Understanding Dysmenorrhea

Is Menstrual Pain Normal?

According to the American College of Obstetricians and Gynecologists, more than 50 percent of menstruating women experience pain for one or two days during their monthly cycle. Mild to moderate pain is normal. Severe pain that interferes with daily life is not normal, but treatment can help to alleviate symptoms. 

What is Dysmenorrhea?

Pain and cramping during menstruation are caused by a condition called dysmenorrhea. Primary dysmenorrhea begins when people first begin their menstrual cycle and it persists until menopause. Strong uterine contractions during the menstrual cycle cause pain, cramping, and other symptoms. 

Some people develop secondary dysmenorrhea as they get older, instead of during puberty. Secondary dysmenorrhea arises due to other health issues that affect the uterus or pelvic cavity, such as endometriosis, uterine fibroids, infections, polyps, tumors, or pelvic inflammatory disease.

Are You at Risk?

Some factors make people more disposed to experience severe menstrual pain. Smoking, alcohol consumption (especially during your period), and excess body weight can cause dysmenorrhea. Starting your period at n early age or never being pregnant may also increase the severity of dysmenorrhea. However, some women develop dysmenorrhea without any of these traits.

How is it Diagnosed?

Your ob-gyn will perform a complete pelvic exam, physical exam, and take your medical history. Imaging tests such as ultrasound or MRI may be performed to produce images of your internal organs. In some cases, the doctor may need to use laparoscopy or hysteroscopy to capture images from inside the pelvic cavity or uterus.

What are Some Medical Treatment Options?

Hormonal birth control methods such as the pill, patch, vaginal ring, implant, injections, and hormonal IUD can help reduce pain during your periods. These methods inhibit ovulation and make periods shorter and lighter, resulting in less pain and cramping. 

For short-term relief, NSAIDs such as ibuprofen or naproxen can be taken for a day or two to relieve pain. Take them at the first sign of pain or even before the pain begins. These medications decrease the effect of prostaglandins, chemicals in the body that trigger uterine contractions.

Dysmenorrhea caused by endometriosis, uterine fibroids, or adenomyosis may require surgical procedures to remove tissue or block blood flow to tissues that are causing pain.

Can Alternative Treatments Help?

Alternative therapies such as acupuncture and acupressure may reduce menstrual pain. Nerve stimulation, biofeedback, and other types of physical therapy can be used as an alternative to medication or as a complement to medication.

Should You See a Doctor?

While most women experience some discomfort during their periods, severe pain or pain accompanied by additional symptoms may indicate that testing and treatment are needed. Symptoms of dysmenorrhea to watch out for include lower abdominal pain and cramping, low back pain, nausea, vomiting, diarrhea, weakness, fainting, and general fatigue. If you experience these symptoms, contact a local gynecologist to schedule an appointment.