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Painful menstrual periods

• Overview
• Treatment

Definition:

Painful menstrual periods are marked by crampy lower abdominal pain. A woman may feel sharp pain that comes and goes, or have dull, aching pain. Painful menstrual periods may also cause back pain.

Alternative Names:

Menstruation - painful; Dysmenorrhea; Periods - painful; Cramps - menstrual; Menstrual cramps

Considerations:

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 20s.

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. The medical term for excessively painful periods is dysmenorrhea.

There are two general types of dysmenorrhea:

• Primary dysmenorrhea refers to menstrual pain that occurs in otherwise healthy women. This type of pain is not related to any specific problems with the uterus or other pelvic organs.
• Secondary dysmenorrhea is menstrual pain that is attributed to some underlying disease or structural abnormality either within or outside the uterus.

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:

• Premenstrual syndrome (PMS)
• Stress and anxiety
• Endometriosis
• Pelvic inflammatory disease
• Sexually transmitted diseases
• Fibroids
• Ovarian cysts
• Intrauterine Device (IUD)

References:

Mahutte NG. Medical management of endometriosis-associated pain. Obstet Gynecol Clin North Am . 2003; 30(1): 133-150.

French L. Dysmenorrhea. Am Fam Physician . 2005; 71(2): 285-291.

Rakel D. Integrative Medicine . 1st edition. Philadelphia, Pa: WB Saunders; 2003:385.

• Review Date: 2/27/2006
• Reviewed By: Melanie N. Smith, M.D., Ph.D., Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.

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