Dysmenorrhea is the medical term for pain with menstruation. There are two types of dysmenorrhea: "primary" and "secondary".
Primary dysmenorrhea is common menstrual cramps that are recurrent (come back) and are not due to other diseases. Pain usually begins 1 or 2 days before, or when menstrual bleeding starts, and is felt in the lower abdomen, back, or thighs. Pain can range from mild to severe, can typically last 12 to 72 hours, and can be accompanied by nausea-and-vomiting, fatigue, and even diarrhea. Common menstrual cramps usually become less painful as a woman ages and may stop entirely if the woman has a baby.
Secondary dysmenorrhea is pain that is caused by a disorder in the woman's reproductive organs, such as endometriosis, adenomyosis, uterine fibroids, or infection. Pain from secondary dysmenorrhea usually begins earlier in the menstrual cycle and lasts longer than common menstrual cramps. The pain is not typically accompanied by nausea, vomiting, fatigue, or diarrhea.
Menstrual cramps are caused by contractions (tightening) in the uterus (which is a muscle) by a chemical called prostaglandin. The uterus, where a baby grows, contracts throughout a woman's menstrual cycle. During menstruation, the uterus contracts more strongly. If the uterus contracts too strongly, it can press against nearby blood vessels, cutting off the supply of oxygen to the muscle tissue of the uterus. Pain results when part of the muscle briefly loses its supply of oxygen.
Menstrual pain from secondary dysmenorrhea is caused by a disease in the woman's reproductive organs. Conditions that can cause secondary dysmenorrhea include:
If you have severe or unusual menstrual cramps or cramps that last for more than 2 or 3 days, contact your healthcare provider. Both primary and secondary menstrual cramps can be treated, so it's important to get checked.
First, you will be asked to describe your symptoms and menstrual cycles. Your healthcare provider will also perform a pelvic exam. During this exam, your doctor inserts a speculum (an instrument that lets the clinician see inside the vagina) and examines your vagina, cervix, and uterus. The doctor will feel for any lumps or changes, and a small sample of vaginal fluid may be taken for testing.
If secondary dysmenorrhea is suspected, further tests may be needed. If a medical problem is found, your healthcare provider will discuss treatments.
If you use tampons and develop the following symptoms, get medical help right away:
These are symptoms of toxic shock syndrome, a life-threatening illness.
To relieve mild menstrual cramps:
Women who exercise regularly often have less menstrual pain. To help prevent cramps, make exercise a part of your weekly routine.
If these steps do not relieve pain, your health care provider can order medications for you, including ibuprofen or another anti-inflammatory medication (higher dose than is available over-the-counter). Also, oral contraceptives may be prescribed because women who take oral contraceptives have less menstrual pain.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 07/13/2014