Dysmenorrhea

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. Some 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 occur.

How do we diagnose dysmenorrhea?

We can make a diagnosis after establishing a history of pain related to your or your child’s menstrual cycle. An internal (or pelvic) exam is usually not needed to diagnose dysmenorrhea.

There are other disorders that can cause painful periods, such as endometriosis, adenomyosis and fibroids. However, these are not very common. We usually don’t test for these disorders unless we find that the treatment for dysmenorrhea is not helping.

How do we treat dysmenorrhea?

For some teens, painful periods can be embarrassing to talk about with parents, teachers, coaches and even doctors or nurses. This can make those experiencing dysmenorrhea less likely to ask for help. However, once your doctor knows about the condition, they can provide effective treatment that can be very helpful.

The first step in treating painful periods is to consider what changes you can make that may prevent or reduce pain from occurring. These changes can include:

• Eating nutritious, healthy foods including fruits, veggies, protein and complex carbs (such as whole wheat breads and grains)
• Stop eating or limiting fast foods and sugary drinks (such as soda, juices, energy drinks and sweet teas)
• Exercising every day
• Sleeping enough: 8 hours each night is the goal, and catch up when needed
• Learning relaxation techniques and ways to handle stress
• Getting help for depression and anxiety if needed

Ways to reduce pain and cramps associated with dysmenorrhea:

• Use a heating pad on the lower abdomen 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 works best when used right away instead of waiting until the pain becomes intense.
• Keep track of bleeding days and days that cramps or pain are a problem. Learn what makes it better or worse (if anything).

When do we recommend hormonal therapy?

If you or your child has already tried the suggestions above and the pain is still interfering with daily life, we may recommend hormonal therapy. These medications are safe to use and effective. Some types of hormonal therapy include:

• 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 usually packaged as "birth control," doctors can use them for menstrual pain. This means they lower or stop bleeding and pain and can help make periods more regular. They can also help with other problems like acne, premenstrual mood changes or headaches. 

Why choose Children's Hospital Colorado to treat 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, teens and young adults.

Our board-certified gynecologists have specialized training in the reproductive health concerns of people of all ages. And depending on your or your child’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 reproductive health issues can be stressful to address, which is why we're very 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.