Painful Menstrual Periods
Physician's Weekly
November 5, 2021
Painful Menstrual Periods

Q: I’m 25 years old and every month I have severe period pains, nothing seems to be helping. HELP!!!

The medical term for period pains is dysmenorrhea. Such pain is often described as severe and cramping in nature, and generally begins with or just before the period. It is often classified as primary or secondary.

Primary dysmenorrhea starts from the time that the person experiences their first period and continues throughout their reproductive life. This is as a result of severe and abnormal contractions of the womb (uterus). This pain ushually last 12-72 hours. May sometimes be associated with bloating, nausea, vomiting, fatigue and diarrhea.

While secondary dysmenorrhea begins at a later point in life and is caused by a new medical condition. This pain lasts longer than the common menstrual cramps and is normally not associated with bloating, nausea, vomiting, fatigue or diarrhea.

Causes of dysmenorrhea

  • Chemical imbalance in the prostaglandins leading to abnormal contractions of the womb
  • Endometriosis – This is where the lining of the womb (endometrium) is found inside of the wall of the womb

(adenomyosis) or outside of the womb itself

  • Pelvic infections – (PID/ Pelvic Inflammatory Disease). This is caused by a bacterium – STIs/ STDs. There may also be pain during sex.
  •  Fibroids of the womb
  • Ectopic pregnancies and miscarriages
  • Cervical stenosis (a narrowed cervical passage)
  • Tumors or polyps of the pelvis

Symptoms associated with dysmenorrhea

The patient may experience:

  • Pains and cramping in the abdomen and pelvic area. This pain can be severe.
  • Pressure in the abdomen.
  • Pain in the hips, lower back and inner thighs.
  • Bloating, nausea, vomiting diarrhea.
  • Severe fatigue.
  • Light headedness and dizziness.
  • Headaches

Which women are at highest risk for dysmenorrhea?

  • Being under the age of 30
  • Having a family history of painful periods
  • Those with irregular and or heavy periods
  • The overweight
  • Those with pre-menstrual syndrome
  • Those who started their periods before age 12


  • Those who drink alcohol when having their period
  • Those who have never been pregnant
  • History of sexual abuse

How is dysmenorrhea assessed?

The doctor will take a thorough medical history and perform a complete physical and pelvic exam. Tests that may be ordered (if available) include:

  • Pelvic & Abdominal Ultrasound.
  • MRI or CT scan: Either can be used to do a 3D radiological assessment of the pelvis.
  • Laparoscopy of the pelvis: An elongated flexible devise with a camera attached is used to directly look when the patient is anesthetized at the organs in the pelvic cavity.
  • Hysteroscopy: A specialized scope is used to examine the cavity of the womb.

Treatment options for dysmenorrhea include:

  •  Nonsteroidal anti-inflammatory medications (NSAIDs) – e.g. ibuprofen, diclofenac, Voltaren, Cataflam, Naprosyn, etc. These inhibit prostaglandin synthesis and can significantly reduce pain, especially if taken shortly before the pain starts.
  • Paracetamol/ Acetaminophen
  • Oral contraceptive pill
  • Progesterone (tablets or injections)
  •  Dietary modifications (reducing sugar and caffeine)
  •  Avoid smoking and the drinking alcohol.
  •  Massages of the lower back and abdomen
  • Regular exercise
  • Heating pad across the abdomen
  • Hot bath or shower
  •  Hysterectomy (in extreme cases the surgical removal of the uterus)

Author: Dr. C. Malcolm Grant – Family Physician, c/o Family Care Clinic, Arnos Vale,,, 1(784)570-9300 (Office), 1(784)455-0376 (WhatsApp)

Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.