Painful Menstrual Periods

Painful menstrual periods, also called dysmenorrhea, may include pain in the pelvis, 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:

  • 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:

    • Endometriosis
    • Ovarian cysts
    • Pelvic inflammatory disease
      —infection of the female reproductive organs
    • Uterine fibroids
      —noncancerous growths in the uterus
    • Intrauterine device
      (IUDs)
    • Scars inside the abdomen from previous surgery
    • Tumors
    • Inflammatory bowel disease

  • Definition

    Painful menstrual periods, also called dysmenorrhea, may include pain in the pelvis, 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:

    • Primary dysmenorrhea—painful regular menstrual cycles caused by uterine muscle contractions

    • Secondary dysmenorrhea—painful periods due to an underlying condition, such as
      endometriosis
      , which is a condition involving the lining of the uterus, or infection
    Menstrual Flow
    IMAGE
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  • Diagnosis

    Your doctor will ask detailed questions about your symptoms and medical history. A pelvic exam will be done.

    Your internal structures may need to be viewed. This can be done with:


    • Pelvic
      ultrasound
    • Hysteroscopy
    • Hysterosalpingogram

    • Pelvic
      laparoscopy

  • Prevention

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

    • Exercise regularly.

    • If you smoke,
      talk to your doctor about how you can quit.
    • Drink only moderate amounts of caffeine and alcohol.

  • Risk Factors

    Painful menstrual periods are more common in women under age 30 years. Other factors that may increase your risk of having painful menstrual periods include:

    • Low body weight, especially during adolescence
    • Smoking
    • Early onset of menstruation—younger than 12 years old
    • Longer menstrual cycles
    • Heavy bleeding during periods
    • Never having delivered a baby
    • Psychological disorders, such as
      depression
      or
      anxiety

    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 spread to the low back or thighs. Other symptoms may include:

    • Nausea
    • Vomiting
    • Diarrhea
    • Headache
    • Irritability

  • Treatment

    Primary dysmenorrhea is usually treated with medications and lifestyle changes.

    The treatment of secondary dysmenorrhea varies depending on the underlying condition.