Period Pain
Painful periods, or dysmenorrhea, can range from common menstrual cramps to secondary conditions requiring medical intervention.
What are painful periods?
Menstruation is normal vaginal bleeding that happens as part of a woman's monthly cycle. Many women have painful periods, also called dysmenorrhea. The pain is most often menstrual cramps—a throbbing, cramping pain in your lower abdomen. You may also have lower back pain, nausea, diarrhea, and headaches. Period pain is not the same as premenstrual syndrome (PMS), which causes symptoms like bloating and irritability one to two weeks before a period starts.
Causes
There are two types of dysmenorrhea:
- Primary dysmenorrhea: The most common kind, not caused by another condition. It is usually caused by high levels of prostaglandins, chemicals that make the uterus muscles tighten and relax.
- Secondary dysmenorrhea: Often starts later in life and is caused by conditions affecting the reproductive organs, such as endometriosis and uterine fibroids. This pain often gets worse over time.
Management and Self-Care
To help ease period pain, you can try:
- Using a heating pad or hot water bottle on your lower abdomen.
- Getting some exercise.
- Taking a hot bath.
- Doing relaxation techniques, including yoga and meditation.
- Taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, which reduce prostaglandin production.
Note: Do not take NSAIDs if you have ulcers, stomach problems, bleeding problems, liver disease, or an aspirin allergy. Always consult your provider.
When to Seek Medical Help
Contact your health care provider if:
- NSAIDs and self-care measures don't help, and the pain interferes with your life.
- Your cramps suddenly get worse.
- You are over 25 and you get severe cramps for the first time.
- You have a fever with your period pain.
- You have the pain even when you are not getting your period.
Diagnosis and Treatment
To diagnose severe pain, your provider may perform a medical history review, a pelvic exam, an ultrasound, or a laparoscopy. Treatment for primary dysmenorrhea may include hormonal birth control (pill, patch, ring, or IUD) or prescription pain relievers. Treatment for secondary dysmenorrhea depends on the underlying condition and may include surgery.