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OVERVIEW

What is dysmenorrhea?

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.

SYMPTOMS

What are the symptoms of menstrual cramps?

Menstrual cramps can feel like a dull ache in the abdomen, lower back, hips or inner thighs. The pain may start just before your period or at the beginning of your period and can last 1 to 3 days. The pain may be bad enough to keep you from doing your normal activities.

How can I tell if I have a more serious problem?

Contact your healthcare provider if you have any of the following symptoms:

• Painful periods that started later in life
• Pain at times other than the first couple of days of your period
• Unusual vaginal discharge or bleeding
• Pain that doesn’t go away when you take medicine to relieve it

CAUSES & RISK FACTORS

What causes dysmenorrhea?

There are two types of dysmenorrhea:

• Primary dysmenorrhea is pain caused by common menstrual cramps.
• Secondary dysmenorrhea is pain caused by a disease or condition, such as infection, ovarian cysts (fluid-filled sacs in the ovary), or endometriosis (say: “en‑doe‑me‑tree-oh-sis”), a problem with the lining of the uterus.

TREATMENT

How are painful periods treated?

You can try using heating pads or taking a warm bath. You can buy medicines without a prescription to help with the symptoms of PMS. These medicines usually combine aspirin or acetaminophen with caffeine, antihistamines or diuretics (example Midol).

Over-the-counter pain relievers can also help with the pain. These include ibuprofen (brand names: Advil, Motrin) and naproxen (brand name: Aleve). These medicines work well for mild or moderate pain. If these don’t help, you can contact your healthcare provider about a stronger pain reliever.

Your healthcare provider might want you to try using birth control pills or a birth control shot. These medicines can make your periods less painful.

What if these treatments don’t work?

If none of these treatments work, your healthcare provider might want to check for ovarian cysts or endometriosis. An ultrasound test lets your healthcare provider see if you have ovarian cysts. A minor surgery called a laparoscopy (say: “lap-ah-ross-ca-pee”) is used to check for endometriosis. This is a way of looking inside your uterus by making a small cut in your skin and putting a thin tube inside.

QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER

• Is my pain just a normal part of my menstrual cycle?
• Do I need any tests?
• What can I do to help relieve my pain?
• Will lifestyle changes, such as to my diet or exercise, help relieve my pain?
• What should I do if my pain doesn’t get better or gets worse?

Sources

Dysmenorrhea by L French, M.D. (01/15/05, http://www.aafp.org/afp/20050115/285.html )