Most women experience some amount of pain and discomfort associated with their period. But there’s actually a medical term that describes the condition when it is uncomfortable enough to warrant treatment: dysmenorrhea. Its symptoms, which can be constant or sporadic, can occur before or during a menstrual period and last throughout the cycle.
Dysmenorrhea is common. More than half of women experience some degree of discomfort with their periods. Up to 15% of women with dysmenorrhea find the discomfort so disruptive and debilitating that they stay home from school or work to recuperate.
There are two types of dysmenorrhea: primary, which means the pain is from menstruation itself, and secondary, which means the condition is caused by a reproductive system disorder that leads to painful menstrual cramps and other symptoms.
About half of all women diagnosed with the condition experience primary dysmenorrhea, which usually occurs within the first few years of menstruation. The problems tend to become less common with age; pain and other symptoms may gradually fade over time. Some may notice their symptoms improve after childbirth.
Secondary dysmenorrhea is more common as women age, when they may develop endometriosis, fibroids, or other conditions that can cause painful menstruation. Endometriosis is the most common cause of secondary dysmenorrhea; it’s a condition where tissue from the inside of the uterus implants in the pelvis. This can cause painful periods, painful bowel movements, pain with sex, and sometimes chronic pelvic pain when not menstruating.
Treatments are available for both primary and secondary dysmenorrhea, which may help to improve quality of life.
What is dysmenorrhea?
Dysmenorrhea is the medical term for moderate to severe pain caused by menstrual periods:
- Primary dysmenorrhea may begin one to three days before your period and last until two to three days after the onset of menstruation. It typically includes a collection of other symptoms, such as nausea, vomiting, and fatigue.
- Secondary dysmenorrhea may cause pain and discomfort for longer periods of time, which varies, depending on the condition that causes symptoms. Nausea, vomiting, or fatigue are typically not associated with secondary dysmenorrhea.
During a menstrual cycle, the uterus produces different levels of chemicals called prostaglandins. Prostaglandins cause uterine contractions, leading to cramping as the uterine muscles contract and relax. Experts believe that high levels of prostaglandins are responsible for primary dysmenorrhea.
What causes dysmenorrhea?
The uterus contracts throughout your menstrual cycle—and more strongly during menstruation. But if the uterus contracts too strongly, it can press against nearby blood vessels, cutting off the oxygen supply to muscle tissue. You feel pain when part of the muscle briefly loses its supply of oxygen. Because the uterine lining is shed during menstruation, the level of prostaglandins drops during a menstrual period, causing symptoms to ease.
Secondary dysmenorrhea can be caused by conditions such as:
What are the symptoms of dysmenorrhea?
People who experience dysmenorrhea may have:
- Menstrual cramps
- Throbbing or achiness in the lower abdomen
- Pain or achiness that radiates to the legs or thighs
- Lower back pain
- An increased urge to pee
How is dysmenorrhea diagnosed?
Some women don’t need to seek a diagnosis or receive treatment for dysmenorrhea. Others seek medical help if their symptoms intensify. Your doctors can diagnose the condition after learning about your medical history, performing a physical examination, and offering diagnostic tests.
During the medical history portion of the visit, you should tell your doctor how long you’ve experienced pain and other symptoms associated with your period, how old you were when you started getting your periods, and if you’ve been diagnosed with endometriosis, fibroids, ovarian cysts, or other conditions that may cause secondary dysmenorrhea.
During a physical exam, your doctor will perform a pelvic exam to rule out other conditions or find signs of primary or secondary dysmenorrhea.
The following diagnostic tests may be used to diagnose dysmenorrhea or rule out other conditions:
- Ultrasound of the pelvic region
- A pregnancy test
- Cultures for sexually transmitted diseases
- Sonohysterography or hysterosalpingography—specialized tests that look inside the uterus with fluid or dye
How is dysmenorrhea treated?
Many people manage their dysmenorrhea pain and discomfort at home. Treatments may include:
- Non-steroidal anti-inflammatory drugs (NSAIDs), which relieve pain and may decrease the amount of prostaglandin in the body
- Placing a heating pad on the lower abdomen
- Taking a warm or hot shower or bath
- Going for a walk
- Doing yoga
- Practicing meditation
- Getting enough sleep
- Avoiding alcoholic beverages
- Quitting smoking
- Consuming omega-3 fatty acids
When dysmenorrhea pain is too intense to be managed with lifestyle changes or over-the-counter medications, the following may be prescribed:
- Oral contraceptives (birth control pills) containing both estrogen and progestin, which help to suppress ovulation and may reduce symptoms
- Other methods of hormonal contraception, such as the patch, ring, or shot, or long-acting reversible methods such as an intrauterine device (IUD) or implant
- Other medications, which may ease symptoms from secondary causes
- Prescription-strength NSAIDs for pain relief alone or in combination with other medications
For intense pain that has been consistent with your periods for at least a year and hasn’t responded to any other treatments, a minimally invasive surgery to remove or destroy the nerves that send pain signals from the uterus to the brain, called radiofrequency endometrial ablation, may be recommended.
What is the outlook for people with dysmenorrhea?
Dysmenorrhea is uncomfortable to experience, but it typically resolves in a short period of time.
Women with primary dysmenorrhea typically have discomfort and other symptoms for a few days every menstrual cycle. The symptoms may be manageable with over-the-counter medications and home remedies.
People with secondary dysmenorrhea may experience relief if the cause of their symptoms—such as endometriosis—is identified and treated.
All dysmenorrhea resolves at menopause when menstrual cycles cease.