Dysmenorrhea: Painful Periods & Cramps

Dysmenorrhea at a glance

  • Many girls experience cramping in their lower abdomen each month around the time of their period. These cramps are called dysmenorrhea.
  • Dysmenorrhea, or cramps, is dull or throbbing pain in the lower abdomen
  • Cramps may begin a day or two before bleeding starts or on the first days of a girl’s period
  • For some girls, cramping is short-lived and manageable with over-the-counter medication, such as ibuprofen. Others may experience severe cramps that interfere with daily activities.

What causes dysmenorrhea?

The uterus is the organ inside a woman’s body that causes menstrual bleeding. It has an inside lining that sheds or bleeds every month, caused by muscles in the uterus squeezing and contracting. For women who have dysmenorrhea, these muscle contractions activate the nerves in the pelvic area and send pain messages to the brain.

Dysmenorrhea is often referred to as painful periods. It can be either primary or secondary.

Primary dysmenorrhea begins with a girl’s first period. Primary dysmenorrhea pain generally starts right before the beginning of the period and tapers off as the period progresses.

Secondary dysmenorrhea develops over a woman’s lifetime and is usually associated with an underlying disorder or structural abnormality of the reproductive system. Pain from secondary dysmenorrhea can begin days before the beginning of the period and last even after the period is over.

As many as one in four teen girls have severe pain or dysmenorrhea with their periods. Dysmenorrhea is one of the most common reasons that girls and teens miss school. For many women, dysmenorrhea gets better as she gets older.

Symptoms associated with dysmenorrhea

Symptoms that can also be present with menstrual cramps include:

  • Lower back pain
  • Nausea and/or vomiting
  • Faintness or dizziness
  • Change in stools

Treatment for dsymenorrhea

Regular exercise may improve cramping. A heating pad along with over-the-counter ibuprofen can help to alleviate pain, and sometimes taking a warm bath or shower can also help.

Other lifestyle changes that can help dysmenorrhea include:

  • Eating nutritious foods including fruits, veggies, protein and complex carbs.
  • Limiting or avoiding fast foods and sugary drinks like soda, juices, energy drinks and sweet teas.
  • Getting regular exercise (at least 60 minutes each day is the goal).
  • Sleeping enough (8 hours each night is recommended).
  • Learning relaxation techniques and ways to manage stress.
  • Getting help for depression and anxiety if needed.

Keep track of bleeding days and days that cramps/pain are a problem, noting what (if anything) helps with the pain or discomfort.

Be sure to see your gynecologist if over-the-counter medications are not alleviating your pain, cramps persist for longer than your period, or they become extremely painful.  There may be a better pain regimen that the doctor can offer.

Light cramps or discomfort are normal during menstruation (your period); however, if you are experiencing severe pain and painful cramps that interfere with daily activities, there could be an underlying disorder causing dysmenorrhea.

When is hormonal therapy recommended?

Treating cramps with hormone therapy can help alleviate painful cramping for girls who experience heavy bleeding and severe cramps.
Learn more about hormone therapy

Some examples of hormonal therapy include:

  • Low dose birth control pills, patch, or ring
  • Extended or continuous use of birth control pills, patch or ring
  • Medroxyprogesterone acetate (Depo-Provera)
  • The levonorgestrel-IUD (Mirena, Skyla)
  • The subdermal implant (Nexplanon)

Although these medications are packaged as “birth control,” they are being recommended for their noncontraceptive effects. This means they decrease or eliminate bleeding and pain, can be used to regulate periods, and can help with other concerns like acne, premenstrual mood changes, or headaches.