Painful Menstrual Periods (Dysmenorrhea)

Cross-section of uterus with Fallopian tubes, ovaries, cervix, and vagina.

Dysmenorrhea is the term used to describe painful menstrual periods.

The uterus is a muscle. Normally, chemicals called prostaglandins cause the uterus to contract during your period. The contractions push out the build-up of tissue that occurs each month inside the uterus. If the contraction is very strong, it can cause pain. The pain may feel like cramping in the lower abdomen, lower back, or thighs. In severe cases, you may have other symptoms as well. These can include nausea, vomiting, loose stools, sweating, or dizziness.

There are 2 types of dysmenorrhea:

Primary dysmenorrhea refers to common menstrual cramps. It may begin 1 or 2 years after you first get your period. It may get better or go away as you get older or when you have a baby. The cramps are most often felt just before, or on the day of your period. They may last 1 to 3 days. Treatment is with medicines and comfort measures as described below (see the “Home care” section).

Secondary dysmenorrhea may start later in life. It describes menstrual pain that occurs due to underlying health problem. The pain may last longer than common menstrual cramps. It may also worsen over time. Some problems that can lead to secondary dysmenorrhea include: 

  • Pelvic inflammatory disease (PID): Infection that involves the female reproductive organs, such as the uterus and fallopian tubes

  • Fibroids: Benign growths within the wall of the uterus (not cancer)

  • Endometriosis: Tissue that normally only lines the uterus also grows outside of it (because the abnormal tissue also swells and bleeds each month, it can cause pain)

Once the cause of secondary dysmenorrhea is found, it can be treated. Your healthcare provider will discuss options with you as needed. Your care may also include some of the treatments described below (see the “Home care” section).

Home care


Certain medicines can be used to help relieve or prevent menstrual pain and cramping. These can include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen

  • Prescription pain medicine, if needed

  • Hormone therapy (this includes most methods of hormonal birth control such as pills, shots, or a hormone-releasing IUD)

General care

To help relieve pain and cramping, try these tips:

  • Rest as needed.

  • Apply a heating pad to the lower belly or back as directed. A warm bath or massage to these areas may also help.

  • Exercise regularly. Many women find that being more active each week helps reduce pain and cramping.

  • Ask your healthcare provider for advice about other treatments you can try to help control pain and cramping.

Follow-up care

Follow up with your healthcare provider as advised.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Fever of 100.4°F (38°C) or higher, or as directed by your provider

  • Pain or cramping worsens or doesn’t improve with medicine

  • Pain or cramping lasts longer than usual or occurs between periods

  • Unusual vaginal discharge between periods

  • Bleeding becomes heavy (soaking more than 1 pad or tampon every hour for 3 hours)

  • Passage of pink or gray tissue from the vagina

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