Ladies, most of you are all too familiar with the monthly visits from Aunt Flo(w). 

Having a regular menstrual cycle is usually a sign of good reproductive health. That doesn’t mean it’s fun to deal with the stomach cramps, but for most of us, the pain is reasonably mild and resolves within a few days. We’re able to manage the discomfort without it interfering too much with our daily lives. 

However, for some people, the pain from menstrual stomach cramps goes beyond mere inconvenience—it can be debilitating. Severe period pain like this is known as dysmenorrhea. 

What Does Dysmenorrhea Feel Like?

If you have dysmenorrhea, you may feel very intense pain, throbbing, achiness and/or pressure in your:

• Lower abdomen
• Thighs
• Back
• Hips

You may also experience:

• Fatigue
• Nausea and vomiting
• Headaches
• Diarrhea
• Weakness
• Dizziness 

What Causes Dysmenorrhea?

There are two types of dysmenorrhea:

• Primary dysmenorrhea: This is the more common type of dysmenorrhea. These cramps usually start a day or two before your period or on the first day of bleeding. After two or three days, they go away. The cause is prostaglandin, a naturally occurring chemical in your body that causes your uterus to contract. Your prostaglandin levels increase during your period, so your uterus’ contractions become more intense, resulting in menstrual cramps.
• Secondary dysmenorrhea: Cramps from secondary dysmenorrhea also accompany your period, but will usually start sooner and last longer than cramps from primary dysmenorrhea. These cramps are a symptom of a health condition related to your reproductive system, such as:
  • Endometriosis: When your uterus lining begins growing outside of your uterus in other parts of your pelvic area
  • Polycystic ovary syndrome (PCOS): When your ovaries begin producing too many male hormones, leading to a hormone imbalance
  • Fibroids: Noncancerous growths that form on the wall of the uterus
  • Congenital conditions: When you’re born with an abnormality that affects your reproductive system, such as an irregularly shaped uterus
  • Adenomyosis: When the endometrial layer of your uterus infiltrates into the muscular layer of your uterus

How Do I Know If My Period Cramps Are Normal or Dysmenorrhea?

If it’s normal cramping, the pain:

• Subsides when you use over-the-counter pain relievers
• Is uncomfortable, but not incapacitating
• Goes away after two or three days 

If it’s dysmenorrhea, the pain:

• Does not lessen when you use over-the-counter pain relievers
• Hinders your ability to do your daily activities like school, work or chores
• Coincides with heavy bleeding or clotting 

How Do I Know If I Have Primary or Secondary Dysmenorrhea?

First, call your Mercy doctor to schedule an appointment and explain your symptoms. If your doctor concludes that you have dysmenorrhea, they can determine whether it’s primary or secondary by conducting a pelvic exam. 

If the pelvic exam results are normal, that indicates that you have primary dysmenorrhea. 

If the exam/test results point towards another health condition, it’s likely secondary dysmenorrhea. In this case, your doctor may try to determine what that condition is though a diagnostic service, such as:

• Ultrasound
• CT scan or MRI
• Hysteroscopy
• Diagnostic laparoscopy 

How Do I Manage My Dysmenorrhea?

• Take over-the-counter pain relievers, such as ibuprofen and acetaminophen, the day before you usually start experiencing cramps. This may be more effective than taking medication after your cramps have started.
• Use a heating pad on your lower abdomen or soak in a hot bath. The heat relaxes your uterine muscles and improves blood circulation. 
• Stay physically active. Regular exercise has been associated with less period pain.
• Eat foods that can help reduce inflammation, such as:
  • Olive oil
  • Walnuts
  • Leafy green vegetables, such as kale and spinach
  • Certain fruits, such as blueberries, strawberries and grapes
  • Tomatoes
• Take supplements—such as magnesium and vitamins D, B-1 and B-6—that may help ease inflammation
• Avoid caffeine, cigarettes and alcohol
• Manage your stress. This is easier said than done, but even five minutes of breathing exercises or meditation before bed can help.