Dysmenorrhea is the medical term for painful periods or menstrual cramps. The majority of women are thought to experience some degree of dysmenorrhea. Dysmenorrhea is either primary or secondary. In cases of primary dysmenorrhea, no disease or other medical cause can be found for the pain and other symptoms, which may include backache, diarrhea, dizziness, headache, nausea, vomiting, and a feeling of tenseness. Primary dysmenorrhea frequently affects women in their teens and early 20s, who have never had a baby.

The symptoms are caused by prostaglandin, a natural hormone produced by cells in the uterine lining. The level of prostaglandin increases in the second half of the menstrual cycle. When a woman’s period begins, the cells in the uterine lining release prostaglandin as they are shed. Women with severe primary dysmenorrhea have significantly higher prostaglandin levels in their menstrual fluid than do other women. Usually the symptoms do not last very long - one or two days, but rarely longer.

Secondary dysmenorrhea is caused by a variety of uterine conditions. Women who suffer from it tend to be older than those with primary dysmenorrhea. Endometriosis and fibroids should be investigated as possible causes.

On physical exam and/or ultrasound, if everything is normal, the doctor might recommend prostaglandin-inhibiting medications such as aspirin, ibuprofen, or naproxen. The birth-control pill is sometimes recommended, as it stops ovulation and decreases prostaglandin levels.

In secondary dysmenorrhea, dilation and curettage (D&C) may be recommended to open the cervix and remove tissue for microscopic testing. Once the reason for your secondary dysmenorrhea has been found, your doctor will be able to discuss an appropriate treatment with you. You might also be advised to use prostaglandin-inhibiting drugs or the birth-control pill to relieve symptoms.