Is it dysmenorrhea or just plain cramps? Dysmenorrhea is the medical name for painful menstrual periods. Most women consider a little discomfort and a few cramps as par for the course, but if your period causes you to miss work, school, or other activities, you might be experiencing dysmenorrhea. 

It's unclear how many women have dysmenorrhea because too many think excessive cramping is normal or that nothing can be done so they don't seek medical care. Some studies say that 20 to 90 percent have experienced dysmenorrhea at some time in their reproductive history.

What does it feel like? The American Congress of Obstetricians and Gynecologists says the symptoms of dysmenorrhea include:

  • Cramps or pain in the lower abdomen or back
  • Pulling feeling in the inner thighs
  • Diarrhea
  • Nausea
  • Vomiting
  • Headache
  • Dizziness

What causes dysmenorrhea? The uterus is a muscle that contracts in response to natural chemicals called prostaglandins, which are made by the lining of the uterus. When the uterus contracts, it sometimes causes cramps.  Prostaglandin levels are highest during the beginning of your period and gradually decrease. That's why most women experience more cramping during the first few days of their period. 

There are two types of dysmenorrhea:

  • Primary dysmenorrhea isn't associated with any type of pelvic disease or abnormality. It's caused by the natural production of prostaglandins. It's most common in adolescent and young women, especially during their first few years of having periods. It's not uncommon for women to have fewer symptoms of dysmenorrhea and less painful cramps as they get older and after they've given birth.
  • Secondary dysmenorrhea is caused by underlying medical conditions and usually starts after women have already had normal periods. Symptoms of secondary dysmenorrhea are similar to those of primary dysmenorrhea, but they might begin days before a woman's period starts, last longer, and get worse as her period progresses.

According to the National Institutes of Health (NIH), secondary dysmenorrhea may be caused by:

  • Endometriosis
  • Fibroids
  • Intrauterine devices (IUD) made of copper
  • Pelvic inflammatory disease
  • Premenstrual syndrome (PMS)
  • Sexually transmitted infections
  • Stress and anxiety

How do you know if you have primary or secondary dysmenorrhea? If your period is so painful that you're missing out on normal activities, it's time to see your doctor. She'll evaluate what's causing your discomfort and decide how to best to treat it. 

If she decides you have primary dysmenorrhea, she might recommend you start with self-care measures such as:

  • Non-steroidal anti-inflammatory medications (ibuprofen, aspirin or naproxen)
  • Heat applied to the abdomen and back (heating pads or warm baths)
  • Exercise
  • Vitamin supplements (B6, magnesium, calcium are very effective for some women)

If this doesn't work, your doctor's next step might be to prescribe hormonal contraceptives, which have proven very effective in reducing cramping and bleeding and regulating your menstrual cycle. She might prescribe stronger medication for pain and recommend medications to treat symptoms like nausea, diarrhea, and more.  

If your doctor determines you have secondary dysmenorrhea, her treatment will be tailored to whatever is causing your pelvic pain. That might include hormonal contraception, antibiotics, surgery or other medical treatments. 

Finding a solution for your super-tough periods might be easier than you think.  Talk to your doctor about how you can spend fewer days feeling miserable and more days feeling like your normal, healthy self.