Dysmenorrhea
Dysmenorrhoea is cramping pelvic pain around menstruation that may be primary or caused by an underlying pelvic disorder.
Key takeaways
- Primary pain usually begins soon after periods start and follows a consistent cycle pattern without other pelvic disease.
- Pain that begins later, worsens progressively, occurs between periods or accompanies painful sex or infertility needs further assessment.
- NSAIDs work best when timed around the start of symptoms but are unsuitable with some stomach, kidney, bleeding and cardiovascular risks.
The listings below do not identify primary or secondary pain; pregnancy possibility, symptoms and medical history guide treatment.
Looking for a secondary cause
History covers bleeding, pain timing, bowel or bladder symptoms, sex and fertility. Examination and ultrasound may identify fibroids, adenomyosis, ovarian disease or other abnormalities, while normal imaging does not exclude endometriosis.
Symptom control
Heat and activity can help some people. NSAIDs reduce prostaglandin-driven cramping; hormonal contraception can reduce ovulation or menstrual flow and may suit those also wanting contraception. Persistent symptoms despite correct use should trigger diagnosis review rather than indefinite escalation.
When to seek urgent care
Seek urgent care for sudden severe or one-sided pelvic pain, fainting, fever with pelvic pain, very heavy bleeding, repeated vomiting, or pain and bleeding when pregnancy is possible.