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Alternative Names Return to topMenstruation - painful; Dysmenorrhea; Periods - painful; Cramps - menstrual; Menstrual cramps
Definition Return to top
Painful menstrual periods are periods in which a woman experiences crampy lower abdominal pain, sharp pain that comes and goes, aching pain, or possibly back pain.
Considerations Return to top
Painful menstruation affects many women. For a small number of women, the discomfort makes it difficult to perform 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.
The pain may begin several days before, or just at the start of your period. It generally subsides as menstrual bleeding tapers off.
Although some pain during menstruation is normal, excessive pain is not. The medical term for excessively painful periods is dysmenorrhea.
There are two general types of dysmenorrhea:
Activity of the hormone prostaglandin, produced in the uterus, is thought to be a factor in primary dysmenorrhea. This hormone causes contraction of the uterus and levels tend to be much higher in women with severe menstrual pain than in women who experience mild or no menstrual pain.
Causes Return to top
Home Care Return to top
The following steps may allow you to avoid prescription medications:
If these self-care measures do not work, your doctor may prescribe medications such as:
When to Contact a Medical Professional Return to top
Call your doctor right away if:
Also call your doctor if:
What to Expect at Your Office Visit Return to top
Your doctor will examine you, paying close attention to your pelvis and abdomen, and ask questions about your medical history and current symptoms, such as:
Diagnostic tests that may be performed include:
Your health care provider may prescribe birth control pills to relieve menstrual pain. If you don't 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.
Surgery may be necessary for women who are unable to get enough pain relief or pain control. Procedures may range from removal of cysts, polyps, adhesions, or fibroids to complete hysterectomy in cases of extreme endometriosis.
Prescription medications may be used for endometriosis. For pain caused by an IUD, removal of the IUD and alternative birth control methods may be needed.
Antibiotics are necessary for pelvic inflammatory disease.
References Return to top
French L. Dysmenorrhea. Am Fam Physician. 2005;71(2):285-291.
Harel Z. Dysmenorrhea in adolescents and young adults: etiology and management. J Pediatr Adolesc Gynecol. 2006;19:363-371.Update Date: 11/9/2007 Updated by: Peter Chen, M.D., Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.