Painful menstrual cramps. Primary dysmenorrhea most commonly begins within a year or two of the first menstrual period (puberty). Secondary dysmenorrhea usually occurs after a woman has had normal periods for some time.
FREQUENT SIGNS AND SYMPTOMS
Severity of symptoms varies from woman to woman, and from one time to the next in the same woman.
Cramping and, sometimes, sharp pains in the lower abdomen, lower back, and thighs. The pain usually begins with your period and lasts for hours to days. For some women, the pain may begin a week or more before her period and last for a few days after it stops.
Other symptoms that may occur:
Nausea, vomiting, diarrhea, headache, and sweating.
Lack of energy.
Feeling irritable, anxious, or depressed.
Menstrual pain is a result of strong contractions of the muscles of the uterus. In primary dysmenorrhea, this is due to excess prostaglandin (a hormone-like substance) production. In secondary dysmenorrhea, this is due to an abnormality or disease of the uterus, fallopian tubes, or ovaries.
RISK INCREASES WITH
Sexually transmitted diseases.
Endometriosis or endometritis (uterine lining disorders).
Adenomyosis (benign growth of the uterine lining).
Fibroids or other conditions of the uterus.
Congenital (being born with) uterine or vaginal abnormalities.
Use of an intrauterine device (IUD).
Smoking or alcohol use.
Not having given birth.
Family history of dysmenorrhea.
Take female hormones that prevent ovulation, such as oral contraceptives.
Treatment of the underlying cause.
Symptoms can be helped with treatment.
Symptoms improve with age and with childbirth. Symptoms are rare in postmenopausal women.
Severe pain that interferes with normal activity.
Infertility from underlying cause.
DIAGNOSIS & TREATMENT
Your health care provider will do a physical exam and a pelvic exam. Questions will be asked about your menstrual history. Medical tests may include blood and/or urine studies, or an ultrasound.
Initial treatment aims are to relieve pain. Long-term goals of treatment involve treating any underlying cause with drugs, counseling, or possibly surgery.
Heat helps relieve pain. Use a heating pad or hot-water bottle on the abdomen or back. Take warm baths. Sit in a tub of hot water for 10 to 15 minutes as often as needed.
Transcutaneous electrical nerve stimulator (TENS) treatment may help relieve pain.
Counseling may be helpful, if stress is a problem.
Hypnosis therapy may help some women.
Try to stop smoking and decrease alcohol use.
Surgery may be recommended for women whose pain cannot be controlled by other methods.
For minor discomfort, use nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen.
Antiprostaglandins (for painful menstrual periods) and oral contraceptives, which prohibit ovulation, may be prescribed.
In severe cases, hormones (e.g., gonadotropin-releasing hormone [Gn-RH]) can stop ovary function to relieve pain.
You may be prescribed vitamin B or vitamin E supplements. These help relieve symptoms in some persons.
Exercise reduces the discomfort of menstrual cramps.
Reduce or discontinue drinking caffeine-containing beverages.
Herbal teas may help reduce symptoms for some.
NOTIFY OUR OFFICE IF
You or a family member has symptoms of dysmenorrhea that cannot be relieved.