BACK
TO
TOP
Browse A-Z

Spanish Version
 
E-mail Form
Email Results

 
 
Print-Friendly
Bookmarks
bookmarks-menu

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, which can be sharp or aching and come and go. Back pain may also be present.

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

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
  • Secondary dysmenorrhea

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 is 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:

  • Apply a heating pad to your lower belly area, below your belly button. Never fall asleep with the heating pad on.
  • Do light circular massage with your fingertips around your lower belly area.
  • Drink warm beverages.
  • Eat light but frequent meals.
  • Keep your legs raised while lying down or lie on your side with your knees bent.
  • Practice relaxation techniques such as meditation or yoga.
  • Try over-the-counter anti-inflammatory medicine such as ibuprofen. Start taking it the day before your period is expected to start and continue taking it regularly for the first few days of your period.
  • Try vitamin B6, calcium, and magnesium supplements, especially if your pain is from PMS.
  • Take warm showers or baths.
  • Walk or exercise regularly, including pelvic rocking exercises.
  • Lose weight if you are overweight. Get regular, aerobic exercise.

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

  • Birth control pills
  • Mirena IUD
  • Prescription anti-inflammatory medicines
  • Prescription pain relievers (including narcotics, for brief periods)
  • Antidepressants
  • Antibiotics
  • Pelvic ultrasound
  • Suggest surgery (laparoscopy) to rule out endometriosis or other pelvic disease

When to Contact a Medical Professional

Call your provider right away if you have:

  • Increased or foul-smelling vaginal discharge
  • Fever and pelvic pain
  • Sudden or severe pain, especially if your period is more than 1 week late and you have been sexually active.

Also call if:

  • Treatments do not relieve your pain after 3 months.
  • You have pain and had an IUD placed more than 3 months ago.
  • You pass blood clots or have other symptoms with the pain.
  • Your pain occurs at times other than menstruation, begins more than 5 days before your period, or continues after your period is over.

What to Expect at Your Office Visit

Your provider will examine you and ask questions about your medical history and symptoms.

Tests and procedures that may be done include:

Treatment depends on what is causing your pain.

References

American College of Obstetricians and Gynecologists. Dysmenorrhea: painful periods. FAQ046, January 2015. www.acog.org/Patients/FAQs/Dysmenorrhea-Painful-Periods. Accessed May 20, 2018.

Mendiratta V, Lentz GM. Primary and secondary dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder: etiology, diagnosis, management. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 37.

Pattanittum P, Kunyanone N, Brown J, et al. Dietary supplements for dysmenorrhea. Cochrane Database Syst Rev. 2016;3:CD002124. PMID: 27000311. www.ncbi.nlm.nih.gov/pubmed/27000311.

Sciscione A, Mcguirk B. Dysmenorrhea. In: Ferri FF, ed. Ferri's Clinical Advisor 2019. Philadelphia, PA: Elsevier; 2019:471-471.

  • Female reproductive anatomy - illustration

    External structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries, and cervix.

    Female reproductive anatomy

    illustration

  • Painful periods (dysmenorrhea) - illustration

    Primary dysmenorrhea is a normal cramping of the lower abdomen caused by hormone-induced uterine contractions before the period. Secondary dysmenorrhea may be caused by abnormal conditions such as endometriosis or pelvic inflammatory disease. Unless one of these potentially serious conditions is present, the treatment for painful periods is pain relief. If a hormone imbalance is detected, birth control pills may restore the proper hormone levels.

    Painful periods (dysmenorrhea)

    illustration

  • Relieving PMS - illustration

    The cause of premenstrual syndrome is not known but severe symptoms have been shown to be responsive to lifestyle changes. Getting exercise several times a week, eating a balanced diet, getting adequate sleep, and reducing or eliminating caffeine and alcohol are some of the changes most often recommended.

    Relieving PMS

    illustration

  • Uterus - illustration

    The uterus is a hollow muscular organ located in the female pelvis between the bladder and rectum. The ovaries produce the eggs that travel through the fallopian tubes. Once the egg has left the ovary it can be fertilized and implant itself in the lining of the uterus. The main function of the uterus is to nourish the developing fetus prior to birth.

    Uterus

    illustration

  • Female reproductive anatomy - illustration

    External structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries, and cervix.

    Female reproductive anatomy

    illustration

  • Painful periods (dysmenorrhea) - illustration

    Primary dysmenorrhea is a normal cramping of the lower abdomen caused by hormone-induced uterine contractions before the period. Secondary dysmenorrhea may be caused by abnormal conditions such as endometriosis or pelvic inflammatory disease. Unless one of these potentially serious conditions is present, the treatment for painful periods is pain relief. If a hormone imbalance is detected, birth control pills may restore the proper hormone levels.

    Painful periods (dysmenorrhea)

    illustration

  • Relieving PMS - illustration

    The cause of premenstrual syndrome is not known but severe symptoms have been shown to be responsive to lifestyle changes. Getting exercise several times a week, eating a balanced diet, getting adequate sleep, and reducing or eliminating caffeine and alcohol are some of the changes most often recommended.

    Relieving PMS

    illustration

  • Uterus - illustration

    The uterus is a hollow muscular organ located in the female pelvis between the bladder and rectum. The ovaries produce the eggs that travel through the fallopian tubes. Once the egg has left the ovary it can be fertilized and implant itself in the lining of the uterus. The main function of the uterus is to nourish the developing fetus prior to birth.

    Uterus

    illustration

A Closer Look

 

Self Care

 
 

Review Date: 4/19/2018

Reviewed By: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
© 1997- adam.com All rights reserved.

 
 
 

 

 

A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Content is best viewed in IE9 or above, Firefox and Google Chrome browser.