Dysmenorrhea is the medical term for painful menstrual periods. The discomfort during your period may feel like a heaviness in your pelvis or a crampy, uncomfortable tugging. It may be mild or severe.

Period pain may feel different to different people. You may feel aching in your lower back or upper thighs. You might have breast pain or tenderness during your period.

When you have severe period cramps, you may also experience:

• Diarrhea
• Nausea
• Vomiting
• Light-headedness
• Headaches

There are 2 types of painful periods with different causes. Sometimes the exact cause of period pain isn’t clear. Keeping track of when symptoms occur and how long they last may help.

Primary dysmenorrhea

Primary dysmenorrhea is the cramping pain that usually comes before or during your period. It’s the more common type of dysmenorrhea and often starts within a year or two of your first period. Severe period cramps may ease as you get older.

This type of period pain happens when natural chemicals called prostaglandins are made in the lining of the uterus. The prostaglandins make the muscles and blood vessels of the uterus contract, which helps the uterine lining leave the body. Prostaglandins are highest on the first day of your period, which is why period cramps are usually worse then. 

Your risk for primary dysmenorrhea may be higher if:

• You have high levels of stress
• You smoke
• Your first period happened before age 11
• You typically have long, heavy periods

Secondary dysmenorrhea

Secondary dysmenorrhea is usually due to another health problem. The pain usually lasts longer than primary period pain. It often begins later in life and may get worse over time rather than improving with age.

Other health issues that can cause period pain include:

• Endometriosis
• Ovarian cysts
• Uterine fibroids
• Adenomyosis
• Birth defects in the uterus or fallopian tubes
• Pelvic inflammatory disease

At Carilion, we take period pain—and period pain relief—seriously. You can talk about your symptoms with your OB/GYN care team or midwife. Carilion Women's Pelvic Pain Clinic offers specialized care for severe period pain.

Medicine

Medicines are usually the first step in relieving period pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the natural chemicals in the body that produce cramps. You can buy NSAIDs like ibuprofen (Advil, Motrin) and naproxen (Aleve, Midol) over the counter at a drug store.

NSAIDs work best if you take them as soon as you notice period pain. You shouldn’t take them if you have liver problems, bleeding disorders, or ulcers.

Lifestyle changes

Your care team may suggest some simple lifestyle changes to help with painful periods. These include:

• Aerobic workouts like jogging, biking, swimming, or walking, all of which produce pain-blocking chemicals in the body
• Using heat from a warm bath or heating pad to increase blood flow and soothe cramps
• Getting good sleep before and during your period
• Stress-relieving rituals like gentle yoga or meditation

Hormonal birth control

If you’re not trying to get pregnant, you might consider using birth control to decrease period pain. The birth control pill, patch, implant, injection, and vaginal ring contain hormones that can reduce period pain. The hormonal intrauterine device (IUD) may also help ease painful periods.

Alternative treatments

Physical therapy may help by teaching you relaxation exercises and techniques for coping with pain. Some people find relief with therapies for releasing trigger points—acupuncture, acupressure, and nerve stimulation.