What causes painful menstruation? 13 possible conditions

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What Are Painful Menstrual Periods?

Menstruation is a monthly occurrence for women in which the body sheds the lining of the uterus (womb), which is then passed through a small opening in the cervix and out through the vaginal canal.

Some pain, cramping, and discomfort during menstrual periods is normal. However, excessive pain that causes you to regularly miss work or school is not.

The medical term for painful menstruation is dysmenorrhea. Primary dysmenorrhea occurs in women who experience pain just before and during menstruation, but who are otherwise healthy. Women who have had normal periods that later become painful may have secondary dysmenorrhea. This condition is usually accompanied by a problem affecting the uterus or other pelvic organs.

What Are the Causes?

There may not be an identifiable cause of your painful menstrual periods. Certain women are at a higher risk for having painful menstrual periods. Risk factors include:

  • being under age 20
  • having a family history of painful periods
  • smoking
  • having heavy bleeding with periods
  • having irregular periods
  • never having had a baby
  • having experienced early puberty, which is puberty before the age of 11

Hormone-like substances called prostaglandins trigger muscle contractions to help your uterus expel its lining each month. These contractions can cause pain and inflammation. Women with higher levels of prostaglandins may experience more severe menstrual cramping and pain. (Mayo Clinic)

In some cases, such as with secondary dysmenorrhea, painful menstrual periods can be the result of an underlying medical condition, such as:

  • premenstrual syndrome (PMS)
  • endometriosis (a painful medical condition in which cells from the lining of the uterus grow in other parts of the body)
  • fibroids in the uterus (noncancerous tumors)
  • pelvic inflammatory disease, an infection of the uterus, fallopian tubes, or ovaries often caused by sexually transmitted infections
  • sexually transmitted infections (STIs)
  • adenomyosis, a rare condition in which the uterine lining grows into the muscular wall of the uterus
  • cervical stenosis, a rare condition in which the cervix is so small it slows menstrual flow (NLM)

Certain types of birth control, specifically intrauterine devices (IUDs) made of copper, are associated with increased pain during menstruation.

When to Call a Doctor

If menstrual pain is interfering with your ability to perform basic tasks each month, it may be time to talk to your gynecologist about your symptoms. Talk to your doctor if you experience any of the following:

  • pain after IUD placement
  • painful menstrual periods that have lasted longer than three months
  • passing blood clots
  • cramping accompanied by diarrhea and nausea
  • pelvic pain when not menstruating

Sudden cramping or pelvic pain could also be signs of infection. An untreated infection can cause scar tissue that damages the pelvic organs and may lead to infertility. If you have symptoms of an infection, seek prompt medical attention. Symptoms include:

  • fever
  • severe pelvic pain
  • sudden pain, especially if you may be pregnant
  • foul-smelling vaginal discharge

Home Treatment

Home care treatments may be successful in relieving painful menstrual periods. Home treatment includes:

  • using a heating pad on your pelvic area or back
  • massaging the abdomen
  • taking a warm bath
  • regular physical exercise
  • eating light, nutritious meals
  • practicing relaxation techniques or yoga
  • taking an anti-inflammatory medication such as ibuprofen several days before your expected period
  • taking vitamin B-6, vitamin B-1, vitamin E, omega-3 fatty acids, calcium, and magnesium supplements while reducing your intake of salt, alcohol, caffeine, and sugar to prevent bloating
  • raising your legs or lying with your knees bent

Medical Treatment

If home treatment is not successful in relieving your menstrual pain, there are a number of medical treatment options. Treatment will depend on the severity and underlying cause of your cramps. If your pain is caused by PID or STIs, these need to be treated. Your doctor will prescribe antibiotics to clear the infection. Your doctor may prescribe a medication to help with the pain. These medications include:

  • non-steroidal anti-inflammatory drugs (NSAIDs)
  • pain relievers, such as narcotics
  • antidepressants

Your doctor may also suggest that you try hormonal birth control. Hormonal birth control is available in the form of a pill, patch, vaginal ring, injection, or implant. Hormonal birth control uses hormones to prevent ovulation, which can control your menstrual cramps.

