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Dysmenorrhea

What You Need to Know About Menstrual Cramps

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Updated May 23, 2014

More than 50 percent of women experience dysmenorrhea (menstrual pain) for one or two days during menstruation. Menstrual cramps occur most often in teens; however, women in their twenties and older also suffer from painful periods. Would it surprise you to know that the American College of Obstetricians and Gynecologists (ACOG) says that about one in ten women experience menstrual pain so severely that they are unable to perform their normal routine for one to three days each month?

What is considered menstrual pain?

Many times menstrual cramps are described as a dull ache or a feeling of pressure in the lower abdomen. While the pain and intensity varies from woman to woman, dysmenorrhea is sometimes severe enough to cause nausea, vomiting, diarrhea, and/or a general aches and pains.

What causes menstrual cramps?

Menstrual cramps are caused by the normal contraction of the uterus. Like all muscles, the uterus contracts and relaxes. Most of the time women are unaware of these contractions. During menstruation uterine contractions are much stronger and it is these strong contractions that are most likely to be painful.

Uterine contractions are caused by prostaglandins. Prostaglandins are a natural substance made by the body; uterine prostaglandins cause uterine contractions. Strong uterine contractions cause the blood supply to the uterus to temporarily shutdown, depriving the uterine muscle of oxygen and setting up the cycle of menstrual contractions and pain.

What else should I know about menstrual cramps?

There are two types of dysmenorrhea.

  • The most common type is called primary dysmenorrhea. Primary dysmenorrhea is caused by the normal production of prostaglandins as described above; it often occurs in women who have not had children and disappears after a full-term pregnancy.

  • The second type of menstrual cramps is called secondary dysmenorrhea. Secondary dysmenorrhea may feel like primary dysmenorrhea, however it is caused by a disease in the uterus, fallopian tubes, or ovaries rather than the normal production of prostaglandins. This type of menstrual pain often lasts longer than primary dysmenorrhea and, in many cases, causes more severe pain. Women with secondary dysmenorrhea may experience pelvic pain at other times of the month or during sexual intercourse. Some of the most common causes of secondary dysmenorrhea include endometriosis, pelvic inflammatory disease (PID), uterine fibroid tumors, and aving an intrauterine device (IUD).

    When should you call the doctor?

    Call your healthcare provider if:

  • You are unable to relieve menstrual pain with typical over-the-counter medications such as ibuprofen.

  • You experience pelvic pain that is not associated with menstruation.

  • You experience a fever, nausea, or vomiting with your pain.

  • You experience pelvic pain that is unusually severe or different in any way.

    Remember, your healthcare provider is there to help you. Most medical offices have nurses who are happy to evaluate whether you need to be seen in the office, and/or answer your questions over the phone.

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