February 1, 2017

Dysmenorrhea is the medical term for menstrual cramps, or the pain that many women have just before or at the beginning of their periods. This pain usually is not serious.

Many women have pain with their periods, especially when they are in their teens. In most cases, menstrual pain does not mean a more serious problem, although sometimes it can be associated with endometriosis or uterine fibroids, noncancerous tumors in the uterus.

The uterus is a muscle. Like all muscles, it contracts and relaxes. Most uterine contractions are never noticed, but strong ones are painful. During strong contractions, the uterus may contract too strongly or too frequently, causing the blood supply to the uterus to be temporarily cut off. This deprives the muscle of oxygen, causing pain. This pain may be located in the abdomen or the back. In addition to painful uterine cramping with menses, women with dysmenorrhea may experience nausea, vomiting, diarrhea, headaches, weakness, and/or fainting. Symptoms may vary in severity from cycle to cycle but generally continue throughout the reproductive years. Dysmenorrhea can be an incapacitating problem, causing significant disruption in a woman’s life each month.

Types of Dysmenorrhea

There are two types of dysmenorrhea – primary and secondary dysmenorrhea.

  • Primary dysmenorrhea is menstrual pain that’s not a symptom of an underlying gynecologic disorder but is related to the normal process of menstruation. Primary dysmenorrhea is the most common type of dysmenorrhea, affecting more than 50% of women, and quite severe in about 15%. Primary dysmenorrhea is more likely to affect girls during adolescence. Fortunately for many women, the problem eases as they mature, particularly after a pregnancy. Although it may be painful and sometimes debilitating for brief periods of time, it is not harmful.
  • Secondary dysmenorrhea is menstrual pain that is generally related to some kind of gynecologic disorder. Most of these disorders can be easily treated with medications or surgery. Secondary dysmenorrhea is more likely to affect women during adulthood.


Risk Factors

While any woman can develop dysmenorrhea, the following women may be at an increased risk for the condition –

  • Women who smoke
  • Women who drink alcohol during their period (alcohol tends to prolong menstrual pain)
  • Women who are overweight
  • Women who started their periods before the age of 11
  • Women who have never been pregnant
  • Consult your health care provider for more information


Primary dysmenorrhea is thought to be caused by excessive levels of prostaglandins, hormones that make your uterus contract during menstruation and childbirth. Its pain probably results from contractions of your uterus that occur when the blood supply to its lining (endometrium) is reduced.

Other factors that may make the pain of primary dysmenorrhea even worse include a uterus that tilts backward (retroverted uterus) instead of forward, lack of exercise, psychological or social stress, smoking, drinking alcohol, being overweight, and starting menstruating before age 11.

Secondary dysmenorrhea may be caused by a number of conditions, including –

  • Fibroids – benign tumours that develop within the uterine wall or are attached to it
  • Adenomyosis – the tissue that lines the uterus (called the endometrium) begins to grow within its muscular walls
  • A sexually transmitted infection (STI)
  • Endometriosis – fragments of the endometrial lining that are found on other pelvic organs
  • Pelvic inflammatory disease (PID), which is primarily an infection of the fallopian tubes, but can also affect the ovaries, uterus, and cervix
  • An ovarian cyst or tumour
  • The use of an intrauterine device (IUD), a birth control method


The following are the most common symptoms of dysmenorrhea. However, each person may experience symptoms differently. Symptoms may include –

  • Cramping in the lower abdomen
  • Pain in the lower abdomen
  • Low back pain
  • Pain radiating down the legs
  • Nausea
  • Vomiting
  • Diarrhea
  • Fatigue
  • Weakness
  • Fainting
  • Headaches

The symptoms of dysmenorrhea may look like other conditions or medical problems. Always consult your health care provider for a diagnosis.


Nonsteroidal anti-inflammatory drugs (NSAIDs) – They help relieve pain. They can cause stomach upset, so taking them with food may help. Long-term use can increase the risk of stomach bleeding. NSAIDs include over-the-counter (OTC) medications such as aspirin, ibuprofen (Motrin, Advil), and naproxen (Aleve). Prescription NSAIDs are also available.

Cyclooxygenase-2 (COX-2) inhibitors – These help relieve pain and have fewer gastrointestinal side effects than NSAIDs.

Birth control pills and patches – They can help relieve pain and may be prescribed for problems such as endometriosis.

Intrauterine devices – This helps to reduce menstrual bleeding and dysmenorrhea.

Alternative Treatment

Omega-3 fatty acids, such as fish oil helps to help lower inflammation. A few studies have found that women who took fish oil had less menstrual pain than those who took placebo.

Calcium citrate helps to reduce menstrual pain because it helps maintain muscle tone. However, evidence isn’t clear. One study found that calcium did reduce menstrual pain.

Vitamin D, helps the body use calcium and may reduce inflammation. Vitamin D may interact with a number of medications.

Magnesium dose reduces menstrual cramps. A few other preliminary studies have also suggested that magnesium may help reduce menstrual pain.

Chaste tree or chaste berry, Cramp bark, Black cohosh, Turmeric may help to reduce the cramps.

Evening primrose oil as a source of gamma linolenic acid (GLA) is effective at relieving symptoms of premenstrual syndrome (PMS).

Acupuncture has become a popular treatment for menstrual pain. The National Institutes of Health recommends acupuncture, either by itself or along with other treatments, for menstrual pain. Studies suggest that women treated with acupuncture had less pain and needed less pain medication.

Chiropractic – Some people with menstrual pain may find relief with spinal manipulation, particularly in areas that supply sensory and motor impulses to the uterus and lower back.

Yoga is a type of exercise that has shown to help lessen menstrual cramps for some girls/women.














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