Surgery is an option if your pain is caused by endometriosis or uterine fibroids and other treatment options have not been successful. Surgery will be done to remove any endometriosis implant, uterine fibroids, or cysts.

In very rare cases, a hysterectomy (surgical removal of the uterus) is also an option if other treatments have not worked and pain is severe.

Article Sources:

  • Menstrual Cramps. (2011, May 3). Mayo Clinic. Retrieved July 13, 2012, from http://www.mayoclinic.com/health/menstrual-cramps/DS00506
  • Menstruation and the Menstrual Cycle Fact Sheet. (2009, October 21). U.S. Department of Health and Human Services Office on Women’s Health. Retrieved July 17, 2012, from http://womenshealth.gov/publications/our-publications/fact-sheet/menstruation.cfm
  • Painful Menstrual Periods. (2011, July 25).National Library of Medicine - National Institutes of Health. Retrieved July 13, 2012, from http://www.nlm.nih.gov/medlineplus/ency/article/003150.htm
Read More

See a list of possible causes in order from the most common to the least.

1

Heavy, Prolonged, or Irregular Menstrual Periods

The duration and severity of menstrual bleeding varies from woman to woman. If a woman's menstrual period is excessively heavy, prolonged, or irregular, it is called menorrhagia. Symptoms of menorrhagia include ...

Read more »

2

Endometriosis

Endometriosis is a disorder in which the endometrium grows outside your uterine cavity. The endometrium is the tissue which makes up the inside surface of your uterus. Endometriosis occurs when this lining grows on th...

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3

Fibroids

Fibroids are abnormal growths that develop in or on a woman's uterus. Heavy bleeding, pain in the pelvis or lower back, cramping, and bloating could indicate fibroids.

Read more »

4

What is Fertility?

Infertility is not just a woman's problem - men can be infertile, too. In fact, men and women are equally likely to have a fertility problem

Read more »

5

Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease (PID) is an infection of the reproductive organs in women caused by bacteria. It's marked by pain in the abdomen, especially during urination or sex.

Read more »

6

Depression Overview

Depression is a mood disorder that can cause extreme and persistent feelings of sadness, hopelessness, and worthlessness. Depression type largely determines what kind of medical treatment is best.

Read more »

7

Stress And Anxiety

Stress can be triggered by an event that makes you feel frustrated or nervous, such as moving, death, starting a new job, and having a baby. Long-term stress can produce both physical and psychological symptoms.

Read more »

8

What is Fibromyalgia?

Fibromyalgia is a chronic disorder characterized by widespread, unexplained pain in tender points in muscles and joints, including the head, neck, and sides of hips.

Read more »

9

Anxiety

What is anxiety? Anxiety often manifests itself as an apprehension about daily life. Learn the basics with this overview of the types of anxiety disorders.

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10

PMS (Premenstrual Syndrome)

Premenstrual syndrome (PMS) causes a wide variety of emotional and physical symptoms that occur in the weeks before a woman starts her monthly period.

Read more »

11

Necrotizing Vasculitis

This condition is considered a medical emergency. Urgent care may be required.

Necrotizing vasculitis is the inflammation of blood vessel walls, typically small and medium-sized vessels. This inflammation can interrupt normal blood flow, resulting in damage to skin and muscle including necrosis ...

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12

Polycystic Kidney Disease

Polycystic kidney disease (PKD) is an inherited kidney disorder. It causes fluid-filled cysts to form in the kidneys. PKD may impair kidney function and cause kidney failure. According to the University of Chicag...

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13

Hypoparathyroidism

Hypoparathyroidism is a rare condition that occurs when the parathyroid glands in the neck do not produce enough parathyroid hormone (PTH). Everyone has four parathyroid glands, located near of behind the thyroid gland...

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.
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