Dysmenorrhea – What Causes Painful Menstrual Periods?


Dysmenorrhea or menstrual pain occurs in the lower abdominal region of the women due to periods every month. This pain is annoying and sometimes too severe that it interferes with your routine life. It is a common condition that is generally caused by menstruation, although in rare situations, other underlying health conditions may play a role.

What is dysmenorrhea?

Menstruation in women occurs every month when the wall of the uterus sheds its lining. It is common to experience slight discomfort during this process. However, if this pain is severe and interferes with your daily activities, it is not normal. Dysmenorrhea is a condition of painful menstruation. It causes menstrual cramps that are sometimes difficult to bear.

There are two types of dysmenorrhea. Primary dysmenorrhea occurs before and during menstruation. Secondary dysmenorrhea can be due to some underlying health issues like endometriosis and uterine fibroids. Secondary dysmenorrhea may also occur if you have had painless menstruation that has become painful later at any stage of life.

Symptoms of dysmenorrhea

Symptoms include:

  • Cramping pain in the lower abdomen that radiates to the lower back and thighs
  • Continuous pain
  • In some cases, pain begins even 1 to 3 days before menstruation
  • Some women also experience diarrhea, dizziness, headache, nausea, and vomiting during dysmenorrhea.

Causes of dysmenorrhea

The exact causes of dysmenorrhea are still unknown. However, few women are at higher risk of dysmenorrhea.

These risks include:

  • Age under 20
  • Smoking
  • Family history of dysmenorrhea
  • Irregular periods
  • Heavy bleeding during menstruation
  • Early puberty

Prostaglandin is a hormone that is responsible for the contraction of uterus muscles. It sheds the lining. The pain or inflammation is due to the contraction of the uterus muscles. Before periods, the level of prostaglandin in our bodies rises, resulting in contractions and discomfort.

An underlying health issue may also trigger painful periods like:

PMS (pre-menstrual syndrome): This occurs due to hormonal imbalances of the body that usually occurs before menstruation. This condition goes away after menstruation bleeding starts.

Fibroids: Fibroids do not show any symptoms. These are non-cancerous tumors. Sometimes, these fibroids put extra pressure on the uterus – resulting in cramps and pain.

Endometriosis: Endometriosis is a medical condition in which the lining of the uterus grows and spreads to the other parts of the reproductive system like ovaries, fallopian tubes, or pelvis tissues. This condition is extremely painful.

Cervical stenosis: This is a rare condition but can contribute to dysmenorrhea. It narrows down the cervix for menstrual flow. It puts pressure on the uterus and results in menstrual cramps and pain.

PID (pelvic inflammatory disease): The inflammation of the ovaries, uterus, and fallopian tube is called PID. It is caused by bacteria and results in cramps.

Adenomyosis: The inflammation of the uterus due to abnormal growth of uterine lining into muscles is known as adenomyosis. It is also a rare condition, but it may contribute to dysmenorrhea.

When to see a doctor?

If you have a sickness or a medical condition that is interfering with your daily life or stopping you from executing your job, you should see your doctor.

Immediately talk to your doctor if you are experiencing any of the following conditions:

  • Heavy bleeding with clots
  • Three consecutive painful periods
  • Pelvic pain without menstruation

Pelvic pain and cramping without menstruation can be an indication of infection. It may cause damage to your internal tissues. It is ideal to see your doctor if you experience fever, sudden cramping, pelvic pain, or vaginal discharge without menstruating. 

What are the home remedies for dysmenorrhea?

Certain home remedies may help you relieve the pain of periods like:

  • Abdominal massage
  • Warm bath
  • Use of a heating pad or a water bottle may ease the cramps
  • Eating nutritious food
  • Doing light exercises or yoga, or even sex also helps in relieving the pain
  • Trying relaxation exercises or techniques
  • Use of painkillers
  • Taking vitamins and supplements such as vitamin E, B1, B6, omega-3 fatty acids, and magnesium supplements, in addition to calcium, can help reduce period cramps and pain.
  • Eating fish, soups, and hot foods
  • Avoiding chilled beverages
  • Avoiding stress may help in reducing the severity of dysmenorrhea
  • Sometimes taking herbal teas containing fennel and caraway seeds helps in easing the menstrual cramps and pain


During diagnosis, your doctor will perform various tests while reviewing your medical history. A physical examination along with a pelvic test is performed to see infection or any other underlying health issue.

Your doctor will suggest the following tests if he doubts about any infection:


This test is performed to see the condition of ovaries, uterus, cervix, fallopian tubes, and other reproductive tissues.

CT scan and MRI

Other imaging tests such as CT and MRI scans are performed to get a detailed picture of underlying health issues. Both tests are painless and provide a detailed analysis of various soft body tissues, bones, and other organs.


This test is performed to identify underlying health issues such as endometriosis, cysts, fibroids, and ectopic pregnancy. A small camera lens is used to see the internal organ and reproductive parts by using an optic fiber tube.

Treatment options

Treatment options depend upon the severity of the symptoms. If the pain is due to an infection, your doctor may prescribe you antibiotics to clear up the infection. Your doctor will recommend you several methods to reduce your menstrual pain or ease the cramps:

Pain killers

Pain killers such as ibuprofen are ideal for relieving menstrual pain. Take painkillers before starting your periods. Make a note of your menstrual date and begin taking the painkillers a few days before the predicted day. Taking painkillers before starting your menstruation will ease the cramps. Continue taking medicines for two to three days or until symptoms are gone. 

Hormonal treatment

Hormonal treatment is usually done in form of pills, injections, vaginal rings, skin patches, and IUD (intrauterine device). These hormones prevent ovulation and help in relieving the pain. Birth control pills also contain these hormones that prevent menstrual cramps.


Surgery is done to treat underlying health issues like endometriosis, cysts, or fibroid. If different approaches have failed to ease the symptoms of dysmenorrhea, the surgical removal of the uterus can be another option. This option is used when you longer want to have a child or if the symptoms are extremely painful.

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