The medical term for painful menstrual periods or menstrual cramps is called dysmenorrhea, and it’s one of the most common menstrual disorders. It affects over half of menstruating women for at least one day over the course of a menstrual cycle. In older women, there may be other issues.
It affects a large percentage of women of reproductive age, varying from 20 to 90%. Being the most common menstrual disorder it typically starts within a year of the first menstrual period. Often the pain improves with age or after giving birth. Dysmenorrhea occurs less often in those who exercise regularly and those who have children early in life.
Symptoms of Dysmenorrhea
Menstrual pain symptoms will typically last less than three days but in some longer. Usually, the pain occurs in the pelvis or lower abdomen. Other symptoms may include back pain, diarrhea, or nausea.
Dysmenorrhea is more common among those with heavy menstrual periods, irregular menstrual periods, whose periods started before twelve years of age, or who have low body weight, possibly anemic.
There are two types of dysmenorrhea.
What we usually think of as menstrual cramps. The cramping usually starts right before your menstrual periods and subsides as you shed the uterine lining. Primary dysmenorrhea typically starts when a young woman is just beginning to menstruate, and oftentimes becomes less painful as she gets older. As young women, painful periods often occur without an underlying problem.
Secondary dysmenorrhea is characterized by more severe and longer lasting pain, caused by a problem in the reproductive system. It might start a few days earlier than your menstrual period or continue after your period ends.
What Causes Secondary Dysmenorrhea?
There are several reproductive disorders that can cause painful periods.
These are growths on the walls of the uterus that can be surgically removed.
The endometrium is better known as the inner lining of the uterus. When the endometrial cells also grow outside of the uterus, such as on the fallopian tubes, ovaries, or bladder, this is called endometriosis. The endometrial tissue bleeds in response to hormones, which can form scar tissue called adhesions if these cells are outside the uterus. Adhesions disrupt your pelvic organs and cause pain.
In this condition, the endometrium starts to grow into the muscular tissue of the uterus, causing inflammation in the uterus as well as painful, heavy periods.
If you’re having painful periods, please make an appointment with us. Many women take their painful periods in stride, believing that cramps are just part of the process. If you’re suffering from severe pain and it’s interrupting your day, it is not considered normal.
We will review your medical history and perform a pelvic exam to evaluate your condition. A pelvic exam for those who are sexually active and ultrasound may be useful to help in your diagnosis. Conditions should be ruled out, such as ectopic pregnancy, pelvic inflammatory disease, interstitial cystitis, and chronic pelvic pain.
Other treatment options are:
Non-steroidal anti-inflammatory drugs (or NSAIDs), such as over-the-counter ibuprofen or acetaminophen, target prostaglandins which cause primary dysmenorrhea. You can take them for 1-2 days at a time, however, long-term use may have health risks. Talk to us if you have asthma, bleeding disorders, allergies, liver damage, ulcers, or other stomach disorders, as NSAIDs may not be right for you.
Hormonal birth control
The oral contraceptives, patch, ring, and hormonal birth control, and the IUD with progestogen have all been used to successfully treat painful periods, especially those caused by endometriosis. These are often prescribed by a health care provider because the hormones thin out the lining of the uterus which lessens the cramping and the blood flow. These treatments help regulate your body’s hormones and ease some of the more unpleasant effects of menstruation. Talk to us about your family planning needs so we can find the right treatment for you.
Gonadotropin-releasing hormone agonists
This is another type of hormone therapy that is helpful for treating endometriosis, but they’re not typically given as a long-term solution. They can cause side effects like hot flashes, vaginal dryness, and bone loss, and are usually only recommended in extreme cases.
Home treatment may include the use of a heating pad or hot water bottle. Some women have found that taking a vitamin B1 or magnesium supplement can ease painful periods. Others report success with acupuncture. However, these haven’t been widely studied by the medical community as treatments for dysmenorrhea. Evidence of yoga, relaxation techniques, and massage helping to alleviate menstrual pain is insufficient.
Uterine Artery Embolization
Generally performed on an outpatient basis, this procedure blocks uterine blood vessels with tiny particles in order to stop the growth of uterine fibroids.
Surgical removal of uterine fibroids
This is performed through a small incision either through the vagina or abdomen, depending on the location of the fibroid.
Surgical treatment of endometriosis
This usually relieves pain in the short term, but it does not prevent the endometriosis from returning. Fortunately, the re-growth of tissue can be delayed with hormonal treatment.
Complete removal of the uterus is typically performed only as a last resort.