Painful Menstrual Periods
(Dysmenorrhea; Menstrual Cramps)
- Primary—painful regular menstrual cycles caused by uterine muscle contractions
- Secondary—painful periods due to an underlying condition, such as endometriosis
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- Low body weight, especially during adolescence
- Early onset of menstruation—younger than 12 years old
- Longer menstrual cycles
- Heavy bleeding during periods
- Never having delivered a baby
- Psychological disorders, such as depression or anxiety
When Should I Call My Doctor?
- Severe or unusual cramps
- Cramps that last for more than a few days
- Signs of infection, such as fever or chills
- Cramps with heavy menstrual bleeding
- Abdominal or pelvic tenderness
- Vaginal discharge other than menstrual bleeding
- Heat therapy, which may include heating pads, warm baths, or continuous low-level heat patches
- Regular exercise
- Alternative treatments, such as:
- Exercise regularly
- If you smoke, talk to your doctor about how you can quit
- Drink only moderate amounts of caffeine and alcohol
American Congress of Obstetricians and Gynecologists http://www.acog.org
Family Doctor—American Academy of Family Physicians http://familydoctor.org
Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org
Women's Health Matters http://www.womenshealthmatters.ca
Coco AS. Primary dysmenorrhea. Am Fam Physician. 1999;60:489-496.
Dysmenorrhea. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/disorders/dysmenorrhea/hic%5Fdysmenorrhea.aspx. Accessed August 25, 2014.
Dysmenorrhea. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 6, 2014. Accessed August 25, 2014.
Menstrual cycle problems. American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom/menstrual-cycle-problems.html. Accessed August 25, 2014.
Dysmenorrhea: symptoms. American Academy of Family Physicians' Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/dysmenorrhea.html. Updated April 2014. Accessed August 25, 2014.
French L. Dysmenorrhea. Am Fam Physician. 2005;71:285-291. Available at: http://www.aafp.org/afp/2005/0115/p285.html. Accessed August 25, 2014.
Pelvic inflammatory disease (PID): CDC fact sheet. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/pid/stdfact-pid.htm. Updated July 1, 2014. Accessed August 25, 2014.
9/30/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Witt CM, Reinhold T, Brinkhaus B, et al. Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care. Am J Obstet Gynecol. 2008;198:166.e1-8.
4/15/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Osayande AS, Mehulic S. Diagnosis and initial management of dysmenorrhea. Am Fam Physician. 2014;89(5):341-346.
6/18/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Kannan P, Claydon LS. Some physiotherapy treatments may relieve menstrual pain in women with primary dysmenorrhea: a systematic review. J Physiother. 2014;60(1):13-21.
- Reviewer: Andrea Chisholm, MD
- Review Date: 08/2014 -
- Update Date: 06/18/2014 -
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
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