Pain During Menstruation

This is a very common problem. Known as dysmenorrhea, it is often severe enough to cause absences from work or inability to perform other responsibilities. Symptoms include lower abdominal cramping, nausea, vomiting, and headache during menstruation.

In one type of painful menstruation, called primary dysmenorrhea, doctors cannot find any problem with the reproductive organs. This common disorder tends to affect about half of all young women fairly soon after they first begin to menstruate. Painful contractions may occur as the uterine walls release natural substances called prostaglandins. Psychological factors may play a role.

Primary dysmenorrhea can be treated with ibuprofen (Advil, Nuprin, others), which helps block production of prostaglandins. In some cases, birth control pills or other medications containing hormones can help. Exercise, good nutrition, and reducing stress also are important.

Secondary dysmenorrhea develops after years of normal menstruation and results from disease of the uterus, fallopian tubes, or ovaries. Among the possible causes are tumors and other abnormal growths, pelvic infection, uterine cancer, and endometriosis (in which uterine tissue is found outside the uterus, in the fallopian tubes, ovaries, and abdominal organs). Endometriosis is a serious disease that can cause infertility.

When you see your doctor, he or she will ask you about your periods and the timing and severity of the pain. The doctor will also do a pelvic exam. Since treatment for secondary dysmenorrhea depends on its cause, he or she may do additional tests or refer you to a specialist.