Symptom Information: Painful Periods / Dysmenorrhea

Symptom:

Painful periods (Other names: dysmenorrhea, dysmenorrhoea)

General Description:

Most women will experience some degree of pain during their regular menstrual periods.This is normal and should be expected.  The womb (uterus) is a large muscle and contracts continually but these are mild contractions and not usually felt.  Around the time of the period (menstruation) the contractions become stronger as the blood supply is temporarily cut off during the contractions and this is what causes the pain.  The purpose of the contractions is to enable the womb to shed its lining each month and this is lost as a bleed (menstrual period). This is an essential part of female fertility and the period pain caused by it is a side effect. Occasionally, in some women, the period pain can be extremely intense and the cause should investigated so that treatment can be determined or self-help mechanisms put in place.

Causes:

If you have experienced severe painful periods (dysmenorrhea) since you began menstruating, then it is unlikely that a cause will be found and it may be just a part of your normal fertility cycle.  There are certain things, like stress, which can aggravate the condition. You should speak with your doctor as this could be primary dysmenorrhea and they will be able to recommend lifestyle changes such as swimming or gentle exercise, using medication if necessary, or a trial of a TENS (transcutaneous electronic nerve stimulation) machine to ease the pain.

More serious causes of painful periods (also termed secondary dysmenorrhea) include:

• Endometriosis – this is caused by the cells lining the womb growing in the fallopian tubes or ovaries.  When these cells shed and fall away they cause intense pain.

• Uterine fibroids – non-cancerous tumors grow in the womb and can cause heavy and painful periods.

• Pelvic inflammatory disease – the womb, fallopian tubes and ovaries become infected with a bacteria which leads to inflammation.  Other symptoms include fever and vaginal discharge.

• Adenomyosis – tissue lining the womb starts to grow within the muscular wall of the womb.  This extra tissue causes painful periods.

• Intrauterine device (IUD) – An IUD is a form of contraception, if you have had an IUD recently fitted then this can cause some pain in the first three months.

Period pain is rarely a sign of disease but, as a general rule, you should consult with your doctor if the pain interferes with your life and prevents you from working, or carrying out your normal daily tasks. Also, if you experience any unusual vaginal discharge or pain as a result of sexual intercourse.

Isabel symptom checker showing possible causes of the symptom painful periods

How you can help your doctor:

Before your consultation with you doctor, think about the following questions they may ask you.

• Describe your period pain.
• Do you get pain only around the time of your monthly period or does the pain occur at other times.  If so, how frequently?
• Does anything relieve the pain you experience?
• Do you have any other symptoms like fever, vaginal discharge or pain after sexual intercourse?
• Have you recently had an intrauterine device fitted?

You should call you doctor right away if you experience any of the following symptoms:

• Increased or foul-smelling vaginal discharge
• Fever and pelvic pain
• Sudden severe pain especially if your period is more than a week late and you have been sexually active since your last period.
• You pass blood clots or have other symptoms in addition to the pain

You should also make contact with you doctor if you have any of these longer term problems:

• You have experienced pain with your period for three monthly cycles and the treatments do not control the pain.
• You have pain and had an IUD fitted longer than three months ago.
• Your pain occurs at other times besides during your monthly menstrual period.