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Dysmenorrhea Causes: What You Need to Know

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Dysmenorrhea, also known as period pain, is a health condition characterized by painful cramps during menstruation (or periods). It is a prevalent disorder that affects over half of all menstruating women or Assigned Females at Birth (AFAB). 

Other symptoms accompanying the pain include Diarrhea, Nausea, vomiting, headaches, and dizziness. 

Dysmenorrhea can be of two types: Primary Dysmenorrhea or Secondary Dysmenorrhea. The underlying cause and treatment for Dysmenorrhea vary according to its type and severity. 

Read further to explore Dysmenorrhea causes and ways to overcome the symptoms.

Common Dysmenorrhea Causes

Dysmenorrhea can be caused by a number of factors, depending on whether it is primary or secondary.

Primary Dysmenorrhea is the most common type and generally appears immediately after a woman begins menstruation.

Primary Dysmenorrhea Causes

Primary Dysmenorrhea causes often involves abnormal uterine contractions caused by a chemical imbalance in the body. It is often characterized as the cramping or pain that occurs before or during a period.

This pain is caused by Prostaglandins, which are hormone-like substances synthesized in the uterine lining.

Prostaglandins have various roles in the body, including generating uterine contractions that help in the shedding of the uterine lining.

On the first day of a period, Prostaglandin levels are high, and the higher levels of Prostaglandins can generate severe and painful contractions, resulting in the cramps associated with Primary Dysmenorrhea. 

As the vaginal bleeding progresses and the uterine lining breaks down, the level of Prostaglandin drops. 

Hence, the pain usually lessens after the first few days of your period.

Secondary Dysmenorrhea Causes

Woman in pain sitting on the bedSource: pixelshot
Woman suffering from pain

On the other hand, Secondary Dysmenorrhea is characterized by the pain that might occur years after a woman starts menstruating. 

It is usually more intense and persists longer than regular period cramps.

Causes of Secondary Dysmenorrhea are generally linked to an underlying medical issue affecting the reproductive organs.

These include health conditions like Endometriosis, Adenomyosis, Uterine fibroids, or Pelvic Inflammatory Disease.

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  • Endometriosis

    Endometriosis is a medical condition where tissue identical to the uterine lining (Endometrium) develops in other body parts like the ovaries, fallopian tubes, behind the uterus, and on the bladder. 

    These Endometrial-like tissues degrade and bleed during the menstrual cycle, resulting in inflammation and irritation in the surrounding tissues. 

    This inflammation can cause pain, particularly during menstruation.

    Additionally, Endometriosis can cause the development of scar tissue (adhesions) between pelvic organs. 

    These adhesions can cause painful tugging or stretching sensations, which contribute to painful periods.


    Adenomyosis occurs when the tissue that usually surrounds the uterus develops into the muscular wall of the uterus.

    This abnormal development of Endometrial tissue into the uterine muscle can result in a range of symptoms due to inflammation, including Secondary Dysmenorrhea.

    This inflammation can cause pain, especially during menstruation, when the Endometrial tissue breaks down and bleeds, just like in normal menstrual cycle.

    Uterine Fibroids

    These are noncancerous growths that can develop outside, within, or in the uterine walls. 

    These fibroids can lead to prolonged menstrual bleeding and discomfort. 

    Fibroids can stimulate the synthesis of Prostaglandins, causing painful cramping.

    Sometimes, these fibroids can be mistaken for Polycystic Ovary Syndrome (PCOS) as both produce non-cancerous growths affecting your reproductive system. 

    However, both are different conditions. Want to learn about the differences between PCOS and Uterine Fibroids? Read PCOS and Fibroids: What’s the Difference?

    Pelvic Inflammatory Disease (PID)

    woman suffering from pid pain in lower backSource: getty_images
    Woman suffering from PID pain

    PID is an inflammation of the reproductive organs that is frequently caused by Sexually Transmitted Infections (STIs). 

    Pelvic Inflammatory Disease can induce Secondary Dysmenorrhea because of the inflammation and damage it poses to your reproductive system. 

    Infected tissues become more vulnerable and painful, particularly during menstruation, when the uterus contracts to remove its lining.

    Dysmenorrhea symptoms may resemble those of other diseases or medical concerns. Always get a medical diagnosis from your healthcare practitioner if you suspect you are having the condition.

