What is dysmenorrhea?Dysmenorrhea is a menstrual condition characterized by severe and frequent menstrual cramps and pain associated with menstruation. Dysmenorrhea may be classified as primary or secondary.
- primary dysmenorrhea - from the beginning and usually lifelong; severe and frequent menstrual cramping caused by severe and abnormal uterine contractions.
- secondary dysmenorrhea - due to some physical cause and usually of later onset; painful menstrual periods caused by another medical condition present in the body (i.e., pelvic inflammatory disease, endometriosis).
What causes dysmenorrhea?The cause of dysmenorrhea depends on whether the condition is primary or secondary. In general, females with primary dysmenorrhea experience abnormal uterine contractions as a result of a chemical imbalance in the body (particularly prostaglandin and arachidonic acid - both chemicals which control the contractions of the uterus). Secondary dysmenorrhea is caused by other medical conditions, most often endometriosis (a condition in which tissue that looks and acts like endometrial tissue becomes implanted outside the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity - often resulting in internal bleeding, infection, and pelvic pain). Other possible causes of secondary dysmenorrhea include the following:
- pelvic inflammatory disease (PID)
- uterine fibroids
- abnormal pregnancy (i.e., miscarriage, ectopic)
- infection, tumors, or polyps in the pelvic cavity
Who is at risk for dysmenorrhea?While any female can develop dysmenorrhea, the following females may be at an increased risk for the condition:
- females who smoke
- females who drink alcohol during menses (alcohol tends to prolong menstrual pain)
- females who are overweight
- females who started menstruating before the age of 11
What are the symptoms of dysmenorrhea?The following are the most common symptoms ofdysmenorrhea. However, each adolescent may experience symptoms differently. Symptoms may include:
- cramping in the lower abdomen
- pain in the lower abdomen
- low back pain
- pain radiating down the legs
How is dysmenorrhea diagnosed?Diagnosis begins with a gynecologist evaluating a female's medical history and a complete physical examination including a pelvic examination. A diagnosis of dysmenorrhea can only be certain when the physician rules out other menstrual disorders, medical conditions, or medications that may be causing or aggravating the condition. In addition, diagnostic procedures fordysmenorrhea may include:
- ultrasound (Also called sonography.) - a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
- magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
- laparoscopy - a minor surgical procedure in which a laparoscope, a thin tube with a lens and a light, is inserted into an incision in the abdominal wall. Using the laparoscope to see into the pelvic and abdomen area, the physician can often detect abnormal growths.
- hysteroscopy - a visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.
Treatment for dysmenorrhea:Specific treatment for dysmenorrhea will be determined by your physician based on:
- your age, overall health, and medical history
- extent of the condition
- cause of the condition (primary or secondary)
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the condition
- your opinion or preference
- prostaglandin inhibitors (i.e., nonsteroidal anti-inflammatory medications, or NSAIDs, such as aspirin, ibuprofen) - to reduce pain
- oral contraceptives (ovulation inhibitors)
- progesterone (hormone treatment)
- dietary modifications (to increase protein and decrease sugar and caffeine intake)
- vitamin supplements
- regular exercise
- heating pad across the abdomen
- hot bath or shower
- abdominal massage
The information on this Web page is provided for educational purposes. You understand and agree that this information is not intended to be, and should not be used as, a substitute for medical treatment by a health care professional. You agree that Lucile Salter Packard Children's Hospital is not making a diagnosis of your condition or a recommendation about the course of treatment for your particular circumstances through the use of this Web page. You agree to be solely responsible for your use of this Web page and the information contained on this page. Lucile Salter Packard Children's Hospital, its officers, directors, employees, agents, and information providers shall not be liable for any damages you may suffer or cause through your use of this page even if advised of the possibility of such damages.