What is dysmenorrhea (painful periods)?

From the Guidelines

Painful periods are called dysmenorrhea. This condition is characterized by cramping pain in the lower abdomen that may radiate to the lower back and thighs, and it can be primary or secondary, with secondary dysmenorrhea resulting from disorders like endometriosis 1. The pain occurs because the uterus produces prostaglandins, hormone-like substances that cause contractions to shed the uterine lining.

Key Characteristics of Dysmenorrhea

• Primary dysmenorrhea occurs without an underlying medical condition
• Secondary dysmenorrhea results from disorders like endometriosis or fibroids
• Cramping pain in the lower abdomen that may radiate to the lower back and thighs

Management of Dysmenorrhea

For relief, over-the-counter medications like ibuprofen or naproxen can be effective when started at the first sign of pain or even 1-2 days before expected menstruation.

• Ibuprofen: 400-600mg every 6-8 hours
• Naproxen: 500mg initially, then 250mg every 6-8 hours Additionally, heat therapy using a heating pad, warm baths, regular exercise, and stress reduction techniques can also help manage symptoms 1.

Importance of Accurate Diagnosis

It is essential to note that a histologic examination should be done to confirm the presence of endometrial lesions, especially those with a nonclassical appearance, to rule out underlying conditions like endometriosis 1.

From the FDA Drug Label

Dysmenorrhea: For the treatment of dysmenorrhea, beginning with the earliest onset of such pain, ibuprofen tablets should be given in a dose of 400 mg every 4 hours as necessary for the relief of pain. Painful periods are called dysmenorrhea.

• The term dysmenorrhea refers to painful menstrual cramps that can occur just before or during a woman's menstrual period 2.

From the Research

Definition of Painful Periods

• Painful periods are commonly referred to as dysmenorrhea 3, 4, 5, 6, 7
• Dysmenorrhea is defined as painful uterine cramping associated with menstruation 5
• It is characterized by overproduction of prostaglandins by the endometrium, causing uterine hypercontractility that results in uterine muscle ischemia, hypoxia, and, subsequently, pain 3

Types of Dysmenorrhea

• Primary dysmenorrhea occurs in the absence of an organic cause 3, 5
• Secondary dysmenorrhea is pelvic pain associated with an underlying pelvic pathology 5, 7

Prevalence of Dysmenorrhea

• Dysmenorrhea is the most common gynecological illness in women in their reproductive years 3
• It is estimated to occur in 50% to 90% of adolescent girls and women of reproductive age 7
• It is a leading cause of absenteeism from school and work 3, 6, 7