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Some women have mild discomfort with their menstrual periods; some have much more pain. Is there anything anyone can do to decrease the symptoms of dysmenorrhea?

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    @anongoodnurse A doc is always a doc, even the question feels better :) – Shlublu May 15 '15 at 19:01
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Dysmenorrhea (pain with menstruation) can be primary or secondary. The first thing a woman should do is see a physician to determine which kind of dysmenorrhea she has.

Primary dysmenorrhea is painful menstruation with a normal pelvic examination (no causes can be determined). It is is by far the most common gynecologic problem in menstruating women, can be worse in younger women than older ones, and is worse in smokers. Usually women refer to this kind of pain as "menstrual cramps", and they tend to occur just before and in the early part of menstruation. The cause is increased production of endometrial prostaglandins, natural hormones which cause uterine contractions. If the pain is severe enough, or in any way atypical, an pelvic ultrasound will be done to rule out pelvic pathology.

Nonsteroidal anti-inflammatory medications (NSAIDS) are the usual treatment because they are anti-prostaglandins; NSAIDS include ibuprofen, naproxin, aspirin, etc. If NSAIDS alone do not decrease pain sufficiently, patients are often placed on oral contraceptive pills, which will make periods lighter and less painful, or continuous-use OCP's that result in suppression of menses altogether. If these are inadequate in the absence of pelvic pathology, stronger medications can be prescribed, or one can try accupuncture. Topical heat is often comforting.

Secondary dysmenorrhea is pain in the presence of gynecologic findings, usually endometriosis or adenomyosis (growth of endometrial tissue outside of the endometrial cavity, either outside of the uterus or in uterine muscle walls), adhesions, fibroid (benign) tumors, infection, or other problems. It tends to be more severe pain, later during the period, starts years after the onset of menses, can be associated with heavy menstrual flow or irregular cycles, or other. It's important to have a physician involved in the care of secondary dysmenorrhea.

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Aspirin and NSAIDS - A very nice overview of NSAIDs
Primary Dysmenorrhea
Aspirin and NSAIDS - A very nice overview of NSAIDs
Trials of transcutaneous electrical nerve stimulation (TENS) units, laparoscopic presacral neuronectomy, acupuncture, omega-3 fatty acids, transdermal nitroglycerin, thiamine and magnesium all demonstrated some relief of dysmenorrhea symptoms.

protected by Community Dec 16 '15 at 3:51

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