Dysmenorrhea (Diss-men-or-ree-uh) is the medical term for pain with menses or menstrual cramps. More than half of menstruators experience dysmenorrhea, & it has been reported to affect up to 90% of young women. While dysmenorrhea is most commonly a normal symptom of having a period, many women may have questions about when period pain transitions from normal to abnormal.
During the period, the lining of the uterus releases chemicals called prostaglandins. These trigger the uterus to contract & play a role in a local inflammatory reaction that causes pain. For this reason, dysmenorrhea usually occurs just before menstruation begins & into the first 1-2 days of bleeding, when prostaglandin levels are at their highest. As the period continues, the prostaglandin levels fall & pain usually decreases. This normal pain with menstruation tends to start with the first few periods & lessen with age. Abnormal pain with periods, however, may begin well after the first years of menses & worsen over time.
Some causes of abnormal period pain are Endometriosis, Adenomyosis, & Fibroids. Endometriosis is a condition where tissue that is usually found lining the uterus is located in areas outside of the uterus (bladder, bowel, abdominal wall, etc.). Adenomyosis occurs when tissue that is normally lining the uterus grows within the muscle layer of the uterus. Fibroids are benign tumors of the muscle layer of the uterus. These conditions can lead to debilitating pain during periods & improve only with medical evaluation and targeted treatment.
For this reason, menstruators with bothersome dysmenorrhea should discuss their pain with their qualified healthcare provider to rule out causes of abnormal period pain. Options for treatment are plentiful, from non-steroidal anti-inflammatory drugs (Ibuprofen, Advil, Aleve), to hormonal contraceptives, & even surgical intervention.
Bottom line: Dysmenorrhea is common, but should not prevent you from doing your daily activities like participating in sports, or attending work or school. Speak with your healthcare provider about your period pain, as treatment may be indicated for normal and abnormal causes.
