What Is Dysmenorrhea? Everything You Need To Know About Painful Periods

Updated 14 March 2022

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Medically reviewed by Claudia Pastides, MBBS, Flo director of medical accuracy, Cyprus

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Painful periods are pretty common, and most of us have spent many an afternoon on the sofa, eating ice-cream by the bucketload while waiting for pain relief to kick in and cramps to subside.

For many of us, period pain is an annoyance that, thankfully, doesn’t interfere too much with our everyday lives. However, studies have shown that 20 percent of us experience period pain that’s so severe and disruptive that we have to cancel plans or change the way we dress. The medical name for very painful periods is dysmenorrhea, which we’ll discuss in detail below.

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What is dysmenorrhea?

Stomach cramps, along with acne and bloating, are a natural part of the menstrual cycle, with nearly 75 percent of women and people who menstruate reporting some form of abdominal cramps either before, or during, their period. While some people feel the pain in their lower back, period pain typically targets the lower abdomen.

So what exactly is dysmenorrhea? It’s officially defined as particularly intense or sustained period cramps in the stomach and lower abdomen, which can sometimes cause other symptoms like:

• Pain in your lower back or radiating pain down your legs
• Nausea or vomiting
• Diarrhea

What’s the difference between primary and secondary dysmenorrhea?

Dysmenorrhea falls into two categories, and if you have it you’ll either be diagnosed with primary dysmenorrhea or secondary dysmenorrhea, depending on your symptoms.

Primary dysmenorrhea refers to any cramping that is triggered specifically by menstruation and your period.

Secondary dysmenorrhea is slightly different. This is cramping that is associated with reproductive health conditions, like endometriosis, fibroids, polyps, or pelvic inflammatory disease (PID).

What Causes Dysmenorrhea?

Primary dysmenorrhea is the pain caused by your body preparing itself for your period. When you have a period, you produce chemicals called prostaglandins that affect your perception of pain. They also regulate inflammation, blood pressure, and clotting. And when your uterus contracts to shed its lining, these contractions can cause cramps, or dysmenorrhea in more severe cases.

Secondary dysmenorrhea is related to reproductive health conditions like:

• Endometriosis
  Endometriosis is a condition where tissue similar to the lining of the uterus starts to grow in other places, such as the ovaries and uterine tubes.
• Fibroids
  Fibroids are non-cancerous growths that can develop in the uterus. They are made up of muscle and fibrous tissue and vary in size.
• Infection of the reproductive organs
  Conditions like PID, which is an infection of the upper uterus, ovaries, and uterine tubes, can cause secondary dysmenorrhea.
• Cervical stenosis
  Cervical stenosis happens when the opening of a cervix is too small to allow your uterine lining to freely come out during your period, causing pain or pressure.
• Adenomyosis
  Adenomyosis occurs when the uterine lining grows into the smooth muscle layer  of the uterus.

How to treat dysmenorrhea

Whether you’re experiencing primary or secondary dysmenorrhea, you’ll no doubt be looking for ways to soothe the pain.

Over-the-counter pain medication like acetaminophen (paracetamol) and ibuprofen are often enough to help alleviate the pain, as long as you take the correct dose.

In addition to ibuprofen, other nonsteroidal anti-inflammatory drugs (NSAIDs) can also reduce the amount of prostaglandins your body produces, which could help dial down the intensity of your period cramps.

Studies have also shown that another useful weapon for fighting the pain of dysmenorrhea is hormonal birth control, like the pill, patch, or vaginal ring. The most effective options typically include both the sex hormones estrogen and progestin (a synthetic form of the hormone progesterone).

If none of these seem to help with the pain, don’t feel too disheartened. There are other treatment options available that your healthcare professional can advise you on to determine what’s right for you and make the best plan possible.

What else can help with dysmenorrhea?

If you’re living with dysmenorrhea, there are a few lifestyle changes you can try alongside taking medicine. Practicing self-care like massage, meditation, and acupuncture or gentle exercising, such as yoga, around your period can help you feel more relaxed.

Heat is your new best friend as it’s proven to be really effective at relieving cramps. Curl up in front of your favorite TV show with a hot water bottle or heat patch or take a warm bath or shower. You could even add a few drops of lavender oil to your bath to up the relaxation factor. 

Alternatively, whip yourself up a comforting cup of ginger tea. Studies have shown that fresh root ginger may contribute to easing period pains.

Dysmenorrhea: The takeaway

Living with period pain can be … well, a pain, and it’s normal to feel frustrated by it. So, if you’re struggling on a monthly basis, or the pain is more intense than previous periods, we’d suggest putting your mind at ease and having a chat with your doctor. While you wait for an appointment, you can try some of the alternatives we suggested, but don’t feel disheartened if not much seems to help. Your healthcare professional will be able to give you a proper checkup and recommend a plan of action to help you manage painful cramps.

History of updates

Current version (14 March 2022)

Medically reviewed by Claudia Pastides, MBBS, Flo director of medical accuracy, Cyprus

Published (16 March 2020)