Menstrual cramps (dysmenorrhea) are severe, painful cramps that occur with menstruation. There are 2 types:
- Primary dysmenorrhea. This starts soon after a girl gets her first menstrual period. It's usually lifelong. But it may get better over time.
- Secondary dysmenorrhea. This type is caused by another health problem, such as a growth or infection. It usually starts later.
Primary dysmenorrhea is caused by abnormal tightening of the muscles of the uterus (contractions). This is from changing hormone levels. The hormone prostaglandin controls the contractions of the uterus.
Secondary dysmenorrhea is often caused by endometriosis. This is when tissue that forms the inside lining of the uterus also grows outside the uterus. It can grow on other organs inside the pelvis or belly (abdomen). This can also cause internal bleeding, infection, and pelvic pain.
Other causes of secondary dysmenorrhea can include:
- Infection of the reproductive organs (pelvic inflammatory disease)
- Noncancer (benign) growths in the uterus (uterine fibroids)
- Fertilized egg that implants outside the uterus (ectopic pregnancy)
- Pregnancy loss (miscarriage)
- Other infection in the pelvis
- Growths in the pelvis such as tumors or polyps
A girl is more at risk for menstrual cramps if she has:
- Her first period at an early age
- Long or heavy periods
- A family history of dysmenorrhea
Smoking also increases the risk.
Symptoms can occur a bit differently in each teen. The most common symptoms include:
- Cramping and pain in the lower abdomen
- Low back pain
- Pain spreading down the legs
Other symptoms can include:
Symptoms of primary dysmenorrhea occur just before menstrual bleeding starts each month. The pain can last for 1 to 2 days or more. It then lessens at the end of the period.
Symptoms of secondary dysmenorrhea can start several days before menstrual bleeding starts. The pain may get worse and last for days, weeks, or longer.
The symptoms of dysmenorrhea can be like other health conditions. Make sure your child sees her healthcare provider for a diagnosis.
The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask about your family’s health history. The provider will give your teen a physical exam. The physical exam may include a pelvic exam. Your daughter may also have tests, such as:
- Ultrasound. This painless test uses sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function. They also assess blood flow through various vessels.
- Laparoscopy. This procedure uses a thin tube with a lens and a light (laparoscope). The scope is inserted into a small cut (incision) in the abdominal wall. The healthcare provider can see abnormal growths in the pelvis and abdomen.
- Hysteroscopy. This is an exam of the cervix and inside of the uterus. The exam is done with a viewing tool (hysteroscope) inserted through the vagina.
Treatment will depend on your teen’s symptoms, age, and general health. It will also depend on how severe the condition is. Treatment options include:
- Pain medicines that block prostaglandins, such as aspirin or ibuprofen
- Birth control pills (oral contraceptives)
- IUD with progesterone
- Good diet
- Enough sleep
- Regular exercise
- Heating pad across the lower abdomen
- Hot bath or shower
- Transcutaneous electrical nerve stimulation (TENS)
- Abdominal massage
- Relaxation methods
Talk with your teen’s healthcare providers about the risks, benefits, and possible side effects of all treatments.
Possible complications include missed school or work because of severe pain. Dysmenorrhea can be caused by a condition such as endometriosis. If left untreated, this may have an impact on your teen’s future ability to become pregnant.
Painful periods can be difficult to cope with every month. You can help by making sure your teen has the tools to treat pain symptoms quickly. Your child may also need emotional support during painful days.
Call the healthcare provider if your child has:
- Symptoms that don’t get better, or get worse
- New symptoms
- Dysmenorrhea is severe, painful cramping that occurs with menstruation.
- Primary dysmenorrhea starts soon after a girl gets her first menstrual period. It's usually lifelong. But it may get better over time. It is caused by abnormal tightening of the muscles of the uterus (contractions). This is due to changing hormone levels.
- Secondary dysmenorrhea is caused by another health problem, such as a growth or infection. It is often caused by endometriosis.
- Your teen may be diagnosed with ultrasound, laparoscopy, or hysteroscopy.
- There are many treatment options. They include pain medicines, hormone treatment, heating pad, surgery, and other methods.
- Painful periods can be difficult to cope with every month. You can help by making sure your teen has the tools to treat pain symptoms quickly. Your child may also need emotional support during painful days.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.
December 04, 2017
Primary dysmenorrhea in adolescents. UpToDate., Endometriosis in adolescents: Diagnosis and treatment. UpToDate.
Burd, Irina, MD, PhD,Freeborn, Donna, PhD, CNM, FNP,Cunningham, Louise, RN