Period pain, also known in medical terminology as dysmenorrhea, is a pervasive condition that affects a substantial number of women. This condition can be attributed to a variety of factors including hormonal imbalances, uterine abnormalities, and other prevalent health conditions such as endometriosis, fibroids, and pelvic inflammatory disease.
Period pain is typically classified into two categories: primary dysmenorrhea, which refers to common menstrual cramps without an underlying condition, and secondary dysmenorrhea, which is associated with a reproductive system disorder. Hormonal imbalances, particularly the overproduction of prostaglandins, are a major contributor to primary dysmenorrhea, leading to increased uterine contractions and pain. Secondary dysmenorrhea, on the other hand, is often linked to conditions such as endometriosis, where tissue similar to the lining inside the uterus grows outside it, leading to severe pain.
It is not always possible to identify the cause of painful menstrual periods. Some women are just at a higher risk of having painful periods. These risks include:
- Being under age 20
- Having a family history of painful periods
- Smoking
- Having heavy bleedingwith periods or irregular periods
- Never having had a baby
- Reaching puberty before age 11
Painful menstrual periods can also be the result of an underlying medical condition, such as:
- Premenstrual Syndrome – Caused by hormonal changes in the body occurring 1 to 2 weeks before menstruation begins. Symptoms typically go away after bleeding begins.
- Endometriosis – A painful medical condition in which cells from the lining of the uterus grow in other parts of the body, usually on the fallopian tubes, ovaries, or tissue lining the pelvis.
- Fibroids in the Uterus – Noncancerous tumors that can put pressure on the uterus or cause abnormal menstruation and pain.
- Pelvic Inflammatory Disease – An infection of the uterus, fallopian tubes, or ovaries often caused by sexually transmitted bacteria that cause inflammation of the reproductive organs and pain.
- Adenomyosis – A rare condition in which the uterine lining grows into the muscular wall of the uterus, causing inflammation, pressure, and pain, and perhaps longer, heavier periods.
- Cervical Stenosis – A rare condition in which the cervix is so small or narrow that it slows menstrual flow, causing an increase of pressure inside the uterus that causes pain.
Treatment will depend on the severity and underlying cause of the pain. If PID or sexually transmitted infections (STIs) are causing pain, the doctor will prescribe antibiotics to clear the infection. Other potential medications include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), either over-the counter or prescription-strength.
- Other pain relievers. Over-the-counter options like acetaminophen (Tylenol) or stronger prescription pain medications
- Antidepressants are sometimes prescribed to help lessen some of the mood swings associated with PMS.
A doctor may also suggest trying hormonal birth control. Hormonal birth control is available as a pill, patch, vaginal ring, injection, implant, or IUD. Hormones prevent ovulation, which can control menstrual cramps. Surgery can treat endometriosis or uterine fibroids. This is an option if other treatments haven’t been successful. The surgery removes any endometriosis implants, uterine fibroids, or cysts. In rare cases, a hysterectomy is an option if other treatments have not worked and pain is severe. It is only an option for those no longer able to have children or are not planning on having children.
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