Dysmenorrhea Specialist

Maiden Lane Medical

Multi-Specialty Group Practice located New York, NY

As leading gynecologists in the greater New York City area, Maiden Lane Medical offers women the most advanced treatments for dysmenorrhea to find relief from symptoms of pain and irregular bleeding and reduce their chances of pregnancy complications.

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“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.

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What causes dysmenorrhea?

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
Young asian woman seated on her couch holding her abdomen in pain. - Maiden Lane Medical | New York, NY

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.

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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 contraception like 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 cramps are unbearable or disrupt your day-to-day life, make an appointment with your trusted gynecologist at Maiden Lane Medical. Severe pain and other disruptive symptoms aren’t normal and shouldn’t be ignored. 

Many reproductive health issues can cause dysmenorrhea, and having an exam and diagnostic tests is the first step in getting the treatment you need to relieve your pain and restore your quality of life. 

Medically Reviewed By

Rachel Barr, MD
Board Certified Gynecologist

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Our doctors who provide this service

Marina Arutyunyan Board Certified Gynecologist, NY

Marina Arutyunyan DO, MPH

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Rachel Barr, MD

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Emily Blanton, MD

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Janette Davison, MD

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Armina Eana, DO MPH

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Dena Harris, MD

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Annie Kim, MD

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Kenneth A. Levey, MD MPH FACOG FACS

Board Certified Gynecologist & CEO and Managing Partner of Maiden Lane Medical

Focused Practice Designation in Minimally Invasive Gynecologic Surgery