Dysmenorrhea: When Periods are Painful

No one really knows what causes menstrual pain, also called dysmenorrhea.

 

One theory is that menstrual cramps are caused when hormone-like prostaglandins are secreted and stimulate strong muscle contractions in the uterus. However, this theory has not been proven. Caffeine appears to increase menstrual pain as well as PMS symptoms, and different types of stress may also make it worse.

 

About half of all menstruating women suffer from this condition, characterized by a dull or throbbing ache in the area of the uterus. Sometimes a woman may also experience a headache, nausea or lower back pain.

 

Cramping that goes away after a few days and is not related to other physical problems is called primary dysmenorrhea, which typically begins within a year or two of menarche. When cramps are intense and due to an underlying abnormality, they're called secondary dysmenorrhea, which can occur years after a woman has begun to menstruate.

 

Vomiting, diarrhea, sweating or dizziness may accompany primary or secondary dysmenorrhea. In fact, it can feel just like the flu!

 

Seeing a doctor is important if menstrual pain is so severe that it interferes with a woman's normal activities.

A doctor can determine possible underlying problems, such as endometriosis, which occurs when tissue that normally grows inside the uterus (endometrium), grows outside of it instead. Just like the cells in the uterus, these pieces of tissue respond to hormone fluctuations and bleed during the menses. The internal bleeding, tissue inflammation and eventual scarring cause the pelvic pain associated with endometriosis.

 

Other causes of secondary dysmenorrhea are a tilted uterus, unusually tight cervical opening, fibroids and pelvic inflammatory disease (PID).