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Dysmenorrhea (Period Pain)

Abnormally painful abdominal cramps during menstruation.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Period Pain

Many girls and women have problems like abdominal cramps and pain during their menstrual period. The medical term for painful periods is "dysmenorrhea." Although menstruation is a normal part of a woman's life, severe period pain need not be. Women do not have to simply put up with it — menstrual pain can usually be treated effectively. If you have very painful periods or the pain gets worse over time, it can be a good idea to see a doctor.

Symptoms

Every month the lining of a woman's womb builds up and is then shed again at the end of the menstrual cycle, when she has her period — unless she is pregnant. To shed the lining, the muscles of the womb tighten (contract) and relax in an irregular rhythm. This helps the tissue lining the womb to detach and flow out of the body, together with blood, through the neck of the womb and the vagina... Read more about Dysmenorrhea

What works? Research summarized

Evidence reviews

Combined oral contraceptive pill (OCP) as treatment for primary dysmenorrhoea

Dysmenorrhoea is painful menstruation (woman's monthly bleeding) with the symptoms including cramping, headaches, nausea and vomiting. An excess of the hormone prostaglandin is a known cause. The synthetic hormones in combined oral contraceptive pills suppress ovulation, which could result in a reduction in dysmenorrhoea. The OCP reduces the amount of prostaglandin produced by glands in the lining of the uterus; which then reduces both uterine blood flow and cramps. The preparations of OCP with doses less than 35 mcg were effective and should be the preparation of choice.

Transcutaneous electrical nerve stimulation for primary dysmenorrhoea

High‐frequency nerve stimulation may help relieve painful menstrual cramps. Dysmenorrhoea is a very common complaint that refers to painful menstrual cramps in the uterus. Transcutaneous electrical nerve stimulation (TENS) involves the sending of an electric current by placing electrodes on the skin to stimulate the nerves and reduce pain. It is thought to alter the body's ability to receive and understand pain signals rather than by having a direct effect on the uterine contractions. The review of trials found that high‐frequency TENS may help but there is not enough evidence to assess the effect of low‐frequency TENS. More research is needed.

Not enough evidence to support the use of surgical nerve interruption for dysmenorrhoea

Dysmenorrhoea (painful menstrual cramps) is a common problem. The contraceptive pill and anti‐inflammatory drugs (NSAIDs) are effective treatments in 80% of women with dysmenorrhoea but for others surgery is a considered option. Uterine nerve ablation (UNA) and presacral neurectomy (PSN) both involve surgical interruption of the sensory nerve fibres near the cervix to block the pain pathway. The review of trials found there was only limited evidence to support the use of surgery for primary dysmenorrhoea and little evidence for its use in women with endometriosis. No adverse effects were found with UNA but PSN was found to cause treatable constipation. More research is needed.

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Summaries for consumers

Combined oral contraceptive pill (OCP) as treatment for primary dysmenorrhoea

Dysmenorrhoea is painful menstruation (woman's monthly bleeding) with the symptoms including cramping, headaches, nausea and vomiting. An excess of the hormone prostaglandin is a known cause. The synthetic hormones in combined oral contraceptive pills suppress ovulation, which could result in a reduction in dysmenorrhoea. The OCP reduces the amount of prostaglandin produced by glands in the lining of the uterus; which then reduces both uterine blood flow and cramps. The preparations of OCP with doses less than 35 mcg were effective and should be the preparation of choice.

Transcutaneous electrical nerve stimulation for primary dysmenorrhoea

High‐frequency nerve stimulation may help relieve painful menstrual cramps. Dysmenorrhoea is a very common complaint that refers to painful menstrual cramps in the uterus. Transcutaneous electrical nerve stimulation (TENS) involves the sending of an electric current by placing electrodes on the skin to stimulate the nerves and reduce pain. It is thought to alter the body's ability to receive and understand pain signals rather than by having a direct effect on the uterine contractions. The review of trials found that high‐frequency TENS may help but there is not enough evidence to assess the effect of low‐frequency TENS. More research is needed.

Not enough evidence to support the use of surgical nerve interruption for dysmenorrhoea

Dysmenorrhoea (painful menstrual cramps) is a common problem. The contraceptive pill and anti‐inflammatory drugs (NSAIDs) are effective treatments in 80% of women with dysmenorrhoea but for others surgery is a considered option. Uterine nerve ablation (UNA) and presacral neurectomy (PSN) both involve surgical interruption of the sensory nerve fibres near the cervix to block the pain pathway. The review of trials found there was only limited evidence to support the use of surgery for primary dysmenorrhoea and little evidence for its use in women with endometriosis. No adverse effects were found with UNA but PSN was found to cause treatable constipation. More research is needed.

See all (45)

More about Dysmenorrhea

Photo of an adult woman

Also called: Dysmenorrhoea, Painful periods, Painful menstrual periods, Menstrual cramps

See Also: Menorrhagia, Uterine Fibroids, Endometriosis

Other terms to know:
Endometrium, Menstruation (Periods)

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