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.
Although some pain during your period is normal, excessive pain is not. The medical term for painful menstrual periods is dysmenorrhea.
Many women have painful periods. Sometimes, the pain 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.
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. This pain is usually 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 and is often related to problems in the uterus or other pelvic organs, such as:
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:
Call your doctor right away if you have:
Also call your doctor if:
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:
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 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.
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 relieve your pain. Surgery may be done to remove cysts, fibroids, scar tissue, or your uterus (hysterectomy).
Menstruation - painful; Dysmenorrhea; Periods - painful; Cramps - menstrual; Menstrual cramps
French L. Dysmenorrhea. Am Fam Physician. 2005;71:285-291.
Harel Z. Dysmenorrhea in adolescents and young adults: etiology and management. J Pediatr Adolesc Gynecol. 2006;19:363-371.
Lentz GM. Primary and secondary dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder: etiology, diagnosis, management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 36.
Updated by: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine.
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