Children's Hospital Colorado

Dysmenorrhea in Teenagers

What is dysmenorrhea?

Dysmenorrhea is the medical term used to describe painful periods and cramps that teens may have before or during their menstrual period. This pain may be severe enough to interfere with daily life, for example, causing the teen to miss school because of the pain.

  • As many as one in four teens have severe pain (or dysmenorrhea) with their periods.
  • For some girls and teens, painful periods can be very embarrassing to talk about with parents, teachers, coaches and even a doctor/ nurse. Being embarrassed can make girls and teens less likely to ask for help.
  • Dysmenorrhea is one of the most common reasons that girls and teens miss school.
  • For many women, dysmenorrhea gets better with age.

What causes dysmenorrhea?

The uterus is an organ inside a woman's body. It has a lining inside it called the endometrium, which grows thicker in response to certain hormones that are made after a woman has started to have her period.

When the uterine lining sheds or bleeds, the uterine muscles squeeze. For women who have dysmenorrhea, the squeezing of the uterus causes pain. For women without dysmenorrhea, they may have menstrual bleeding without any cramps or pain.

Who gets dysmenorrhea?

Not all women experience dysmenorrhea. The reason why some teens and women experience dysmenorrhea is unknown.

What are the signs and symptoms of dysmenorrhea?

Discomfort and pain that occurs during the menstrual period is the main symptom of dysmenorrhea.

  • The pain may be described as dull, burning, throbbing or sharp.
  • The pain is most often in the lower abdomen and pelvic area on the center, right or left sides. Sometimes, women experience pain in the lower back and thighs.
  • The pain usually happens when there is menstrual bleeding, but there can also be pain at other times.
  • Along with the pain, nausea (upset stomach), vomiting (throwing up), diarrhea, constipation, feeling very tired, dizziness or fainting may also be present.

How is dysmenorrhea diagnosed?

A diagnosis is made after establishing a history of pain that interferes with daily life. An internal (or pelvic) exam is not needed to diagnose dysmenorrhea.

There are other disorders that can cause painful periods, such as endometriosis, adenomyosis and fibroids. However, these are not common in girls and teens. Testing for one of these disorders is not done unless treatment for dysmenorrhea is not helping.

How is dysmenorrhea treated?

The first step in treating painful periods is to consider what changes can be made that may prevent or reduce the pain from occurring, such as:

  • Eat nutritious, healthy foods including fruits, veggies, protein and complex carbs (such as whole wheat breads and grains).
  • Stop eating or limit fast foods and sugary drinks (such as soda, juices, energy drinks and sweet teas).
  • Exercise at least 60 minutes each day. This is the goal.
  • Sleep enough: 8 hours each night is the goal, and catch up when needed.
  • Learn relaxation techniques and ways to handle stress.
  • Get help for depression and anxiety (worry), if needed.

Reducing pain and cramps associated with dysmenorrhea

  • Use a heating pad on the lower abdomen (belly) or over the area causing pain.
  • Take a warm bath or shower.
  • If it is safe for you to take, use an over-the-counter anti-inflammatory pain medication, such as ibuprofen. This medication can be taken every 6 to 8 hours on the days you have cramps. It works best when it is used right away instead of waiting until the pain becomes intense.
  • Keep track of bleeding days and days that cramps/pain are a problem. Notice what makes it better or worse (if anything).

When is hormonal therapy recommended?

If teens have tried the suggestions above, but the pain is still interfering with their daily life, then hormonal therapy may be recommended. These medications are safe for girls and teens to use, and they work very well. Some types of hormonal therapy are:

  • Low dose birth control pills, patch or ring; these are often prescribed in a certain way to reduce or stop menstrual bleeding and pain
  • Medroxyprogesterone acetate (Depo-Provera)
  • The levonorgestrel IUD (Mirena, Skyla) (intrauterine device)
  • The subdermal implant (Nexplanon)

While these drugs are packaged as "birth control," they are being recommended for their effects on menstrual pain. This means they lower or stop bleeding and pain, and can be used to make periods regular. They can also help with other problems like acne, premenstrual mood changes or headaches. 

Why choose Children's Hospital Colorado for your child's dysmenorrhea?

At Children's Colorado, we provide expert care for the diagnosis, treatment and management of health issues of the female reproductive organs in children and teens.

Our board-certified pediatric and adolescent gynecologists have specialized training in the reproductive health concerns of girls of all ages. And depending on your child/teen's needs and treatment plan, we provide both outpatient and inpatient surgical services.

Compassionate care for sensitive issues

Doctors at Children's Colorado understand that female health issues of reproductive organs can be stressful to address, which is why we're extra-sensitive to the mental and emotional needs of our patients and their families. We create a friendly environment for dialogue and encourage our patients to ask questions and talk openly with their care team.