    Treating Dysmenorrhea

    The treatment for Dysmenorrhea varies according to its specific type and severity. The treatment mostly involves medications and lifestyle modifications.

    Medications are usually the first line of treatment when it comes to managing Dysmenorrhea. Some pain-relieving medications, such as Nonsteroidal Anti-inflammatory medicines (NSAIDs) can help treat Dysmenorrhea. 

    NSAIDs, including Ibuprofen and Naproxen, target Prostaglandins, inhibit their production in the body, and reduce their impact on the body.

    This, in turn, decreases the severity of menstrual cramps.

    Besides NSAIDs, hormonal birth control treatments such as pills, patches, and vaginal rings containing synthetic Estrogen and Progesterone hormone can be used to overcome period pain. 

    They control or suppress ovulation as well as reduce Prostaglandin production, which helps decrease or eliminate the pain associated with Dysmenorrhea.

    Lifestyle adjustments, such as exercise, therapeutic heat therapy, and stress management through yoga and meditation, can also help control pain during periods. 

    Acupuncture, acupressure, and nerve stimulation therapy may be effective in addressing Dysmenorrhea. However, it is always advisable to consult a healthcare professional before considering any treatment approach.

    Long-term or excessive use of Nonsteroidal Anti-inflammatory medicines (NSAIDs) can lead to gastrointestinal issues. Be cautious while using them.


    Dysmenorrhea is a prevalent condition characterized by intense, persistent menstrual cramps and pain during menstruation. Dysmenorrhea can be primary or secondary.

    Primary Dysmenorrhea is usually caused by a rise in Prostaglandins, which produce uterine contractions and pain. 

    Secondary Dysmenorrhea results from an underlying medical issue, such as Endometriosis, Adenomyosis, Uterine fibroids, or Pelvic Inflammatory Disease. 

    Recognizing the Dysmenorrhea causes is essential for productive treatment and prevention. 

    Management of pain during periods includes medical treatment like Nonsteroidal Anti-inflammatory medicines (NSAIDs), hormonal birth control, and lifestyle changes.

    However, it is recommended to reach out to a certified gynecologist before considering any treatment approach to eradicate the chances of any possible complications.

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    Frequently Asked Questions

    What are the risk factors for Primary Dysmenorrhea?

    Having a history of Dysmenorrhea and early menstruation, having a low or high body mass index, using tobacco and alcohol, excessive intake of caffeine, and experiencing emotional issues like stress, Anxiety, or Depression all make you prone to Primary Dysmenorrhea.

    Can ovarian cysts cause Dysmenorrhea?

    Yes, ovarian cysts can lead to painful periods or Dysmenorrhea. 
    These are noncancerous sac-like fluid-filled structures formed inside the ovaries that can lead to menstrual irregularities like pain during periods.

    Can PCOS cause Dysmenorrhea?

    Yes, Polycystic Ovary Syndrome (PCOS) is found to be associated with Primary Dysmenorrhea.
    PCOS can cause a hormonal imbalance that could lead to aberrant development of the uterine lining, contributing to painful periods.

    Can Dysmenorrhea cause infertility?

    Although not directly, Dysmenorrhea can lead to infertility. 
    According to a study, Endometriosis, one of the most prevalent causes of Secondary Dysmenorrhea, can lead to infertility if left untreated.

    Can Dysmenorrhea cause vomiting?

    Yes, Dysmenorrhea, primarily characterized by painful cramps during periods, is often accompanied by secondary symptoms. These may include nausea, vomiting, weakness, fatigue, and diarrhea.

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    Photo of author Janet Fudge
    Janet Fudge is a highly skilled and experienced pharmacologist who serves as a contributing writer for With a strong academic background from a premier US University and a passion for helping others, Janet has become a trusted voice in the pharmaceutical world. After completing her Doctor of Pharmacy degree, Janet embarked on a successful career in the pharmaceutical industry, working with various clients, including hospitals, retail pharmacies, and drug manufacturers. Her in-depth knowledge of pharmacology and dedication to patient-centered care has led her to excel in her field. As a writer for, Janet uses her wealth of expertise to provide readers with accurate, reliable, and up-to-date information on various topics related to medicine and healthcare. Her engaging writing style and ability to break down complex topics into easily digestible content make her a valuable resource for healthcare professionals and the general public.
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