Dysmenorrhea
Also known as: Menstrual Cramps, Painful Periods, Period Pain
Dysmenorrhea refers to painful menstrual cramps that occur before or during menstruation and is the most common gynecological complaint. Primary dysmenorrhea is caused by prostaglandin-induced uterine contractions and occurs without underlying pelvic pathology. Secondary dysmenorrhea is caused by conditions such as endometriosis or uterine fibroids. While menstrual pain is common, severe dysmenorrhea that interferes with daily activities warrants medical evaluation.
Symptoms
Causes
- Excess prostaglandin production causing strong uterine contractions (primary)
- Endometriosis (secondary)
- Uterine fibroids (secondary)
- Adenomyosis (secondary)
- Pelvic inflammatory disease (secondary)
Risk Factors
- Age under 30 (primary dysmenorrhea peaks in late teens and 20s)
- Early onset of puberty (before age 11)
- Heavy or prolonged menstrual periods
- Family history of dysmenorrhea
- Smoking
- Nulliparity (never having given birth)
Diagnosis
- Clinical history of menstrual pain pattern and severity
- Pelvic examination to rule out structural abnormalities
- Pelvic ultrasound if secondary dysmenorrhea is suspected
- Laparoscopy for definitive diagnosis of endometriosis
Treatment
- NSAIDs (ibuprofen, naproxen) started 1-2 days before expected menstruation
- Hormonal contraceptives (pills, patch, IUD) to suppress ovulation and reduce pain
- Heat therapy (heating pad applied to lower abdomen)
- Regular exercise to reduce menstrual pain severity
- Surgical treatment of underlying conditions (endometriosis, fibroids)
Prevention
- Regular physical exercise has been shown to reduce menstrual pain
- Start NSAIDs before pain becomes severe
- Consider hormonal contraceptives for ongoing prevention
- Maintain a balanced diet and adequate hydration
When to See a Doctor
- Menstrual pain is severe enough to miss school, work, or activities
- Pain worsens over time or changes in character
- Over-the-counter pain medications provide inadequate relief
- You develop heavy bleeding, fever, or pain outside your menstrual period
Frequently Asked Questions
Related Conditions
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