1. Your cycle
  2. Health
  3. Period

Flo Fact-Checking Standards

Every piece of content at Flo Health adheres to the highest editorial standards for language, style, and medical accuracy. To learn what we do to deliver the best health and lifestyle insights to you, check out our content review principles.

Dysmenorrhea: The Reason for Your Painful Periods

Is period pain cramping your style? Like many women, you’ve probably experienced nagging symptoms like acne, bloating, and abdominal discomfort. Read on for more info on severe menstrual cramping ‒ known as dysmenorrhea ‒ as well as helpful tips to remedy the problem.

Cramps are a natural part of your menstrual cycle, with nearly 75 percent of women reporting some form of uterine cramping before or during their period. It typically targets the lower abdomen but can trigger other related symptoms.

So exactly what is dysmenorrhea? It’s defined as severe cramping that’s unusually painful and may lead to chronic pelvic pain (lasting at least six months). Dysmenorrhea can be classified into one of two categories: primary dysmenorrhea and secondary dysmenorrhea.

Primary dysmenorrhea refers to any cramping that’s triggered specifically by menstruation. The duration of primary dysmenorrhea symptoms falls somewhere between 8 and 72 hours.

In contrast, secondary dysmenorrhea is cramping that’s associated with one or more reproductive health conditions. Examples of secondary dysmenorrhea include endometriosis, fibroids, polyps, or pelvic inflammatory disease (PID). Note that secondary dysmenorrhea might also be associated with the use of an IUD (intrauterine contraceptive device). This condition is marked by uterine or cervical abnormalities and varying degrees of pain at any point in your menstrual cycle

According to the dysmenorrhea definition, it involves particularly intense or sustained period cramps, most often observed in the lower abdomen. Other symptoms of dysmenorrhea include: 

  • Pain in your lower back or radiating pain down your legs
  • Nausea or vomiting
  • Diarrhea
  • Headaches
  • Muscle weakness or fatigue

However, dysmenorrhea doesn’t always present the same symptoms. Those with secondary dysmenorrhea might not experience nausea, vomiting, diarrhea, or fatigue, for instance. That’s why it’s important to see your doctor for signs of dysmenorrhea lasting more than 72 hours, as it could point to an underlying medical issue.

In the instance of primary dysmenorrhea, the process proceeds as follows: Your body prepares itself for menstruation by producing prostaglandins. These lipids affect your perception of pain and act like hormones to regulate inflammation, blood pressure, and clotting. The smooth muscles of your uterus then contract and relax in order to shed its lining. Contractions, in turn, bring about the usual monthly cramping or dysmenorrhea (in more severe cases).

If your body shows higher levels of prostaglandins, you’re more likely to observe symptoms of dysmenorrhea. Otherwise, alternative causes for menstrual cramping include: 

  • Being younger than 30 years old
  • Irregular periods
  • Heavy or irregular menstrual bleeding
  • Smoking 

Keep in mind that your chances of developing dysmenorrhea also increase when there’s a family history of dysmenorrhea or related conditions, such as: 

Your uterine lining attaches outside of your uterus to the fallopian tubes or other pelvic tissues.

  • Fibroids

These are noncancerous growths on the walls of your uterus.

  • Infection of the reproductive organs

This includes PID.

  • Cervical stenosis

The opening of your cervix is too small to allow for your uterine lining to freely shed itself, producing pain or pressure. 

  • Adenomyosis

It occurs when your uterine lining attaches to the smooth muscle tissues of your uterus.

While there’s no way to completely cure dysmenorrhea, different treatment options are available to manage its symptoms. Speak with your doctor about dysmenorrhea to determine what’s right for you.

Pain relieving medications can temporarily address headaches and severe discomfort in your abdomen, lower back, or legs. Nonsteroidal anti-inflammatory drugs (NSAIDs), reduce the amount of prostaglandins your body produces. This should help dial down the intensity of your period cramps

Hormone-based birth control, like the pill, patch, or vaginal ring, could be another useful weapon for fighting dysmenorrhea. The most effective options typically include both estrogen and progestin.

Consider treating dysmenorrhea with alternative or complementary therapies, such as acupuncture, massage, dietary supplements, or herbal remedies. Please note, however, that none of these approaches are backed by sufficient scientific research regarding their efficacy.

Or, think about seeing a psychotherapist who can teach you pain management techniques and mindfulness exercises to push through the pain.

If you’re battling dysmenorrhea, try to reduce your stress levels by practicing yoga or meditation, exercising regularly, and getting plenty of sleep. Also, remember to stay hydrated, eat healthy, nutritious whole foods, and don’t smoke! 

Whenever you start to feel dysmenorrhea cramps coming on, apply a heat pack to your abdomen to soothe discomfort. Hopping into a warm bath is another way to relieve dysmenorrhea symptoms. 

Lastly, surround yourself with friends and family members who are compassionate and understanding about your condition and will help you cope with dysmenorrhea.

If you’ve been diagnosed with secondary dysmenorrhea caused by endometriosis, those treatment protocols could reduce the severity of your dysmenorrhea. If the symptoms persist, however, surgical removal of the endometriosis tissue might be necessary. (This is only a temporary fix since the tissue often grows back.) As a last resort for treating dysmenorrhea, your doctor may suggest a hysterectomy. 

When secondary dysmenorrhea is the result of fibroids, uterine artery embolization (UAE) can cut off blood flow to the fibroids so they stop growing. Your doctor could also recommend surgical removal of the fibroids.

Having dysmenorrhea is disruptive to your daily life, especially if it causes you to miss work, school, or social activities. 

Primary dysmenorrhea isn’t generally responsible for any other health problems besides painful periods, nausea, lower back pain, and fatigue. But secondary dysmenorrhea carries with it the unfortunate possibility of future fertility issues or ectopic pregnancies.

For some women, the severe signs and symptoms of dysmenorrhea have become commonplace. If you’re concerned about the pain and discomfort you’ve been struggling with on a monthly basis, talk to your doctor. They’ll be able to examine your reproductive organs and determine if you have primary dysmenorrhea or secondary dysmenorrhea. Afterwards, they can recommend an appropriate course of action. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459624/#!po=11.5385

https://my.clevelandclinic.org/health/diseases/4148-dysmenorrhea

https://www.hopkinsmedicine.org/health/conditions-and-diseases/dysmenorrhea

https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/symptoms-causes/syc-20374938

https://www.acog.org/Patients/FAQs/Dysmenorrhea-Painful-Periods?IsMobileSet=false

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459624/#!po=11.5385

https://www.ncbi.nlm.nih.gov/books/NBK279324/

Read this next