Period pain (dysmenorrhea): Types, causes, and treatments – Medical News Today

Period pain, or dysmenorrhea, refers to pain and cramping that occurs during or around menstruation. According to a 2014 review, anywhere between 16–91% of people who menstruate experience dysmenorrhea, with 2–29% experiencing severe pain.
These statistics come from Epidemiologic Reviews.
Period pain can be a mild inconvenience, or it can be a severe illness that affects a person’s ability to carry out daily tasks. The level and duration of pain can also change over time.
In this article, we will look at the types and causes of period pain, how people can reduce it, and when it is time to seek help.
Period pain is pain that occurs just before or during a menstrual period.
Every person’s experience of period pain is different, but it can cause:
Some people also experience digestive symptoms alongside period pain, such as:
Other symptoms associated with dysmenorrhea include irritability and headaches. Period pain and cramping can vary from mild to intense.
There are two types of period pain: primary and secondary.
Primary dysmenorrhea occurs as a result of menstruation alone. This means another condition does not cause it.
Researchers believe that prostaglandins are what cause primary dysmenorrhea. Prostaglandins are hormone-like substances that control inflammation.
As a period begins, the body releases prostaglandins. This triggers contractions in the uterus, prompting the womb lining to shed.
These contractions are at their strongest during the first 2 days of a period. But before a period begins, progesterone levels drop, which could also cause an increase in prostaglandins before the period begins.
The amount of prostaglandins the body releases correlates with the intensity of these contractions, and so the severity of period pain. People with primary dysmenorrhea also often experience longer, heavier periods.
Certain risk factors may contribute to the condition, including:
Secondary dysmenorrhea occurs as a result of another medical condition. Examples of conditions that can cause secondary dysmenorrhea include:
It is possible for a person to have primary dysmenorrhea and then to develop secondary dysmenorrhea, making the existing pain worse.
There are a number of approaches people can try to reduce period pain. Coping strategies can reduce current pain, while others may help reduce the likelihood of dysmenorrhea overall.
Some strategies that may help relieve period pain when it occurs include:
Some approaches that may reduce or help prevent dysmenorrhea include:
Some research suggests that stress can increase the likelihood or severity of period pain and PMS.
An older 2008 nationwide survey in Hungary found that females in more stressful work environments experienced more severe period pain, particularly those with low job security and a lack of support from coworkers.
It can be difficult to avoid stress, but learning how to manage it may help. Ideas for this include:
Learn more about stress, its causes, and how to manage it here.
Some forms of hormonal birth control may help to reduce the severity of period pain. Some forms can also stop periods entirely. Examples of methods that may do this include the pill, the implant, and the injection.
Hormonal IUDs can also reduce or stop periods, but the insertion process may cause cramping. People with conditions that can cause dysmenorrhea, such as PID, may want to avoid hormonal IUDs.
A 2018 clinical trial found that regular exercise has an impact on period pain. Out of 70 students, those who did 30 minutes of aerobic exercise three times per week saw a reduction in dysmenorrhea symptoms after 8 weeks.
But this study was small and only focused on younger females. Other studies have concluded that there is no association between exercise and period pain reduction.
In cases of secondary dysmenorrhea, identifying and managing the cause is essential for reducing period pain. For example, a person with a uterine growth or endometriosis may benefit from surgery to remove growths that are causing pain.
Dysmenorrhea is a common condition that has a significant impact on public health.
A large 2019 study conducted in the Netherlands found that during a 4-month timeframe, nearly 14% of respondents missed work or school due to their period. In fact, 3.4% missed school or work in every or almost every menstrual cycle.
Despite this, people with dysmenorrhea can face difficulty getting medical care. This is partly due to the belief that painful periods are normal. Another component is prejudice as a result of sexism, racism, and other sources of bias.
According to a 2018 literature review, women are more likely to experience chronic pain conditions than men. But doctors are also more likely to blame that pain on mental illness or malingering, resulting in a “struggle” for women to be believed.
This can result in people being unable to get a diagnosis or treatment. For example, an older article notes that while around 10% of females have endometriosis, it takes 8–12 years on average to get a diagnosis.
These barriers are even more significant for women of color. Several studies show doctors are less likely to prescribe pain medication for Black women, while a 2016 study showed that 47% of medical residents and students underestimated pain in Black people.
Being aware of these barriers is important for both healthcare professionals and for patients, who may avoid seeking help for severe pain after negative experiences with doctors.
While mild period pain is common, nobody should have to endure severe or debilitating pain. A person should speak with a doctor if:
People should also speak with a doctor if they have painful periods along with other symptoms, such as:
If a person faces difficulty getting a diagnosis, there are things they can do to advocate for themselves. For example:
Some people may feel a benefit from having someone else accompany them to appointments for support.
Period pain, or dysmenorrhea, is a common condition that can lower a person’s quality of life. Home care can treat mild or occasional period pain. But if a person has severe and disruptive periods, it is important for doctors to investigate the cause and treat the pain wherever possible.
Last medically reviewed on April 20, 2021
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