Dysmenorrhoea is the term used to describe 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 may 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 of dysmenorrhoea
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.
- the pain starts when the period starts, or earlier
- the first 24 hours is the most painful
- clots are passed in the menstrual blood.
Dysmenorrhoea can be associated with:
- nausea and vomiting
- digestive problems, such as diarrhoea or constipation
- premenstrual symptoms, such as tender breasts and a swollen abdomen, which may 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 harder than normal 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 primary dysmenorrhoea tend to have raised levels of prostaglandins, which cause more intense contractions of the uterus than normal. The reason for the increased prostaglandins is not known.
Treatment for primary dysmenorrhoea
Women with dysmenorrhoea need a thorough medical examination to make sure their period pain is not 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-relieving medication, such as paracetamol
- medication that inhibits prostaglandins, such as ibuprofen or other anti-inflammatory medication
- regular exercise and attention to overall physical fitness
- relaxation techniques
- the oral combined contraceptive pill, which usually reduces period pain.
Causes of secondary dysmenorrhoea
Some of the causes of secondary dysmenorrhoea include:
- Endometriosis – the cells lining the uterus can move to other areas of the pelvis, causing severe pain during periods.
- Fibroids – benign tumours made of muscle and tissue can grow inside the uterus and are thought to be affected by the sex hormone oestrogen.
Where to get help
- Your doctor
- Family Planning Victoria Tel. (03) 9257 0100 or freecall 1800 013 952
Things to remember
- Dysmenorrhoea is the term used to describe 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-relieving medication and surgery.
This page has been produced in consultation with and approved by:
Family Planning Victoria
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