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What is Dysmenorrhea?

Painful cramps (the medical term for it is dysmenorrhea), are the leading cause of missed school for young women, and they are in the top five reasons for missing work.

Menstrual flow can vary a lot from one woman to another, and can also change over time during a woman’s reproductive years. Some women have no cramps at all, some have some mild ones that 2 ibuprofen pills can alleviate, and some women live with cramps so severe, that they have to take a sick day from work.

The cramps usually occur in the lower belly and back. They may lessen over time or even disappear altogether after the birth of the woman’s first child.

The uterus is a muscle that contracts to some degree throughout the woman’s cycle. If the contractions are too strong, they put pressure on blood vessels and temporarily cut off oxygen to the uterus. This lack of oxygen causes pain and menstrual cramps.

young asian american woman

What Are the Main Symptoms of Dysmenorrhea?

Your Viva Eve gynecologist will classify your cramps as primary dysmenorrhea or secondary dysmenorrhea.

Primary dysmenorrhea (painful periods in young women) is directly related to their cycle.

Secondary dysmenorrhea occurs in women often between the ages of 30 to 45, indicating a problem in their reproductive organs.

Symptoms of primary dysmenorrhea include:

  • Starts shortly after the onset of menstruation, usually within six months, but possibly up to two years
  • Lasts for 48 to 72 hours, often starting several hours before the start of the period
  • Severe cramping radiating to the back, hips, or thighs or labor-like pains
  • Feeling of pressure in the abdomen
  • Unremarkable pelvic exam result

Symptoms of secondary dysmenorrhea include:

  • Symptoms beginning in the woman’s 20s or 30s, with no previous painful cycles
  • Heavy menstrual flow or irregular bleeding
  • Pelvic abnormality on exam
  • Poor response to NSAIDs or oral contraceptives
  • Infertility
  • Painful intercourse
  • Vaginal discharge

What can cause secondary dysmenorrhea?

Many different structural issues or organic diseases may contribute to secondary dysmenorrhea, such as:


  • Endometriosis, which is when uterine lining tissue can be found outside the uterus
  • Pelvic inflammatory disease (PID), which occurs when an infection spreads from the uterus to other reproductive organs
  • Stenosis or narrowing of the cervix, usually caused by scarring or lack of estrogen at menopause
  • Uterine Fibroids, the most common benign tumors of the female reproductive system
  • Adenomyosis, a condition in which the inner lining of the uterus (the endometrium) breaks through the muscle wall of the uterus
  • Ovarian cysts or tumors – growths on or in the ovaries – the small reproductive organs located on each side of the uterus that store and release eggs and produce female hormones
  • Uterine polyps – growths attached to the inner wall of the uterus that extend into the uterine cavity
  • Intrauterine adhesions – a condition when scar tissue builds up between the inner walls of the uterus causing the walls to bind together
  • Intrauterine device issues

How is Dysmenorrhea Diagnosed?

The goal of the doctor is to determine the underlying reasons or to rule out organic or structural causes for dysmenorrhea. Your Viva Eve gynecologist may request any combination of the following:

  • Blood count with differential
  • Gonococcal and chlamydial cultures
  • Urinalysis and/or stool culture
  • Ultrasound, an MRI, or CT scan
  • Laparoscopy, Hysteroscopy, or Dilation and curettage
  • Pregnancy test and/or thyroid function test
  • Ovary function test
  • Prolactin test that measures the levels of a hormone called prolactin
  • Male hormone tests

How is Dysmenorrhea Treated?

Treatment for dysmenorrhea depends on whether it’s primary or secondary in nature.

If primary dysmenorrhea is the diagnosis, you can take aspirin, acetaminophen, ibuprofen, or naproxen to relieve your symptoms. Other helpful tips include:

  • Heat from a heating pad or hot water bottle on your lower back or stomach
  • Rest
  • Avoid caffeine and salt
  • Stop using tobacco and alcohol
  • Massage
  • Regular exercise

If the diagnosis is secondary dysmenorrhea, your Viva Eve gynecologist will work with you to provide an accurate diagnosis and together you will decide on a treatment option that is best for you and your unique circumstances.

Talk to a specialist to see how we can help.