Dysmenorrhea Specialist

Q: What is dysmenorrhea?

Painful menstruation is termed dysmenorrhea. It is a common issue for women in their reproductive years and can range from mild pelvic cramping to severe pain interfering with daily activities such as school or work. The pain is usually sharp intermittent cramping in the midline of the pelvis starting around the start of a period typically lasting 1-3 days. There may also be associated symptoms of nausea, vomiting, diarrhea, headache, and backache.

Are you tired of enduring the discomfort and disruption caused by frequent menstrual cramps? Do pelvic pain and distress during your menstrual cycle often interfere with your daily activities?

At Maiden Lane Medical, we understand that dysmenorrhea, commonly known as menstrual cramps, can be a significant hindrance to your well-being. That’s why we have a team of dedicated specialists ready to provide expert care and relief from these troublesome symptoms.

Book a consultation with our experienced dysmenorrhea specialists at Maiden Lane Medical today. Our compassionate team will conduct a thorough evaluation of your symptoms, medical history, and lifestyle to create a personalized treatment plan that suits your needs.

“My doctor was very pleasant and easy to talk to. She was extremely knowledgeable and addressed all my issues and concerns. Very positive experience!”

Janice A.

What is Dysmenorrhea?

Dysmenorrhea is the clinical term for painful menstruation.

It is a common issue for women in their reproductive years and can range from mild pelvic cramping to severe pain interfering with daily activities such as school or work.

The pain is usually sharp, intermittent cramping in the midline of the pelvis starting around the start of a period, typically lasting 1-3 days.

There may also be associated symptoms of nausea, vomiting, diarrhea, headache, and backache.

Primary Dysmenorrhea

Primary dysmenorrhea is the pain and cramping that accompanies a menstrual period. It can begin before or during the period.

Primary dysmenorrhea is caused by prostaglandins — chemicals made in the lining of the uterus.

These chemicals cause contractions in the muscles and blood vessels in your uterus. Usually, prostaglandins are highest on the first day of a period, and the levels decline as the uterine lining is shed.

Secondary Dysmenorrhea

Secondary dysmenorrhea is menstrual pain caused by an abnormality in your reproductive organs.

Instead of declining as your period nears its end, the pain may worsen and often lasts longer than regular menstrual cramping.

For example, some women begin to have pain before their period starts, continuing after the period ends.

Period Pain

Period pain affects many women, and it can be severe. The pain is most often menstrual cramps. Learn about the causes of menstrual cramps, what you can do to feel better, and when you need to see a doctor.

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What Causes Dysmenorrhea?

Dysmenorrhea can be caused by various factors, with uterine fibroids, abnormal pregnancy, and ovarian cysts being significant contributors.

Primary dysmenorrhea occurs during menstruation when the inner lining of the uterus or endometrium is shed.

At this time, it releases hormones called prostaglandins. These prostaglandins induce painful uterine contractions.

Secondary dysmenorrhea occurs when painful menstrual cramps are due to another physical issue outside of menstruation, such as the following:

Endometriosis: implants of uterine lining cells outside of the uterus in the pelvis & abdomen
Fibroids: benign muscular tumors of the uterus.
Adenomyosis: gland growth within the walls of the uterus
Ovarian cysts: A variety of solid or fluid-filled masses on the ovary
Pelvic inflammatory disease (PID): sexually transmitted infection that has spread to the uterus, ovaries, fallopian tubes, inner pelvis, and abdomen
Uterine malformations: structural abnormalities from birth, such as a narrowing or blockage where the cervix opens into the vagina

What Does Dysmenorrhea Feel Like?

Many women experience mild dysmenorrhea before or during their periods. It might feel like cramping or a dull ache in the lower abdomen.

Some women experience higher fatigue levels, and some have nausea, vomiting, or diarrhea.

Secondary dysmenorrhea causes moderate to severe pain in your lower abdomen, abdominal pressure, or pain in your lower back, hips, and thighs.

When Should I See a Doctor for Dysmenorrhea?

While mild discomfort and cramping are expected before and during a period, your symptoms shouldn’t disrupt your life.

For example, if your pain and other symptoms are so severe that you can’t go to work or school, you should talk to your trusted gynecologist at Maiden Lane Medical.

Additionally, if your menstrual symptoms last longer than two or three days or become more severe instead of subsiding, you should make an appointment to find out what’s causing your pain and get the treatment you need.

