
Dysmenorrhea or menstrual cramps occur when the uterus contracts strongly during menstruation. The contraction of the uterus aids to expel its lining (endometrium) and clots out through the vaginal opening. Prostaglandin is the chemical responsible for the contraction of the uterus. The higher the prostaglandins, the higher are the contractions. The uterus contracts throughout the menstrual cycle; however, the maximum contraction occurs during menstruation. Dysmenorrhea may be primary or secondary. Primary dysmenorrhea is due to chemicals called prostaglandins secreted during normal periods. These activate the body’s pain pathways.
Other causes of dysmenorrhea are disorder of the organs of reproduction. This is called secondary dysmenorrhea:
- Endometriosis: The endometrium gets implanted outside your uterus, most commonly on your fallopian tubes, ovaries, or the tissue lining your pelvis.
- Uterine fibroids: These noncancerous tumors in the wall of the uterus can cause pain.
- Adenomyosis: The endometrium begins to grow into the muscular walls of the uterus.
- Pelvic inflammatory disease: This refers to the infection of the female reproductive organs.
- Cervical stenosis: In some women, the cervical opening is small enough to obstruct menstrual flow, causing a painful increase in pressure within the uterus.
- Abnormal pregnancy
- Infections, tumors, or polyps in the pelvic cavity
What is dysmenorrhea?
Dysmenorrhea refers to the pain and cramps that women experience during menstruation. More than half of the women experience some pain for 1-2 days during their menses. However, for some women, the pain is so severe that it interferes with their normal activities for several days a month. There are two types of dysmenorrhea:
- Primary dysmenorrhea: This occurs during your menarche (first start of your period) and continues throughout your life. It may cause severe and frequent menstrual pain due to abnormal or severe uterine contractions.
- Secondary dysmenorrhea: It starts later in life and is caused due to any underlying medical conditions such as pelvic inflammatory disease or endometriosis.
What are the symptoms of dysmenorrhea?
Symptoms may vary among women. However, the most common symptoms noted include:
- Cramping in the lower abdomen
- Feeling of pressure in the abdomen
- Pain in the lower abdomen
- Low back pain
- Pain radiating down the legs
- Nausea
- Vomiting
- Loose stools
- Fatigue
- Weakness
- Fainting
- Headaches
See your doctor if you have
- Menstrual cramps disrupt your life every month.
- Progressively worsening symptoms.
- Severe menstrual cramps after the age of 25 years.
How can you relieve mild dysmenorrhea?
To ease mild or moderate menstrual cramps
- Place a heating pad or hot water bottle on your lower back or abdomen.
- Take ibuprofen as soon as bleeding or cramping starts.
- Rest when needed.
- Avoid caffeine.
- Avoid smoking and drinking alcohol.
- Massage your lower back and abdomen.
- Exercise regularly.
Your doctor may also recommend
- Hormonal birth control.
- Surgery in case of secondary dysmenorrhea.

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