What is Dysmenorrhea?
Cramps and menstrual periods seem to go hand in hand. A woman’s monthly cycle prompts the body to shed uterine lining each month, which can feel uncomfortable for some and unbearable to others. Cramps may start before and during periods and last several days. Cramp pain is a condition called dysmenorrhea, which may warrant a visit to your doctor. So, what is dysmenorrhea? Let’s find out.
The cramping pain associated with menstruation is dysmenorrhea. This condition causes severe and frequent cramps and pain before and during a woman’s period. In general, the pain is mild and manageable but for some women the pain is so severe it becomes debilitating for a few days each month, keeping them from engaging in daily activities. Some cramping discomfort is common, as more than half of menstruating women experience pain one to two days each month.
Primary and Secondary Dysmenorrhea
Dysmenorrhea is a medical condition that occurs in people one of two ways:
- Primary dysmenorrhea: It is usually lifelong. It starts at the time of a person’s first period and persists throughout their menstruating years. This abdominal pain starts before or during a period and comes from menstrual cramping as a result of severe and abnormal uterine contractions.
- Secondary dysmenorrhea: It usually starts later in life, brought on by a physical cause—usually another medical condition.
There’s a reason some people seem more affected by their menstrual period. The pain and other symptoms are not universal; symptoms vary between each woman; some have many symptoms while others have few. Some dysmenorrhea symptoms may appear to be another medical issue, which may take a physician to tie some symptoms to dysmenorrhea.
Here are some symptoms to look for:
- Cramping or pain in the lower abdomen during a menstrual period. Pain can range from a dull continuous ache to a severe, stabbing pain
- Low back pain
- Pain radiating down the legs
- Nausea and/or vomiting
- Diarrhea (loose stools)
- Fatigue and/or weakness
- Dizziness and/or fainting
Causes of Dysmenorrhea
Causes of this condition differ depending on whether a person has primary or secondary dysmenorrhea.
In primary dysmenorrhea, there is a chemical imbalance in the body. During a woman’s menstrual period, her uterus tightens to help shed its lining. This action gets triggered by prostaglandins, natural chemicals made in the uterine lining, which cause the muscles and blood vessels to contract. Abnormal contractions prompted by prostaglandins create the cramping pain. At the beginning of a period, prostaglandin levels are high and as the period continues the level goes down, lessening the pain after the first few days.
Secondary dysmenorrhea is caused by other medical conditions. Cramping and abdominal pain may result from one of several medical conditions that contribute to dysmenorrhea, including:
- Endometriosis: occurs when tissue similar to lining of the uterus grows in other areas of the body
- Uterine fibroids: growths that form on the outside, inside, or the walls of the uterus
- Adenomyosis: develops when tissue that normally lines the uterus starts growing in the muscle wall of the uterus
- Pelvic inflammatory disease: an infection of the reproductive organs
- Abnormal pregnancies: miscarriages or ectopic
Infection, tumors, or polyps in the pelvic cavity can also cause severe menstrual pain. Other health issues with the uterus, fallopian tubes, and other reproductive organs might as well.
There are several risk factors that can indicate whether a woman may experience dysmenorrhea. These include women who:
- Drink alcohol during their period
- Started their periods before age 11
- Are younger than 30
- Are overweight
- Have never been pregnant
- Have irregular menstrual bleeding
- Have a family history of dysmenorrhea
Some of these risk factors can be minimized by taking care of your health. Try to reach a healthy weight, cut out smoking, and avoid drinking alcohol during your menstrual period.
How to Manage Dysmenorrhea Pain
The way to handle dysmenorrhea pain depends on the severity of your cramps. Some women with mild pain can handle the discomfort until it passes. More severe pain calls for action to relieve the tightness and discomfort a period brings.
Some easy remedies many include:
- Taking over-the-counter, non-steroidal anti-inflammatory medications (NSAIDs), such as aspirin and ibuprofen
- Taking acetaminophen
- Using oral contraceptives, which inhibit ovulation
- Making changes to your diet to increase protein and decrease sugar and caffeine consumption
- Using heat, such as a hot bath or shower, heating pad, or hot water bottle
- Taking dietary supplements to reduce cramps, such as omega-3 fatty acids, vitamin E, vitamins B1 and B6
- Massaging the abdomen
When to Seek Medical Help
More severe dysmenorrhea cases require a doctor’s visit. If monthly cramping causes severe pain or disrupts your life every month, do not suffer through it—see a doctor. Also see a doctor if your symptoms get worse each menstrual cycle or if your cramps become severe after age 25.
Your doctor will evaluate your situation and make a treatment recommendation based on your age, overall health, medical history, the cause of your dysmenorrhea, other aspects of the condition, and your treatment preferences. In some cases, doctors may suggest:
- Progesterone as a hormone treatment
- Endometrial ablation, a procedure to destroy uterine lining
- Endometrial resection, a procedure to remove the lining of the uterus
- Hysterectomy, the surgical removal of the uterus
- Alternative treatments, including acupuncture, herbal medicine, and acupressure
Don’t ignore the cramps and pain that come each month with a menstrual period. If you are unable to cope or have difficulty keeping up with your daily activities, there are things you can do to alleviate the pain. When in doubt, reach out to your doctor for their professional opinion.