Dysmenorrhea

Dysmenorrhea, also known as painful periods or menstrual cramps, is pain during menstruation. Its usual onset occurs around the time that menstruation begins. Symptoms typically last less than three days. The pain is usually in the pelvis or lower abdomen. Other symptoms may include back pain, diarrhea or nausea.

In young women, painful periods often occur without an underlying problem. In older women, it is more often due to an underlying issues such as uterine fibroids, adenomyosis or endometriosis. It is more common among those with heavy periods, irregular periods, whose periods started before twelve years of age or who have a low body weight. A pelvic exam in those who are sexually active and ultrasound may be useful to help in diagnosis. Conditions that should be ruled out include ectopic pregnancy, pelvic inflammatory disease, interstitial cystitis and chronic pelvic pain.

Dysmenorrhea occurs less often in those who exercise regularly and those who have children early in life. Treatment may include the use of a heating pad. Medications that may help include NSAIDs such as ibuprofen, hormonal birth control and the IUD with progestogen. Taking vitamin B or magnesium may help. Evidence for yoga, acupuncture and massage is insufficient. Surgery may be useful if certain underlying problems are present.

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