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Dysmenorrhea

What is it?

Dysmenorrhea (dis-men-uh-ree-uh) is also known as cramps or menstrual (men-strull) pain. Cramps are the pain in the lower abdomen (belly) which often occur during your monthly period. The cramps usually go away 1 to 2 days after the start of your period. Cramps during your period often become less painful as you get older.

Causes:

The uterus (womb) tightens to push blood out of it once a month. Menstrual cramps may be caused by a tightening of the muscles of the uterus. This tightening causes pain in the lower abdomen that sometimes spreads to the back and legs. You may have pain when the cervix (bottom part of the uterus) opens to pass blood clots. An infection or a tumor may also cause you to have cramps.

Signs and Symptoms:

You may have dull or sharp pain in the lower abdomen, back, or legs. You may have nausea (upset stomach), vomiting (throwing up), or diarrhea with your cramps. Or you may feel tired and irritable.

Wellness Recommendations:

Regular exercise may help prevent menstrual cramps. Try to get enough rest and eat healthy food. Do not smoke. Smoking makes dysmenorrhea worse. Stress may make menstrual cramps worse. Since it is hard to avoid stress, learn to control it. Learn new ways to relax (deep breathing, meditation, relaxing muscles, music, or biofeedback). Talk to someone about things that upset you. You do not need to stay in bed.

Medical Care:

You may need to have a pelvic exam (an "internal") if you are having bad pain. A pelvic exam is done to check your female organs for problems. There is usually no way to keep from getting cramps but they can be treated. If the cramps are new or worse than before, they may be caused by an infection or tumor. In these cases, more tests will be done. Treatment will begin after it is known what is causing the problem.

You may use ibuprofen (i-bew-pro-fin), acetaminophen (uh-c-tuh-min-o-fin), or other over-the-counter medicine for menstrual cramps. Do not take ibuprofen if you are allergic to aspirin, have ulcers, or kidney disease. Sometimes birth control pills are used for dysmenorrhea.

You may use heat to lessen the pain and cramps. Use a heating pad (turned on low), a hot water bottle, or sit in a warm water bath. Place the heating pad or water bottle on the painful part of your lower abdomen or back. Do this for 15 to 20 minutes out of every hour as long as you need it. Do not sleep on the heating pad or hot water bottle.

Herbs and Supplements:

Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.

Herbs:

    Supplements:

      Complementary Therapies:

      • Acupuncture is helpful for dysmenorrhea.
      • Biofeedback is helpful for dysmenorrhea.
      • Osteopathic manipulation can help the low back pain of dysmenorrhea.
      • Relaxation is helpful for dysmenorrhea.

      Other ways of treating your symptoms : Other ways to treat your symptoms are available to you.

      Talk to your caregiver if:

      • You would like medicine to treat dysmenorrhea.
      • Your symptoms have not gone away or improved by these self-help measures.
      • You have pain when urinating or having a BM.
      • You have questions about what you have read in this document.

      SEEK CARE IMMEDIATELY IF:

      • Your pain is so bad that you cannot walk.

      Care Agreement:

      You have the right to help plan your care. To help with this plan you must learn about your health condition and how it may be treated. You can then discuss the treatment options with your caregivers. Work with them to decide what care will be used to treat you. You always have the right to refuse treatment.

      References:

      1. Amodei N, Nelson RO, Jarrett RB et al: Psychological treatments of dysmenorrhea: differential effectiveness for spasmodics and congestives. J Behav Ther Exp Psychiatry 1987; 18(2):95-103.

      2. Balick L, Elfner L, May J et al: Biofeedback treatment of dysmenorrhea. Biofeedback Self Regul 1982; 7(4):499-520.

      3. Boesler D, Warner M, Alpers A et al: Efficacy of high-velocity low-amplitude manipulative technique in subjects with low-back pain during menstrual cramping. J Am Osteopath Assoc 1993; 93(2):203-208, 213-214.

      4. Helms JM: Acupuncture for the management of primary dysmenorrhea. Obstet Gynecol 1987; 69(1):51-56.

      5. Thys-Jacobs S, Ceccarelli S, Bierman A et al: Calcium supplementation in premenstrual syndrome: a randomized crossover trial. J Gen Intern Med 1989; 4(3):183-189.


      Last Updated: 11/4/2014

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