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Menstrual Problems: Dysmenorrhea

By HERWriter
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The American Congress of Obstetricians and Gynecologists (ACOG) defines dysmenorrhea as severe pain during menstruation that keeps women from normal activity. The National Institutes of Health (NIH) adds that although some pain during a period is normal, excessive pain is not. Painful menstruation is the leading cause of lost time from school and work among women in their teens and 20s.

There are two types of dysmenorrhea: primary and secondary.

The Cleveland Clinic says primary dysmenorrhea is common menstrual cramps. Cramps usually begin one to two years after a woman starts her period. Common menstrual cramps usually become less painful with age and may stop entirely after childbirth.

ACOG says secondary dysmenorrhea has causes other than menstruation. It may begin later in life than primary dysmenorrhea. This type of pain often lasts longer than normal cramps.

Mayo Clinic lists symptoms of menstrual cramps as dull, throbbing or cramping pain in the lower abdomen; pain that radiates to the lower back and thighs; nausea and vomiting; loose stools, sweating and dizziness.

What causes this pain? According to ACOG, the uterine muscles contracts during a period when prostaglandins are produced. Sometimes when it contracts, cramping pain is felt.

Prostaglandins are chemicals made by the lining of the uterus. The level of these chemicals increases before a period, is very high at the start of a period and decreases during menstruation. This is why pain tends to lessen after the first few days of the period.

The Cleveland Clinic says two of the most common causes of second dysmenorrhea are endometriosis and fibroids. Other causes are pelvic inflammatory disease, cervical stenosis (narrowing of the uterine opening), and adenomyosis (tissue lining the uterus begins growing into the muscular walls of the uterus).

There are several ways to treat dysmenorrhea. NIH says doctors may prescribe antibiotics, antidepressants, birth control pills, prescription anti-inflammatory medicines and prescription pain relievers.

ACOG adds NSAIDs (non-steroidal anti-inflammatory drugs), block the body from making prostaglandins and makes cramps less severe. The Mayo Clinic says hormonal birth control like pills, patches, rings and implants contain hormones that prevent ovulation and reduce the severity of menstrual cramps.

If fibroids are causing the pain, ACOG says surgery or uterine artery embolization may be the answer. During surgery, the fibroid or the entire uterus may be removed.

To treat endometriosis, laparoscopy may be used. The tissue growth may return after the surgery but removing it can reduce the pain. For the most severe cases, a hysterectomy may be done.


Dysmenorrhea. ClevelandClinic.org by the Cleveland Clinic. Web 3 Oct 2011.

Dysmenorrhea. ACOG.org by the American Congress of Obstetricians and Gynecologists. Web 3 Oct 2011.

Menstrual Cramps. MayoClinic.com by Mayo Foundation for Medical Education and Research. Web 3 Oct 2011.

Painful Menstrual Periods. MedlinePlus by the U.S. Department of Health and Human Services and National Institutes of Health. Web 3 Oct 2011.

Reviewed October 6, 2011
by Michele Blacksberg RN
Edited by Malu Banuelos

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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