Dysmenorrhea
Dysmenorrhea is painful menstruation. The pain is crampy and felt low in the abdomen or pelvis. It begins shortly before or during a period. Back pain, leg pain, nausea, diarrhea, or headache can accompany it.
Dysmenorrhea has two types. Primary dysmenorrhea is menstrual pain without pelvic disease. It is very common, and it is often dismissed or poorly treated.1 Prostaglandins, a type of chemical messenger, cause strong contractions of the uterus. The contractions reduce blood flow and cause pain. Secondary dysmenorrhea is menstrual pain caused by a disease. The most common cause is endometriosis.23 Other causes include adenomyosis, fibroids, pelvic infection, and a uterus shaped differently from birth.3
Restorative care treats menstrual pain as a clue that points to a cause. Suppressive medications, such as birth control pills, can reduce the pain. They do not remove endometriosis. NSAIDs, a class of pain relievers, are the usual first choice for menstrual pain.1 Pain that is severe or recurrent calls for a closer evaluation. Clinicians may use cycle charting (Creighton Model FertilityCare System, FEMM), a pelvic ultrasound, or laparoscopy to find the cause. When surgery finds endometriosis, excision removes the diseased tissue itself. Its removal can ease menstrual pain that has lasted for years.
Cited in this entry
- Iacovides S, Avidon I, Baker FC. What we know about primary dysmenorrhea today: a critical review. Human Reproduction Update. 2015. https://pubmed.ncbi.nlm.nih.gov/26346058/
- Osayande AS, Mehulic S. Diagnosis and initial management of dysmenorrhea. American Family Physician. 2014. https://pubmed.ncbi.nlm.nih.gov/24695505/
- Rohan P, Common M, Ryan J, Mulholland D, O'Shea A. Multimodality imaging findings in secondary dysmenorrhea. Clinical Radiology. 2025. https://pubmed.ncbi.nlm.nih.gov/40347829/
This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.
