Dysmenorrhea |Overview
What is dysmenorrhea?
The pain associated withmenstrual crampingis called dysmenorrhea. There are two types of dysmenorrhea, primary and secondary:
- Primary dysmenorrhea is menstrual cramping that happens before or during a monthly period. The pain is usually mild, but can be severe for some teen girls and women.
- Secondary dysmenorrhea is cramping pain that develops because of some other condition, such asendometriosisorovarian tumors.
十几岁的女孩或女人可以开发痛经,but factors that may predispose her include:
- smoking
- alcohol(alcohol tends to prolong menstrual pain)
- beingoverweight
- starting menstruation before age 11
What are menstrual cramps?
Menstrual cramping is dull, throbbing, or squeezing pains in the lower abdomen before or during menstruation. For one girl, these aches may be mild and no cause for concern. For another, the discomfort may be so severe she has to stay home from work or school.
What are the symptoms of dysmenorrhea?
Every teen girl and woman experiences dysmenorrhea differently. Some common symptoms include:
- dull, throbbing, or cramping pain in her lower abdomen
- pain that radiates to her lower back and thighs
- nausea and vomiting
- loose stools
- sweating
- dizziness
- headaches
What causes dysmenorrhea?
Primary dysmenorrhea happens before or during a monthly period. During menstruation, a hormone called prostaglandin causes the blood vessels and muscles of the uterus to contract and shed its lining. The level of prostaglandin is highest on the first day of menstruation and decreases as the lining is shed. This is why period pain lessens over time. Period pain may improve with age or after giving birth. Some teen girls and young women experience more severe pain during menstruation.
Secondary amenorrhea is caused by other conditions such as:
- endometriosis
- pelvic inflammatory disease (PID)
- uterine fibroids
- abnormal pregnancy (i.e., miscarriage, ectopic)
- infection, tumors, or other growths in the pelvic cavity
- cervical stenosis
How is dysmenorrhea diagnosed?
When you or your daughter suspects dysmenorrhea, a healthcare provider will take a complete medical history. Dysmenorrhea can often be diagnosed without a pelvic examination. Diagnostic tests for dysmenorrhea include:
- ultrasound
- magnetic resonance imaging (MRI)
- laparoscopy, a minor surgical procedure in which a physician looks inside the pelvic cavity with a small camera
What is the treatment for dysmenorrhea?
Medications are often used to treat period pain associated with primary dysmenorrhea. Certain medications reduce prostaglandin and can lessen their effects. These pain relievers are called nonsteroidal anti-inflammatory medications, or NSAIDs, and can reduce the pain associated with menstruation. Women with certain conditions cannot take NSAIDs and should speak with their health care provider to find the best pain reliever.
Many hormonal treatments make periods lighter and less painful or suppress periods completely. Most of these hormonal treatments are birth control methods and include both estrogen and progesterone, or only progesterone. Birth control pills, the patch, or the vaginal ring may be used to treat primary dysmenorrhea. The intrauterine device (IUD) is another type of hormonal birth control that may lessen menstrual bleeding and for some women, may stop bleeding completely.
Other ways of managing menstrual pain include:
- acupuncture or acupressure
- nerve-stimulation therapies
- physical therapy
- relaxation exercises, such as meditation or yoga
- biofeedback
- aerobic exercise
- heat applied to the abdomen
- getting enough sleep
Treatment of secondary dysmenorrhea varies by condition but birth control methods and pain relievers such as NSAIDs may be recommended.
Patient resources
How we care for dysmenorrhea
At theDivision of GynecologyandReproductive Endocrinology and Polycystic Ovary Syndrome (PCOS) Programat Boston Children's Hospital, we understand the seriousness of severe menstrual cramps. Our experienced physicians will work with your daughter to provide an accurate diagnosis and treatment of the problem underlying her dysmenorrhea.
TheCenter for Young Women's Healthprovides extensive and easy to access information for girls with questions about their menstrual cycles.
Dysmenorrhea |Programs & Services
Departments
Adolescent/Young Adult Medicine
Department
The team in the Division of Adolescent and Young Adult Medicine provides medical, gynecological, nutritional, and psychological care and counseling.
Gynecology
Department
Boston Children's Hospital - Division of Gynecology
Programs
Reproductive Endocrinology and PCOS Program
Program
The Boston Children's Hospital Reproductive Endocrinology and Polycystic Ovary Syndrome (PCOS) Program provides care to adolescents and young adults with disorders of puberty, abnormal menstrual periods, polycystic ovary syndrome (PCOS), ovarian insufficiency, breast disorders, hormonal acne and hair growth, and bone health concerns.
Learn more about Reproductive Endocrinology and PCOS Program
Long-acting Reversible Contraception Program
Program
Learn more about Long-acting Reversible Contraception Program