What Is Dysmenorrhea?

Dysmenorrhea is the medical term for severe menstrual cramping. The cramping is experienced in the lower part of the abdomen and can feel like an ache or throb. Period cramping is common among females and can range from mild to severe. Cramping usually occurs right before the period starts and during the period. Cramping and severity of cramping tends to lessen with age, and sometimes completely goes away after childbirth. There are two types of this condition—primary dysmenorrhea and secondary dysmenorrhea.

Types of Dysmenorrhea: Primary and Secondary

Some women experience severe pain and cramping for a prolonged amount of time during their menstrual cycle. This condition is known as dysmenorrhea and there are two distinct types of the condition.

• Primary Dysmenorrhea: This condition develops upon the onset of a female’s period and usually continues throughout her lifetime. Symptoms include severe and prolonged menstrual cramping, stemming from abnormal uterine contractions.
• Secondary Dysmenorrhea: Usually develops later in life and is triggered by a physical issue. It may also be due to a medical condition, such as endometriosis or pelvic inflammatory disease.

What Are the Symptoms of Dysmenorrhea?

Symptoms of dysmenorrhea vary among women in terms of severity, frequency, and duration. The most common symptom is severe prolonged cramping. The following list includes other symptoms that may be experienced by those with dysmenorrhea:

• Severe cramping in lower abdomen (can feel like an ache or throb)
• Lower back pain
• Pain radiating down the legs
• Nausea or vomiting
• Diarrhea
• Fatigue
• Headaches
• Weakness
• Fainting

Symptoms of dysmenorrhea look similar to other medical conditions, so it is important to consult with your Baptist Health gynecologist for an accurate diagnosis, if you are experiencing symptoms.

What Causes Dysmenorrhea?

Menstrual cramping happens when a chemical known as prostaglandin causes the uterus to contract. The uterus contracts more strongly during menstruation. When the uterus contracts too strongly, it can contract blood vessels, which briefly cuts off the oxygen supply to the muscle and causes cramping.

Secondary dysmenorrhea is caused by issues from the reproductive organs. Physical conditions that can cause menstrual cramping include:

• Endometriosis: A condition in which the tissue lining the uterus (the endometrium) is located outside of the uterus. This tissue bleeds during menstruation, which can cause pain, swelling and scarring.
• Adenomyosis: A condition in which the uterine lining grows into the muscle of the uterus. It can cause the uterus to get larger than it should be, which leads to abnormal bleeding and pain.
• Pelvic inflammatory disease (PID): A bacterial infection that begins in the uterus and can spread to other reproductive organs. Pain in the stomach or pain during sex can occur with PID.
• Fibroids: Benign tumors that grow on the inside or outside of the uterus, or in the walls of the uterus.
• Cervical stenosis: Causes a narrowing of the cervix, or the opening to the uterus.

How Is Dysmenorrhea Diagnosed?

There are different ways to diagnose dysmenorrhea. A healthcare professional will usually take a medical history and conduct a pelvic exam. Other tests that may be recommended include:

• MRI: Uses magnetic-resonance imaging that generates detailed pictures of internal structures and the physiological processes of the body.
• Ultrasound: Uses soundwaves to create images of internal structures of the body.
• Laparoscopy: A procedure that inserts a small tube with a light and lens through the abdomen and into the pelvis to find any unusual growths.
• Hysteroscopy: a scope is inserted through the vagina to assess the canal of the cervix and inside of the uterus

If you are, or have been, experiencing symptoms of dysmenorrhea, please contact your Baptist Health gynecologist to discuss diagnosis and treatment options.  

How Is Dysmenorrhea Treated?

Treatment for dysmenorrhea depends on several factors. A person’s age, overall health, and medical history will help determine the kind of treatment. Additionally, the severity of symptoms, as well as which condition a person has (primary or secondary dysmenorrhea) also weighs into the decision-making process. Other factors in determining treatment would be a person’s ability to handle certain medications and procedures, and personal preference or opinion.

There are multiple forms of treatment a person may consider. Treatments for dysmenorrhea include the following:

• Prostaglandin inhibitors (non-steroidal anti-inflammatory drugs, such as ibuprofen or aspirin) for pain reduction
• Acetaminophen (Tylenol) for pain reduction
• Oral contraceptives (ovulation inhibitors)
• Progesterone (hormone treatment)
• Vitamins or supplements
• Changes in diet (reducing caffeine and sugar intake; increase protein)
• Exercise on a regular basis
• Heating pad (lay across the abdomen)
• Abdominal massage
• Warm bath or shower

If symptoms persist after these treatments, a patient may consider the following procedures:

• Endometrial ablation (destroys the lining of the uterus)
• Endometrial resection (removes the lining of the uterus)
• Hysterectomy (surgical removal of the uterus)

Most treatments require the use of OTC medications for pain reduction, home remedies, or lifestyle changes. Only a few of the treatment options require surgical procedures, which are mostly done on an outpatient basis. If you are experiencing severe period pain, please consult with your Baptist Health gynecologist to discuss treatment options.