Severe Menstrual Cramps

Many women suffer from painful periods, also known as dysmenorrhea. In fact about half of all young women who have not given birth have severe pain during menstruation.


Dysmenorrhea can be caused by different factors. Primary dysmenorrhea is caused by a spasm-like condition in the uterine muscles. It is caused by prostaglandins, the hormone-like substances that are released during the later phase of the menstrual cycle and cause the uterine musculature to contract. Women with primary dysmenorrhea have a higher level of prostaglandins than those who are not bothered by severe menstrual pain.


Secondary dysmenorrhea often has an underlying cause, such as:


  • Endometriosis, which means that there is a uterine tissue outside the uterus. It affects about 5-10% of women of childbearing age.
  • intramural fibroid tumor, so-called myoma
  • pelvic inflammatory disease.


There are two types of dysmenorrhoeaprimary and secondary.


Primary dysmenorrhea begins shortly after puberty and usually subsides at the age of twenty or after the birth of a child. Secondary dysmenorrhea can debut at any age, but is most common in women over twenty-five years.


The symptoms are different depending on whether the dysmenorrhea is primary or secondary. Primary dysmenorrhea causes pain that usually begins a few hours before or at the time of menstruation and lasts for one to two days. Secondary dysmenorrhea produces pain that usually begins hours or days before menstruation. The pain is usually lessened when the bleeding begins. Both types can also cause headaches, fatigue, dizziness, nausea, and vomiting.


Primary dysmenorrhea – menstrual pain without other symptoms – is common in young people and it may be diagnosed without examination.


In secondary dysmenorrhea, an investigation is needed to find out what causes the pain. This can be done with the help of a gynecological examination and ultrasound scanning.

What you can do for yourself

At-home treatments can be helpful in relieving painful menstrual periods. Things to try at home include:


  • using a heating pad on your pelvic area or back
  • massaging your abdomen
  • taking a warm bath
  • doing regular physical exercise
  • eating light, nutritious meals
  • practicing relaxation techniques or yoga
  • taking anti-inflammatory medications such as ibuprofen several days before you expect your period
  • taking vitamins and supplements


If you have severe symptoms of primary dysmenorrhea, consult a doctor. Contraceptives such as combined contraceptive pills and hormonal spirals can alleviate symptoms.


In the case of secondary dysmenorrhea, a doctor will decide which treatment is better for you, depending on the cause of the pain.

When to consult a doctor

Seek care if you have repeated, severe menstrual cramps.

How APPOTEK can help

APPOTEK can help with assessment, treatment, and referral to a gynecologist if needed.


Valeria Chernikova, Neurologist, M.D.