Primary dysmenorrhea, also known as menstrual pain, affects young women in their teens and early twenties. Pain usually begins a day or two before menstrual flow, and may continue through the first two days of menstruation. Discomfort tends to decrease over time and after pregnancy. Secondary dysmenorrhea is caused by underlying physical problems.

Signs and Symptoms

Symptoms and degree of pain vary, but may include the following.

What Causes It?

Primary dysmenorrhea is caused by the following. Secondary dysmenorrhea can be caused by the following.

What to Expect at Your Provider's Office

A pelvic examination may include an internal examination, laparoscopy, and ultrasound. You may need a Pap test or D&C to analyze tissue. Blood and urine samples may be required.

Treatment Options

Drug Therapies

Your provider may suggest the following drugs.

Complementary and Alternative Therapies

Dysmenorrhea may be effectively treated with nutritional support and mind-body techniques such as meditation, yoga, tai chi, and exercise.

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Homeopathy
There have been few studies examining the effectiveness of specific homeopathic remedies. A professional homeopath, however, may recommend one or more of the following treatments for menstrual pain based on his or her knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual. Physical Medicine
The following methods can relieve pelvic pain. Acupuncture
The National Institutes of Health recommend acupuncture as either a supplemental or alternative treatment for dysmennorhea. This recommendation is supported by a well-designed trial involving 43 women with dysmenorrhea. Women treated with acupuncture showed a dramatic reduction in both pain and the need for pain medication

Acupuncture has become a popular treatment for dysmenorrhea. Acupuncturists treat people with dysmenorrhea based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In the case of dysmenorrhea, a qi deficiency is usually detected in the liver and spleen meridians. Moxibustion (a technique in which the herb mugwort is burned over specific acupuncture points) is often added to enhance needling treatment, and qualified practitioners may also recommend herbal or dietary treatments.

Chiropractors report that some people with dysmenorrhea may benefit from spinal manipulation (particularly in areas that supply sensory and motor impulses to the uterus and lower back). Studies of women with a diagnosis or history of primary dysmenorrhea have found that spinal manipulation improves symptoms, but no more effectively than sham manipulation. Sham manipulation refers to maneuvers that shift soft tissues surrounding the bone but to not actually adjust the spine or joint. Sham manipulation has been compared to placebo because both procedures look and feel the same. Interestingly, however, experts are now questioning whether sham is a fair placebo because the massage quality of the manipulation may also have a beneficial effect.

Therapeutic massage is helpful in reducing the effects of stress.

Following Up

If your symptoms change, or treatment does not help, tell your provider.

Special Considerations

Avoid caffeine, alcohol, and sugar prior to onset of your period.


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