Painful Periods (Dysmenorrhea)⠀

Are you missing school, work or any other life event over your period?


Primary dysmenorrhea – pain that comes from having a menstrual period, or “menstrual cramps.” This often begins with 6–12 months after the initial period and may improve as one gets older. Usually caused by natural chemicals called prostaglandins.⠀

Secondary dysmenorrhea – caused by a disorder in the reproductive system. May begin later in life and tends to get worse over time.⠀

What causes it?⠀

The most common cause of painful periods is endometriosis.⠀

Endometriosis is when tissue that normally lines the uterus, known as endometrium, grows in areas outside the uterus, such as on the ovaries or fallopian tubes.⠀

Causes of secondary dysmenorrhea:⠀

1. adenomyosis⠀

2. infection⠀

3. myomas⠀(aka fibroids)

4. müllerian anomalies

5. obstructive reproductive tract anomalies

6. ovarian cysts.⠀


∙ nausea⠀

∙ vomiting⠀

∙ diarrhea⠀

∙ headaches⠀

∙ muscle cramps⠀

∙ poor sleep ⠀

What tests are done to find the cause?⠀

∙ medical history⠀

∙ pelvic exam⠀

∙ sonogram of the pelvis (vaginal probe)⠀

∙ some cases, laparoscopy (This is a type of surgery that lets your doctor look inside the abdomen at your pelvic region and take biopsies for tissue diagnosis.)⠀


∙ Primary dysmenorrhea usually responds well to treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) or hormonal suppression, or both. If there is no improvement in symptoms with recommended therapy within 3-6 months, further evaluation is necessary.⠀

∙ Hormonal suppression can be accomplished with combined oral contraception pills, the contraceptive patch or vaginal ring, the single-rod contraceptive progestin implant, intramuscular depot medroxyprogesterone acetate (Depo-Provera), and levonorgestrel-releasing intrauterine system (IUD).⠀

∙ Other causes of painful periods may require surgical intervention.

If you are having painful periods and your over the counter medicine isn’t cutting it, see your provider for a full work up.

You don’t have to suffer alone!

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