Dysmenorrhea

Dysmenorrhea, also known as period pain, painful periods or menstrual cramps, is pain during menstruation.[4][5][2] Its usual onset occurs around the time that menstruation begins.[1] Symptoms typically last less than three days.[1] The pain is usually in the pelvis or lower abdomen.[1] Other symptoms may include back pain, diarrhea or nausea.[1]

Quick facts: Dysmenorrhea, Other names, Specialty, Symptom... ▼

Dysmenorrhea
Other names	Dysmenorrhoea, period pain, painful periods, menstrual cramps
Menstrual cycle and changes in hormone production
Specialty	Gynecology
Symptoms	Pain during first few days of menstruation, diarrhea, nausea[1][2]
Usual onset	Within a year of the first menstrual period[1]
Duration	Less than 3 days (primary dysmenorrhea)[1]
Causes	No underlying problem, uterine fibroids, adenomyosis, endometriosis[3]
Diagnostic method	Pelvic exam, ultrasound[1]
Differential diagnosis	Ectopic pregnancy, pelvic inflammatory disease, interstitial cystitis, chronic pelvic pain[1]
Treatment	Heating pad, medication[3]
Medication	NSAIDs such as ibuprofen, hormonal birth control, IUD with progestogen[1][3]
Prognosis	Often improves with age[2]
Frequency	50–90% female adolescents and women of reproductive age[4]

Dysmenorrhea can occur without an underlying problem.[3][6] Underlying issues that can cause dysmenorrhea include uterine fibroids, adenomyosis, and most commonly, endometriosis.[3] It is more common among those with heavy periods, irregular periods, those whose periods started before twelve years of age and those who have a low body weight.[1] A pelvic exam and ultrasound in individuals who are sexually active may be useful for diagnosis.[1] Conditions that should be ruled out include ectopic pregnancy, pelvic inflammatory disease, interstitial cystitis and chronic pelvic pain.[1]

Dysmenorrhea occurs less often in those who exercise regularly and those who have children early in life.[1] Treatment may include the use of a heating pad.[3] Medications that may help include NSAIDs such as ibuprofen, hormonal birth control and the IUD with progestogen.[1][3] Taking vitamin B1 or magnesium may help.[2] Evidence for yoga, acupuncture and massage is insufficient.[1] Surgery may be useful if certain underlying problems are present.[2]

Estimates of the percentage of female adolescents, and women of reproductive age affected are between 50% and 90%.[4][6] It is the most common menstrual disorder.[2] Typically, it starts within a year of the first menstrual period.[1] When there is no underlying cause, often the pain improves with age or following having a child.[2]