Diane W. Shannon, MD, MPH
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 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 include:
You are also at risk if you have a related condition, such as endometriosis or ovarian cysts.
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:
Call your doctor if you have:
Also, call you doctor if you are having vaginal bleeding or pain and are unsure if it is related to menstruation.
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:
Primary dysmenorrhea is usually treated with medications and lifestyle changes.
The treatment of secondary dysmenorrhea varies depending on the underlying condition.
Nonsteroidal anti-inflammatory drugs (NSAIDs), available over-the-counter, are usually the first-line treatment for menstrual pain. Examples of these medications include
Birth control pills
may be prescribed in some cases.
To help reduce your chance of painful menstrual periods, take the following steps:
American Academy of Family Physicians
American Congress of Obstetricians and Gynecologists
Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
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Last reviewed September 2013 by Andrea Chisholm, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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