Center for Young Women's Health

Painful Periods (Dysmenorrhea)



  • Dysmenorrhea means difficult or painful periods.
  • The most common symptoms are cramps in the lower part of the bellY and/or lower back pain during your period.
  • If you have pain, talk to your HCP. Dysmenorrhea can be treated.
Getting Treatment:
The Gynecology Program and Division of Adolescent/Young Adult Medicine at Boston Children's Hospital offer special services in the diagnosis and treatment of painful periods.

It's common for many girls to have mild pain with their periods a couple of days each month. However, if your pain is not relieved with over-the-counter pain medicine, and you miss school or doing things with your friends because of it, you may have “dysmenorrhea” (pronounced: dis–men–o–ree–a). This guide was created to help you understand the causes of painful periods and to help you figure out if you need to seek medical care and treatment.


What is dysmenorrhea?

Dysmenorrhea is a medical term that means "difficult or painful periods". There are two types of dysmenorrhea; primary and secondary.

What causes dysmenorrhea?

The cramps you feel as a result of dysmenorrhea are caused by uterine contractions (when your uterus tightens and relaxes, allowing blood to leave your uterus). The lining of your uterus releases special chemicals called "prostaglandins" (pronounced: pross–ta–glan–dins). These chemicals are released from the lining of the uterus and increase the strength of the contractions, especially during the first couple of days of a woman’s menstrual cycle (when levels are high). High levels of prostaglandins may also cause nausea and lightheadedness.


What are the symptoms of dysmenorrhea?

Most young women who have dysmenorrhea have lower back pain and cramping in the lower area of the abdomen during their periods. This pain can range from dull to throbbing. Some girls may have other symptoms during their period such as nausea, vomiting, loose bowel movements/diarrhea, constipation, bloating in the belly area, headaches, and/or lightheadedness, all of which can be mild to severe.


Is it normal to have cramps during your period?

Yes, it is normal to have mild cramps during your period, because of uterine contractions. The uterus is a muscle that tightens and relaxes. This can cause jabbing, or cramp–like pain. However, if the discomfort is not relieved with over-the-counter medications and causes you to miss school or other daily activities, it could mean that there is another reason for your symptoms.


Some or all of these problems may start a day or two before your menstrual period and can last for part or all of your menstrual period. These signs could be caused by other medical conditions and therefore it is important to tell your health care provider about all of your symptoms.


Is it okay to exercise when I have my period?

Generally, it's fine to exercise when you have your period, and it's a great way to stay fit and healthy. Some girls like to exercise when they have their period; other girls are uncomfortable exercising during their period. Talk to your coach or gym teacher if exercising is uncomfortable during your period.


Are menstrual cramps the same as PMS (Pre–Menstrual Syndrome)?

Menstrual cramps are not the same as PMS. Symptoms of PMS such as mood swings, breast soreness, and bloating happen before a woman's period begins and get a lot better when it starts. On the other hand, with dysmenorrhea, cramps are usually worse the first few days of a woman’s period and have a different cause and treatment.


How is dysmenorrhea treated?

If your menstrual cramps are painful, you may want to take an over–the–counter nonsteroidal antinfLammatory (NSAID) medication for 1–2 days of your cycle. If your pain is severe, you may want to take an NSAID 1-2 days before your period starts. These medications are "anti–prostaglandins" (pronounced: an–tee–pross–ta–glan–dins), meaning that they work to stop the cramping effects of prostaglandins. They help to relieve discomfort, make your flow lighter, and cause your uterus to cramp less. You can use an over–the–counter medicine with ibuprofen or naproxen sodium in it. Make sure you read the label so you know how much and how often to take it. You should not take these medications if you are allergic to aspirin–like medications or if you have stomach problems (such as ulcers). Remember to always take these medications with food.


If you continue to have pain, your health care provider may give you a prescription for oral contraceptive pills (OCP’s, also called birth control pills). OCP’s contain the hormones estrogen and progesterone. The goal of OCP treatment is to stop your periods and pain. If you still have pain after 2–3 months of taking OCP’s and mild pain medication, your doctor may talk to you about scheduling a laparoscopy to find out the reason for your pain.


Is there anything else I can do to help my dysmenorrhea?

Natural remedies such as a microwavable heating pack or a heating pad placed on your lower abdomen may help. Be sure to check that the heating pad is not too hot, as it can burn your skin. Soaking in a warm bath or hot tub may also relieve uncomfortable cramps. Acupuncture is an complementary therapy that's sometimes recommended to treat dysmenorrhea. You can try different treatments to find out what works best for you.


You can also try tracking your menstrual cycle with our Period and Pain Tracker. Download the pdf, which includes instructions on how to fill out the tracker, and a sample sheet that shows you the correct way to fill in the information.


What is a Period and Pain Tracker?

This is a tool to help you keep track of your menstrual cycle and any pain you may have; when it comes, where it hurts, how long it lasts, and what relieves it. It's a good idea to keep track of your pain for about 3 cycles. Be sure to bring your completed Period and Pain Tracker with you when you have appointments with your health care provider or gynecologist.


Dysmenorrhea can be challenging, especially if painful periods get in the way of important things in your life. Learning how to track your periods and pain will help you see if your pain happens more than just 1-2 days a month. Your pain should never make you feel disadvantaged compared to other young women. Remember, if you don't feel equally capable as other young women your age (because of pelvic pain), you need to make an appointment with your health care provider to discuss causes and treatment.


Written and reviewed by the CYWH Staff at Boston Children's Hospital


Updated: 8/22/2013


Related Guides:

Menstrual Periods

You are born with two small, grape-shaped ovaries inside of your belly on either side of your uterus. When you reach puberty and are becoming a woman, your ovaries make hormones (that cause breast development and menstrual periods...


Medical Uses of the Oral Contraceptive Pill

When over-the-counter medications don't help with severe cramps, oral contraceptive pills may be the solution because they prevent ovulation and lighten periods...

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