by Shannon DW
(Dysmenorrhea; Menstrual Cramps)


Dysmenorrhea is a painful menstrual period. Pain may be in the pelvis, belly, back, or legs. It could also be cramps in the belly, a headache, or feeling tired. This pain is bad enough to make it hard to get through the day.

There are 2 types of dysmenorrhea:

  • Primary—caused by uterine muscle contractions
  • Secondary—caused an underlying condition, such as endometriosis
Menstrual Flow
Copyright © 2002 Nucleus Communications, Inc. All rights reserved.


Primary dysmenorrhea is caused by high levels of a hormone called prostaglandins.

Secondary dysmenorrhea is caused by a health issue such as:

Risk Factors

Painful menstrual periods are more common in people under 30 years of age. They may also be more common in people who:

  • Have low body weight, especially as a teen
  • Smoke
  • Started their menstrual periods before 12 years of age
  • Have longer menstrual cycles or heavy bleeding during periods
  • Have not delivered a baby
  • Have depression, anxiety, or other mental health issues


The pain may be sharp and throbbing, or dull and aching. It often starts in the lower belly and may spread to the low back or thighs. A person may also have:

  • Nausea
  • Vomiting
  • Diarrhea
  • Headache
  • Irritability


The doctor will ask about symptoms and past health. A pelvic exam will be done. Other tests may be done to look for causes. Tests may be:


Medicine and home care can help manage primary dysmenorrhea. Treatment for secondary dysmenorrhea will focus on the health issue causing the problem.

Over the counter medicines such as ibuprofen and naproxen can help.

The doctor may advise birth control pills for some. They may help balance hormones.

Other ways to ease discomfort include:

  • Heat therapy—such as heating pads, warm baths, or low-level heat patches
  • Regular exercise
  • Alternative treatments—such as herbs, supplements, acupuncture, and yoga


Things that may reduce the risk of some painful menstrual periods are:

  • Exercising regularly
  • Not smoking.
  • Limiting caffeine and alcohol


American Congress of Obstetricians and Gynecologists 

Family Doctor—American Academy of Family Physicians 


Society of Obstetricians and Gynaecologists of Canada 

Women's Health Matters 


Dysmenorrhea. EBSCO DynaMed website. Available at: Accessed April 19, 2022.

Dysmenorrhea: symptoms. Family Doctor—American Academy of Family Physicians website. Available at: Accessed April 19, 2022.

Menstrual cycle problems. Family Doctor—American Academy of Family Physicians website. Available at: Accessed April 19, 2022.

Pelvic inflammatory disease (PID): CDC fact sheet. Centers for Disease Control and Prevention website. Available at: Accessed April 19, 2022.

Revision Information