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Painful menstrual periods

Menstruation - painful; Dysmenorrhea; Periods - painful; Cramps - menstrual; Menstrual cramps

Painful menstrual periods are periods in which a woman has crampy lower abdominal pain, sharp or aching pain that comes and goes, or possibly back pain.

Some pain during your period is normal, but a large amount of pain is not. The medical term for painful menstrual periods is dysmenorrhea.

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Female reproductive anatomy
Painful periods (dysmenorrhea)
Relieving PMS
Uterus

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Considerations

Many women have painful periods. Sometimes, the pain makes it hard to do normal household, job, or school-related activities for a few days during each menstrual cycle. Painful menstruation is the leading cause of lost time from school and work among women in their teens and 20s.

Causes

Painful menstrual periods fall into two groups, depending on the cause:

Primary dysmenorrhea is menstrual pain that occurs around the time that menstrual periods first begin in otherwise healthy young women. In most cases, this pain not related to a specific problem with the uterus or other pelvic organs. Increased activity of the hormone prostaglandin, which is produced in the uterus, is thought to play a role in this condition.

Secondary dysmenorrhea is menstrual pain that develops later in women who have had normal periods. It is often related to problems in the uterus or other pelvic organs, such as:

Home Care

The following steps may help you to avoid prescription medicines:

If these self-care measures do not work, your doctor may offer you treatment such as:

When to Contact a Medical Professional

Call your health care provider right away if you have:

Also call if:

What to Expect at Your Office Visit

Your doctor will examine you and ask questions about your medical history and symptoms, such as:

Tests and procedures that may be done include:

Treatment depends on what is causing your pain.

Your health care provider may prescribe birth control pills to relieve menstrual pain. If you do not need them for birth control, you can stop using the pills after 6 to 12 months. Many women continue to have symptom relief even after stopping the medication.

Your doctor may prescribe prescription pain medications. For pain caused by an IUD, your doctor may recommend:

Surgery may be needed if other treatments do not help your pain. Surgery may be done to remove endometriosis, cysts, fibroids, scar tissue, or your uterus (hysterectomy).

References

Ferri FF. Dysmenorrhea. In: Ferri FF, ed. Ferri's Clinical Advisor 2015. Philadelphia, PA: Elsevier Mosby; 2015:pages 391-391.

Lentz GM. Primary and secondary dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder: etiology, diagnosis, management. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 36.

Stewart K, Shilpa D. Dysmenorrhoea. Obstetrics, Gynaecology and Reproductive Medicine. 2014:24(10):296-302.

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Review Date: 7/28/2014  

Reviewed By: Cynthia D. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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