Painful menstrual periods Health Article

Definition

Painful menstrual periods are periods in which a woman experiences crampy lower abdominal pain, sharp pain that comes and goes, aching pain, or possibly 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, the discomfort makes it difficult 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 lessens 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.

Primary dysmenorrhea refers to menstrual pain that occurs around the time that menstrual periods first begin in otherwise healthy young women. This type of pain is usually not related to any specific problems with the uterus or other pelvic organs. Increased activity of the hormone prostaglandin, which is produced in the uterus, is thought to be a factor in primary dysmenorrhea.

Secondary dysmenorrhea is menstrual pain that develops later, after periods have been more normal, and is often related to problems in the uterus or other pelvic organs, such as:

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

Home Care

The following steps may allow you to avoid prescription medications:

• Apply a heating pad to your lower abdomen (below your belly button). Be careful NOT to fall asleep with the heating pad on.
• Do light circular massage with your fingertips around your lower abdomen.
• Drink warm beverages.
• Eat light but frequent meals.
• Follow a diet rich in complex carbohydrates such as whole grains, fruits, and vegetables, but low in salt, sugar, alcohol, and caffeine.
• Keep your legs elevated while lying down, or lie on your side with your knees bent.
• Practice relaxation techniques such as meditation or yoga.
• Try over-the-counter anti-inflammatory medicine, such as ibuprofen. Start taking it the day before your period is expected to start, and continue taking it regularly for the first few days of your period.
• Try vitamin B6, calcium, and magnesium supplements, especially if your pain is from PMS.
• Take warm showers or baths.
• Walk or exercise regularly, including pelvic rocking exercises.
• Lose weight if you are overweight.

If these self-care measures do not work, your doctor may prescribe medications such as:

• Antibiotics
• Antidepressants
• Birth control pills
• Prescription anti-inflammatory medicines such as meclofenamate (Meclomen)
• Prescription pain relievers (including narcotics such as codeine, for brief periods)