Dysmenorrhea (Painful Periods)

What is dysmenorrhea?

Dysmenorrhea, or pain with periods, is a common condition experienced by adolescents and women of reproductive age. There are two types of dysmenorrhea. One is called primary dysmenorrhea, or pain caused by the process of menstruation; the other is secondary dysmenorrhea, when pain is caused by an underlying condition like endometriosis or uterine fibroids

Some people have more severe symptoms of dysmenorrhea, such as:

  • Abdominal cramping
  • Fatigue
  • Lower back pain
  • Nausea
  • Radiating pain down the legs

These symptoms vary as one person may experience mild yet painful cramping while another person may be in such discomfort it negatively impacts their ability to function at work or participate socially.

While these symptoms can be particularly distressing and disruptive to people's lives, they rarely indicate cancer. Still, it's important to see a health care provider who can assess your condition.

Diagnosis of dysmenorrhea

When you meet with your provider, they will ask you questions about your pain and how long you've had it, and any triggers such as dietary or exercise. Keeping a journal of when the pain comes and goes is also a useful tool for you and your doctor. Your provider will also want to know how your condition is affecting your life and relationships, and also explore any goals you wish to achieve, such as becoming pregnant.

Your doctor will take all of this information into consideration while also looking at the results of your Pap smear from your annual exam. The next step may involve having various testing done, such as an imaging test (pelvic ultrasound is an example) in order to get an accurate diagnosis and identify any abnormal anatomical issues. Sometimes a non-invasive surgical procedure is done to help gather more information for the doctor.


Primary dysmenorrhea is usually relieved by over-the-counter, non-steroidal medications. For example, such as acetaminophen or ibuprofen taken together can help reduce inflammation and pain.

Other ways to relieve dysmenorrhea include:

  • Exercise
  • Rest
  • Heating pad
  • Avoiding caffeine
  • Staying away from cigarettes

In many cases, common menstrual pain can be relieved by taking a hormonal contraceptive (if you are not looking to get pregnant). If the "pill" doesn't relieve painful symptoms, there are a variety of innovative, nonsurgical and surgical solutions to dysmenorrhea.

Although you may be used to living with the pain, you don't have to.

Endometrial Biopsy

If you have abnormal vaginal bleeding, including the absence of normal menstrual bleeding or bleeding after menopause, you may need an endometrial biopsy.

Endometrial Ablation

An endometrial ablation is a safe and quick procedure to reduce heavy bleeding for patients with uterine problems.

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