What Will a Gynecologist Do for Painful Periods?

Your gynecologist can determine the root cause of your painful periods and identify the best treatment to relieve your symptoms. Your doctor has many diagnostic tools and can run various tests to start your treatment plan.

How is Dysmenorrhea Diagnosed?

The evaluation for dysmenorrhea is centered on ruling out the causes of secondary dysmenorrhea. Primary dysmenorrhea does not involve any changes in exams, labs, or imaging.

History: Diagnosis starts with a careful history of the location, type, duration, timing, and severity of the pain, as well as associated symptoms.
Physical exam: Secondary dysmenorrhea may include abnormal tenderness at the cervix or ovaries in cases of infection. Gynecologists also feel for areas of thickening, enlargement, or irregularly shaped structures at the ovaries or uterus.
Laboratory work: Blood work and urinalysis may reflect signs of infection in cases of PID or hormonal abnormalities.
Imaging: Transvaginal pelvic sonogram or pelvic MRI is used to evaluate the anatomy of the abdomen and pelvis with a focus on the ovaries and uterus.

How is Dysmenorrhea Treated?

Primary dysmenorrhea is treated with over-the-counter nonsteroidal anti-inflammatory medications such as AdvilⓇ or MotrinⓇ.

In addition, a heating pad is often used to help ease pain symptoms. Contraception such as oral contraceptives, NuvaRingⓇ, or an intrauterine device (IUD) may also resolve heavy bleeding and cramping pain.

Secondary dysmenorrhea treatment depends on the exact cause. Oral or intravenous antibiotic treatment is used in cases of PID.

Medical and surgical options exist for endometriosis, fibroids, ovarian cysts, and adenomyosis.

Medical treatment is aimed at symptom control. Surgical options such as laparoscopy or robotic-assisted laparoscopy can be minimally invasive methods utilized to diagnose and treat the primary condition.

Bleeding Disorders in Women

A bleeding disorder is a health problem that makes it difficult for a person to stop bleeding. Bleeding disorders may affect 1 in 10 women with heavy periods and can cause other health problems if not treated.

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What is the Best Treatment for Adenomyosis?

Your gynecologist may suggest using over-the-counter NSAIDs to manage pain caused by adenomyosis.

They might also recommend a hormonal contraceptive such as birth control pills or a hormonal IUD like Mirena®.

In severe cases when non-invasive treatments aren’t successful, your gynecologist may suggest a hysterectomy.

What is the Best Treatment for Endometriosis?

If endometriosis is the root cause of your painful periods, your doctor creates a customized treatment plan to restore your health.

For example, they may recommend surgical treatment in combination with multiple additional therapeutic options such as physical therapy, medical management, (hormonal birth control pills or an IUD to regulate the hormones contributing to endometriosis), and other treatments for additional symptoms.

When hormonal contraception doesn’t relieve your pain, your gynecologist may suggest surgery in severe cases.

The team at Maiden Lane Medical are experts in excisional endometriosis surgery, which can remove the painful lesions and scar tissue while preserving your fertility.

Will I Need Surgery to Address Secondary Dysmenorrhea?

It is unlikely that you will need surgery to manage secondary dysmenorrhea causes like endometriosis, fibroids, or adenomyosis.

The gynecologists at Maiden Lane Medical only recommend surgery when less invasive treatment options aren’t effective.

They also discuss all of your options and answer your questions to help you decide on the best course of action to relieve your painful periods.

What Should I do if My Period Cramps are Unbearable?

If your period pain is unbearable or disrupts your day-to-day life, make an appointment with your trusted gynecologist at Maiden Lane Medical. Severe pain and other disruptive symptoms during menstrual periods aren’t normal and shouldn’t be ignored.

Medically Reviewed By

Rachel Barr, MD

Board Certified Gynecologist

Medically Reviewed By

David M. Kaufman, MD

Board Certified Urologist

Women's Health Specialists

Rachel Barr, MD

Emily Blanton, MD

Janette Davison, MD

Ilene Fischer, MD

Dena Harris, MD

Kenneth A. Levey, MD MPH FACOG FACS

Fernando Mariz, MD

Jordan Pavia, NP

Savita Sukha, WHNP

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If you’re concerned about fibroids or have symptoms that could be caused by these benign growths, call our office or schedule a consultation online for accurate diagnosis and personalized state-of-the-art treatment.