OB/GYN General

Painful Periods

What Causes Painful Periods?

Painful periods, known as dysmenorrhea, may be caused by a number of disorders that include:

• Premenstrual syndrome (PMS) - PMS, a common condition caused by hormonal changes in the body, occurs 1-2 weeks prior to menstruation. After bleeding begins, symptoms typically subside.
• Endometriosis - Endometriosis is one of the most common gynecological disorders, yet women often suffer with it for years before being diagnosed. The symptoms overlap other disorders and may be misdiagnosed as pelvic inflammatory disease (PID), ovarian cysts, or irritable bowel syndrome (IBS). Endometriosis occurs when tissue similar to the uterine lining grows outside the wall of the uterus, sometimes spreading to the ovaries, fallopian tubes, pelvic cavity, bowel and bladder. During normal menstruation the uterine tissue is shed, however with endometriosis the tissue grows outside the uterus and cannot exit the body, causing scar tissue and adhesions, which may lead to infertility.
• Fibroids - Fibroids are noncancerous tumors in the uterus that can cause pain and abnormal menstruation.
• Pelvic inflammatory disease (PID) - PID is often caused by sexually transmitted bacteria. It is an infection of the uterus, fallopian tubes, or ovaries that causes pain and inflammation of the reproductive organs.
• Adenomyosis - Adenomyosis is a rare condition where the uterine lining grows into the wall of the uterus, causing inflammation, pressure, and pain. It may also cause periods to be heavier or longer.
• Cervical stenosis - Cervical stenosis is a rare condition where there is an increase of pressure inside the uterus which causes pain and a slowed menstrual flow due to the cervix being small and narrow.

To determine the underlying cause of painful periods, our physicians perform a pelvic exam to identify any abnormalities or infection in your reproductive system.

Imaging tests may also be performed which include:

• Ultrasound
• CT scan
• MRI

Treatment Options

Once the underlying cause of pain is identified, a treatment plan will be developed. Treatment options consist of:

• Antibiotics - If PID or a sexually transmitted infection is causing the pain, antibiotics will be prescribed to clear the infection.
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) - Depending upon the severity of the pain, over the counter or prescription strength NSAIDs may be prescribed as a first line treatment for the pain.
• Other Pain Relievers - Stronger prescription pain medications or other over the counter options may also be prescribed to treat the pain.
• Antidepressants - To lessen some of the mood swings associated with PMS, antidepressants are sometimes prescribed.
• Hormonal Birth Control - Birth control may be prescribed to prevent ovulation, and may help control menstrual cramps.
• Surgery - For patients diagnosed with endometriosis or uterine fibroids, surgery may be an option to remove any endometriosis tissue, fibroids or cysts.
• Hysterectomy - Hysterectomy, a surgery to remove the uterus, can sometimes be used to treat painful, heavy menstrual bleeding due to uterine cramping in those who don't want to become pregnant. At BHS Physician Network, we offer both traditional and robotic-assisted hysterectomy procedures. Robotic-assisted procedures are minimally invasive, reducing bleeding, scarring, and recovery time.

To schedule an appointment, find a doctor here.

Still have questions about painful periods? Watch these videos to learn more.