Menstruation - dysmenorrhoea

Dysmenorrhoea means painful periods. Normal menstruation that happens to be painful is known as primary dysmenorrhoea. Period pain caused by certain reproductive disorders, such as endometriosis or fibroids, is known as secondary dysmenorrhoea.

In primary dysmenorrhoea, it is thought that the muscles of the uterus (womb) squeeze and contract harder than normal to dislodge the thickened lining (endometrium). These contractions might also reduce blood flow to the uterus, making the pain worse. Women of any age can experience painful periods and some women find periods are no longer painful after pregnancy and childbirth.

Symptoms

Symptoms of dysmenorrhoea can include:

• Pain low in the abdomen that can spread to the lower back and legs
• Pain that is gripping or experienced as a constant ache, or a combination of both
• Typically, the pain starts on or before the period starts
• The first 24 hours is the most painful
• Clots are passed in the menstrual blood.

Dysmenorrhoea can be associated with:

• Headache
• Nausea and vomiting
• Digestive problems, such as diarrhoea or constipation
• Fainting
• Premenstrual symptoms, such as tender breasts and a swollen abdomen, which might continue throughout the period
• Pain continuing after the first 24 hours (this tends to subside after two or three days).

Causes of primary dysmenorrhoea

In primary dysmenorrhoea, the uterus works too hard to dislodge its lining and the resulting contractions and associated ischaemia (reduced blood flow) cause pain. The hormone-like compounds that prompt these contractions are prostaglandins.

Women with dysmenorrhoea tend to have raised levels of prostaglandins, which cause more intense contractions of the uterus than normal. The reason for the increased prostaglandins isn’t known.

Treatment for primary dysmenorrhoea

Women with dysmenorrhoea need a thorough medical examination to make sure their period pain isn’t caused by certain reproductive disorders such as endometriosis or fibroids. Treatment options can include:

• Bed rest during the first day or so of the period
• Applying heat, such as a hot water bottle, to the abdomen
• Pain-killing drugs, such as paracetamol
• Drugs that inhibit prostaglandins, such as ibuprofen or other anti-inflammatory medications
• Regular exercise and attention to overall physical fitness
• Relaxation techniques
• The oral combined contraceptive pill, which usually decreases period pain.

Causes of secondary dysmenorrhoea

Some of the causes of secondary dysmenorrhoea include:

• Endometriosis - the cells lining the uterus move to other areas of the pelvis, causing severe pain during periods.
• Fibroids - benign tumours made of muscle and tissue that grow inside the uterus and are thought to be affected by the sex hormone oestrogen.

Treatment for secondary dysmenorrhoea

Treatment depends on the cause, but can include:

• Medications - such as anti-inflammatories or the oral combined contraceptive pill.
• Surgery - can be used to treat fibroids or endometriosis.

Where to get help

• Your doctor
• Gynaecologist
• Family Planning Victoria Tel. 1800 013 952 or (03) 9257 0100.

Things to remember

• Dysmenorrhoea means painful periods.
• Normal menstruation that happens to be painful is known as primary dysmenorrhoea.
• Period pain caused by certain reproductive disorders, such as endometriosis or fibroids, is known as secondary dysmenorrhoea.
• Treatment options include hormone replacement therapy, pain-killing drugs and surgery.

You might also be interested in:

• Endometriosis.
  
• Fibroids.
  
• Menstrual cycle.
  
• Menstruation - abnormal bleeding.
  
• Menstruation - amenorrhoea.
  
• Menstruation - athletic amenorrhoea.
  
• Ovulation.
  
• Ovulation pain.
  
• Premenstrual syndrome.
  
• Premenstrual syndrome - treatment options.
  
• Reproductive system.
  
• Vaginal bleeding - irregular.
  

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Family Planning Victoria

Last reviewed: May 2011

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Dysmenorrhoea means painful periods. Normal menstruation that happens to be painful is known as primary dysmenorrhoea. Period pain caused by certain reproductive disorders, such as endometriosis or fibroids, is known as secondary dysmenorrhoea. Treatment options include hormone replacement therapy, pain-killing drugs and surgery.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

For the latest updates and more information, visit www.betterhealth.vic.gov.au

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