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Alternative names Return to top
Menstrual periods - painful; Menstruation - painful; Dysmenorrhea; Periods - painful; Cramps - menstrual; Menstrual crampsDefinition Return to top
Painful menstruation is when menstrual periods are accompanied by either sharp, intermittent pain or dull, aching pain, usually in the pelvis or lower abdomen.Considerations Return to top
Painful menstruation affects many women. For a small number of women, such discomfort makes it next to impossible to perform normal household, job, or school-related activities for a few days during each menstrual cycle. Painful menstruation is the leading cause of lost time from school and work among women in their teens and 20's.
The pain may begin several days before or just at the start of your period. It generally subsides as menstrual bleeding tapers off.
Although some pain during menstruation is normal, excessive pain is not. Dysmenorrhea refers to menstrual pain severe enough to limit normal activities or require medication.
There are two general types of dysmenorrhea:
Activity of the hormone prostaglandin, produced in the uterus, is thought to be a factor in primary dysmenorrhea. This hormone causes contraction of the uterus and levels tend to be much higher in women with severe menstrual pain than in women who experience mild or no menstrual pain.
Common Causes Return to top
Home Care Return to top
The following steps may allow you to avoid prescription medications:
If these self-care measures do not work, your doctor may prescribe medications like:
Call your health care provider if Return to top
Call your doctor right away if:
Also call your doctor if:
What to expect at your health care provider's office Return to top
Your health care provider will obtain your medical history and perform a physical examination, paying close attention to your pelvis and abdomen.
Your doctor will ask questions about your symptoms, such as the following:
Diagnostic tests that may be performed include:
Birth control pills may be prescribed to alleviate menstrual pain. If not needed for birth control, they may be discontinued after 6 to 12 months. Many women note continued freedom from symptoms despite stopping the medication.
Surgery may be necessary for women who are unable to obtain adequate pain relief or pain control. Procedures may range from removal of cysts, polyps, adhesions, or fibroids to complete hysterectomy in cases of extreme endometriosis.
Prescription medications may be used for endometriosis. For pain caused by an IUD, removal of the IUD and alternative birth control methods may be needed.
Antibiotics are necessary for pelvic inflammatory disease.
Update Date: 10/5/2004 Updated by: A.D.A.M. editorial. Previously reviewed by Jacqueline A. Hart, M.D., Department of Internal Medicine, Newton-Wellesley Hospital, Boston, Ma., and Senior Medical Editor, A.D.A.M., Inc. (6/13/2004)
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Page last updated: 28 October 2004 |