Painful Periods

Painful periods at a glance

• Most women at some time experience some form of pain during their menstrual cycle. Painful periods, with no physical abnormality present, are one of the most common reasons why women see a gynecologist.
• Lower abdominal pain from cramping and sharp pain that comes and goes are the most common forms of discomfort with menstruation. This is normal.
• More than half of all women have painful periods due to dysmenorrhea, which is defined as pain during menstruation that is so severe that it interferes with daily activities.

Causes of painful periods

Primary dysmenorrhea begins with a woman’s first period, and is usually caused by prostaglandins, which are made in the lining of the uterus. Primary dysmenorrhea pain generally starts right before the beginning of the period and tapers off as the period progresses.

Secondary dysmenorrhea develops over a woman’s lifetime and is usually associated with an underlying disorder or structural abnormality of the reproductive system. Pain from secondary dysmenorrhea can begin days before the beginning of the period and last after it is over.

Some of the conditions that can cause secondary dysmenorrhea include:

• Endometriosis, which occurs when tissue from the lining of the uterus spreads to the abdomen and pelvis
• Fibroids, which are growths on or in the uterus
• Adenomyosis, which is an overgrowth of the lining and wall of the uterus

Treatments for painful periods

Treatments for dysmenorrhea include:

• NSAIDs, such as Aleve or Motrin, taken just before the start of the period and continued for a day or two to control the duration of bleeding and painfulness
• Hormones via birth control pills, the patch, Depo-Provera shot, vaginal rings and the Mirena IUD
• Surgical removal of the uterus or sometimes ablation of the uterus

It is important that women having painful periods consult with their gynecologist to ensure the pain is not being caused by something serious, such as:

• Neuropathic nerve damage
• A mass in the uterus or ovaries
• A sexually transmitted disease
• Any pelvic infection
• A misplaced IUD in the wall of the uterus