Dysmenorrhea

Dysmenorrhea
Other names	Dysmenorrhoea, period pain, painful periods, menstrual cramps
Menstrual cycle and changes in hormone production
Specialty	Gynecology
Symptoms	Pain during first few days of menstruation, diarrhea, nausea[1][2]
Usual onset	Within a year of the first menstrual period[1]
Duration	Less than 5 days (primary dysmenorrhea)[1]
Causes	No underlying problem, uterine fibroids, adenomyosis, endometriosis[3]
Diagnostic method	Pelvic exam, ultrasound[1]
Differential diagnosis	Ectopic pregnancy, pelvic inflammatory disease, interstitial cystitis, chronic pelvic pain[1]
Treatment	Heating pad, medication[3]
Medication	NSAIDs such as ibuprofen, hormonal birth control, IUD with progestogen[1][3]
Prognosis	Often improves with age[2]
Frequency	50–90% female adolescents and women of reproductive age[4]

Dysmenorrhea, also known as period pain, painful periods or menstrual cramps, is pain during menstruation.^[4][5][2] Its usual onset occurs around the time that menstruation begins.^[1] Symptoms typically last less than three days.^[1] The pain is usually in the pelvis or lower abdomen.^[1] Other symptoms may include back pain, diarrhea or nausea.^[1]

Dysmenorrhea can occur without an underlying problem.^[3][6] Underlying issues that can cause dysmenorrhea include uterine fibroids, adenomyosis, and most commonly, endometriosis.^[3] It is more common among those with heavy periods, irregular periods, those whose periods started before twelve years of age and those who have a low body weight.^[1] A pelvic exam and ultrasound in individuals who are sexually active may be useful for diagnosis.^[1] Conditions that should be ruled out include ectopic pregnancy, pelvic inflammatory disease, interstitial cystitis and chronic pelvic pain.^[1]

Dysmenorrhea occurs less often in those who exercise regularly and those who have children early in life.^[1] Treatment may include the use of a heating pad.^[3] Medications that may help include NSAIDs such as ibuprofen, hormonal birth control and the IUD with progestogen.^[1][3] Taking vitamin B1 or magnesium may help.^[2] Evidence for yoga, acupuncture and massage is insufficient.^[1] Surgery may be useful if certain underlying problems are present.^[2]

Estimates of the percentage of female adolescents, and women of reproductive age affected are between 50% and 90%.^[4][6] It is the most common menstrual disorder.^[2] Typically, it starts within a year of the first menstrual period.^[1] When there is no underlying cause, often the pain improves with age or following having a child.^[2]