Dysmenorrhea is the medical term for painful menstrual cycles, or periods, and can be a primary or secondary condition. A primary condition means that it usually starts with a person’s first period and is present for the vast majority of cycles. In this case, there is not a physical cause that can be pointed to for the pain, since the pain is thought to be caused by abnormal uterine contractions that are most likely hormone-related. A secondary condition means that it is due to a physical cause, such as endometriosis or fibroids.
If a person experiences pain that interferes with their daily life, it is important to discuss this with a healthcare provider. If the pain is manageable, but uncomfortable, it is typically okay to try medications such as ibuprofen or other nonsteroidal anti inflammatories (NSAIDs). Heating pads may also help with discomfort. Many young people may benefit from keeping a menstrual cycle journal on paper or using one of the many phone apps available. This may allow them to see if they have any triggers that worsen their pain with their cycles, such as caffeine or alcohol. It may also allow them to identify patterns about when their pain appears so that they may be able to premedicate with NSAIDs.
Besides NSAIDs, another medication often used to help with dysmenorrhea is oral contraception, or the birth control pill. The birth control pill works to prevent surges in hormones that are normal during a menstrual cycle and to suppress ovulation. Many times, this ovulation suppression will be enough to help with the pain, and the pill may be taken continuously so that bleeding does not occur. This is usually what works best for dysmenorrhea, and it is a completely safe way to take the medication.
If these methods do not help the pain, or the pain is unbearable, further evaluation may be needed and a doctor may order additional tests to see what is causing the pain. These tests may include imaging using various modalities such as ultrasound, CT scan, or MRI. She may even suggest surgery to take a look at what is going on internally through laparoscopy or hysteroscopy. Additional medications may also be prescribed to help treat the underlying condition. Finally, surgical treatment may also be an option if all other conservative methods fail, but it is usually used as a last resort. Desire for future fertility also plays a big role in what treatments may be available to you.
I know that painful menstrual cycles can be difficult to deal with and can also be scary. It is hard to know what normal pain is and what may be an underlying problem. It is beneficial to schedule an appointment with an OB/GYN in your teenage years to discuss these types of issues, as well as a multitude of other important health measures. It is also wonderful to establish a relationship with a provider who will be able to answer these types of questions for you in the future and who can hopefully help to remove some of the anxiety surrounding these questions.