Dysmenorrhea – Causes, Symptoms and Treatment

Dysmenorrhea is defined as a difficult or painful period. The term menstrual disorders refers to any of a number of conditions that are related to the menstrual cycle. Menstruation is the shedding of the lining of the uterus (the endometrium) each month, also referred to as the menstrual period. More than one half of women who menstruate have some pain for 1–2 days each month. Usually, the pain is mild. But sometimes the pain is so severe it keeps them from normal activity. Pain this severe is called dysmenorrhea.

Primary dysmenorrhea which is also known as spasmodic dysmenorrhea is defined as menstrual pain. This type of dysmenorrhea occurs a few years after a woman has had her first menstrual period. It affects 50% of all post-pubescent females.

Secondary or congestive dysmenorrheal which is on the other hand, is linked to an underlying pelvic condition, such as endometriosis, uterine fibroids or ovarian cysts.


The uterus is a muscle. Like all muscles, it can contract and relax. During your period, it contracts more strongly. Sometimes when it contracts you feel a cramping pain. Primary dysmenorrhea occurs when the uterus contracts because the blood supply to the endometrium is reduced. This pain occurs only during a menstrual cycle where an egg is released. If the cervical canal is narrow, the pain may be worse as the endometrial tissue passes through the cervix. Secondary dysmenorrhea usually begins well after the age of onset of menstruation, sometimes as late as the third or fourth decade of life.

Some women produce higher levels of prostaglandins, which may cause increased contractions of the uterus. These cramps may be more painful because there is reduced blood (and therefore oxygen) supply to the myometrium (muscle wall of the uterus) during the contractions.


Primary dysmenorrhea usually presents during adolescence and begins within three years of menarche. Pain begins with the onset of menstruation and lasts for a few hours and can be spasmodic and colicky.

Common symptoms may include:

* cramping in the lower abdomen
* pain in the lower abdomen
* low back pain
* pain radiating down the legs
* nausea
* vomiting
* diarrhea
* fatigue
* weakness
* fainting
* headaches


Over-the-counter pain relievers can also help with the pain. These include ibuprofen, ketoprofen and naproxen. These medicines work well for mild or moderate pain.

For secondary dysmenorrhea, you’ll need treatment for the underlying cause. Depending on the cause, treatment could include antibiotics to treat infection or surgery to remove fibroids or polyps.

Menstrual cramps have been around for thousands of years, and so have many non-medical treatments. I recommend that nonmedical remedies be used in addition to the pain medications described above. Rest and stress reduction like many other conditions, cramps may be made worse by fatigue from too many late nights and by anxiety.