What is the exact definition of this term?

Cramping pelvic pain with periods. Primary dysmenorrhea is due to prostaglandin-driven uterine contractions; secondary dysmenorrhea results from conditions like endometriosis, fibroids, or adenomyosis.

Symptoms

Cramping that may radiate to the back or thighs, nausea, diarrhea, headache, fatigue; pain typically peaks in the first 1–2 days of flow.

Relief & treatment

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First-line: NSAIDs started 1–2 days before expected menses and continued for the first days of bleeding.

Hormonal options: combined pills/patch/ring, progestin-only methods, or LNG-IUS to reduce pain and flow.

Lifestyle: heat therapy, exercise, adequate sleep, stress management.

When to investigate further: pain that is severe, begins later in life, or does not improve with NSAIDs/hormonal therapy—evaluate for endometriosis, adenomyosis, or fibroids.

Deep Dive

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Why it hurts: prostaglandins make the uterus contract strongly; high levels correlate with more pain and nausea/diarrhea.

When to image: if pain starts later in life, is one-sided, or is unresponsive to treatment, we consider ultrasound to look for secondary causes.

Non-medicine supports: heat pads, TENS units, regular aerobic activity, and mindfulness-based strategies have supportive evidence for some people.

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