Painful menstrual periods, also called dysmenorrhea, may include pain in the pelvis, abdomen, back, or legs, abdominal cramps, headache, and fatigue. Most women have painful periods at some time in their lives. In some women, the pain is severe enough to interfere with normal activities.
There are 2 types of dysmenorrhea: Primary—painful regular menstrual cycles caused by uterine muscle contractions
Secondary—painful periods due to an underlying condition, such as
Copyright © Nucleus Medical Media, Inc.
Painful menstrual periods are more common in women under age 30 years. Other factors that may increase your risk of having painful menstrual periods include: Low body weight, especially during adolescenceSmokingEarly onset of menstruation—younger than 12 years oldLonger menstrual cyclesHeavy bleeding during periodsNever having delivered a baby
Psychological disorders, such as
You are also at risk if you have a related condition, such as endometriosis or ovarian cysts.
The pain associated with either primary or secondary dysmenorrhea may be sharp and throbbing, or dull and aching. It is most typically located in the lower abdomen and may spread to the low back or thighs. Other symptoms may include: NauseaVomitingDiarrheaHeadacheIrritability
Call your doctor if you have: Severe or unusual crampsCramps that last for more than a few daysSigns of infection, such as fever or chillsCramps with heavy menstrual bleedingAbdominal or pelvic tendernessVaginal discharge other than menstrual bleeding
Also, call you doctor if you are having vaginal bleeding or pain and are unsure if it is related to menstruation.
You will be asked detailed questions about your symptoms and medical history. A pelvic exam will be done.
Specific tests can evaluate your pelvic organs and surrounding structures. Tests may include:
Primary dysmenorrhea is usually treated with medications and lifestyle changes.
The treatment of secondary dysmenorrhea varies depending on the underlying condition.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first-line treatment for menstrual pain. Examples of these medications include
Birth control pills
may be prescribed in some cases.
Other ways to ease discomfort include: Heat therapy, which may include heating pads, warm baths, or continuous low-level heat patchesRegular exercise
Alternative treatments, such as:
Herbs or supplements, such as
Chinese herbal medicineAcupuncture
Talk to your doctor before taking any herbs and supplements. They may interact with your other medications and conditions.
To help reduce your chance of painful menstrual periods: Exercise regularly
If you smoke,
talk to your doctor about how you can
quitDrink only moderate amounts of caffeine and alcohol
Coco AS. Primary dysmenorrhea.
Am Fam Physician. 1999;60:489-496.
Dysmenorrhea. Cleveland Clinic website. Available at:
http://my.clevelandclinic.org/disorders/dysmenorrhea/hic_dysmenorrhea.aspx. Updated July 13, 2014. Accessed October 8, 2015.
Dysmenorrhea. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated October 5, 2015. Accessed October 8, 2015.
Menstrual cycle problems. American Academy of Family Physicians website. Available at:
http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom/menstrual-cycle-problems.html. Accessed October 8, 2015.
Dysmenorrhea: symptoms. Family Doctor—American Academy of Family Physicians website. Available at:
http://familydoctor.org/familydoctor/en/diseases-conditions/dysmenorrhea.html. Updated April 2014. Accessed October 8, 2015.
French L. Dysmenorrhea.
Am Fam Physician. 2005;71:285-291.
http://www.aafp.org/afp/2005/0115/p285.html. Accessed October 8, 2015.
Pelvic inflammatory disease (PID): CDC fact sheet. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/std/pid/stdfact-pid.htm. Updated July 1, 2014. Accessed October 8, 2015.
9/30/2008 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Witt CM, Reinhold T, Brinkhaus B, et al. Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care.
Am J Obstet Gynecol.
4/15/2014 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Osayande AS, Mehulic S. Diagnosis and initial management of dysmenorrhea. Am Fam Physician. 2014;89(5):341-346.
6/18/2014 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Kannan P, Claydon LS. Some physiotherapy treatments may relieve menstrual pain in women with primary dysmenorrhea: a systematic review. J Physiother. 2014;60(1):13-21.
Last reviewed September 2015 by Andrea Chisholm, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.