Menstrual Pain (Dysmenorrhea): Concise Overview

     Menstrual pain, or dysmenorrhea, refers to lower abdominal cramps occurring just before or during menstruation. Typically lasting 2–3 days, the pain is often described as throbbing or cramping in the lower abdomen or pelvic region, and may radiate to the lower back or thighs. Severity varies and may be accompanied by symptoms such as nausea, diarrhea, headache, or fatigue.

Causes

Primary Dysmenorrhea

     Caused by uterine muscle contractions that expel the uterine lining during menstruation. Excessive contractions can compress nearby blood vessels, reducing oxygen supply and causing pain. The hormone prostaglandin, which increases uterine contractions, is a key contributor.

Secondary Dysmenorrhea

Associated with underlying reproductive health conditions, often in women over 25. Common causes include:

• Endometriosis/Chocolate cysts: Chronic pelvic pain, often >6 months, and may cause infertility.
• Uterine fibroids: Noncancerous growths in uterine muscles, prevalent in women over 30, potentially affecting fertility and causing heavy or prolonged periods.
• Pelvic inflammatory disease: Bacterial infection leading to pelvic pain, foul-smelling discharge, and menstrual discomfort.
• Cervical stenosis: Narrowing of the cervix impeding menstrual flow, increasing uterine pressure, and pain.
• Pelvic adhesions: Often from prior abdominal surgery.
• Other causes: Gastrointestinal or bladder disorders.

Unusual Menstrual Pain: Signs to Seek Medical Advice

• Pain occurring outside the menstrual period.
• Debilitating pain is interfering with daily activities.
• Pain radiating to legs, rectum, arms, shoulders, or back.
• Pain during intercourse, potentially indicating endometriosis.
• Severe gastrointestinal symptoms around menstruation.
• Pain causing vomiting, fainting, or dizziness.
• High fever during menstruation.
• Unilateral pelvic or back pain.
• Persistent back pain after menstruation.
• Need for regular pain injections.
• Pain intensity is increasing monthly.

Diagnosis

     Initial assessment includes medical history and physical examination. Further investigations may involve abdominal ultrasound, infection screening, or diagnostic laparoscopy if internal examination is not feasible.

Self-Care and Prevention

• Apply a warm compress to the lower abdomen or back.
• Take warm baths.
• Practice relaxation techniques (e.g., yoga, meditation).
• Use NSAIDs at the onset or before pain; reserve for severe cases.
• Ensure adequate rest.
• Exercise regularly.

When to See a Doctor

     If symptoms persist or worsen, consult a physician for an accurate diagnosis and appropriate treatment.

Last Updated:

August 18, 2022