgery to remove fibroids).

Nonsteroidal anti-inflammatory drugs (NSAIDs), available over-the-counter, are usually the first-line treatment for menstrual pain. Examples of these medicines include ibuprofen and naproxen .

Birth control pills may be prescribed in some cases.

Prevention

To help reduce your chance of painful menstrual periods, take the following steps: