Do you suffer from unbearable pain every month “these days”? Let’s say that this is not the norm. Perhaps behind these unpleasant sensations is a gynecological disease that requires immediate treatment. 

What is dysmenorrhea, and how to recognize and diagnose it?

What is dysmenorrhea

Despite widespread public opinion, menstruation should not normally cause severe pain in women. If this still happens, it is worth discussing dysmenorrhea’s presence. 

The term came to us from Greek and translated as “difficult menstrual flow.” The healer, physician, and philosopher Hippocrates considered the main cause of this disease to be a mechanical obstacle to the release of blood from the uterine cavity. Of course, in the future, the views of scientists will change their direction. 

Dysmenorrhea is the appearance of pain in the lower abdomen during menstruation. Sensations can be sharp, cramping, sharp, pulling, and bursting.

This gynecological pathology greatly aggravates “women’s days”: the pain can be so severe that a woman is forced to stay in bed, thereby becoming practically incapacitated. 

According to statistics, from 50 to 90% of women of reproductive age experience signs of dysmenorrhea. Such a high percentage indicates the need for detailed coverage of this topic. 

How should normal menstruation proceed?

Menstruation is a “litmus test” of a woman’s health and has its characteristics. 

Normally, a woman whose history is not burdened with chronic and inflammatory diseases of the small pelvis does not experience severe pain in the abdomen. However, a few days before menstruation, PMS symptoms may be mild or moderate:

  • Headache;
  • Irritability;
  • Tearfulness;
  • swelling;
  • Tachycardia;
  • Breast engorgement;
  • skin rashes;
  • Nausea;
  • Flatulence.

As for pains in the abdomen, they have a pulling character, but at the same time, they do not prevent a woman from walking and being in an upright position.  

If you expect your period every month like a terrible nightmare, and all plans are ruined because you have to stay in bed, you should suspect dysmenorrhea. 

Types of dysmenorrhea


Dysmenorrhea is either primary or secondary.

  • Primary (functional).
  • These are painful menstruation without pathological phenomena of the genital organs. Appears in adolescence with the onset of the first menstruation or after 2-3 years. 
  • Painful symptoms make themselves felt a few days before bleeding. Pain can be expressed in different ways. As a rule, it occurs in the lower abdomen in the lower back and has a cramping, bursting, pulling, and pulling character. In some cases, pain may radiate to the rectum, ovaries, and bladder. 
  • The most difficult “critical days” occur in girls with late first menstruation (menarche). 
  • It was also found that with the normalization of the hormonal background, dysmenorrhea disappears in about half of the patients. 
  • Causes of primary dysmenorrhea can be:
    • Physiological factors. Namely, a violation of the synthesis of hormones. The following chain reaction occurs: during PMS, the level of prostaglandins rises, this leads to a strong uterine contraction, and pain appears. An increase in hormones such as serotonin, dopamine, adrenaline, and norepinephrine can also contribute to discomfort.
    • Psychological factors. For example, the patient’s low pain threshold, fear of menstruation, and psycho-emotional instability.
    • Vascular disorders.
    • Malformations of the uterus or its atypical position.
    • Magnesium deficiency in the blood. 
  • Secondary dysmenorrhea (organic).
  • In this case, pain in the lower abdomen during menstruation provokes various gynecological diseases and conditions:
    • endometriosis;
    • Inflammatory diseases of the pelvic organs;
    • Allen-Masters syndrome;
    • Varicose veins of the pelvic veins;
    • STDs (sexually transmitted diseases);
    • Adhesions in the pelvis and fallopian tubes;
    • The presence of an intrauterine device (it contributes to increased production of prostaglandins);
    • Anomalies of the genital organs that impede the outflow of menstrual blood;
    • Metabolic disease;
    • Cardiovascular diseases. 

Endometriosis is one of the most common causes of secondary dysmenorrhea in young girls. This is a chronic, hormone-dependent, relapse-prone disease that occurs due to abnormal growth of endometrial tissue in atypical places for it. 

The vital activity of endometrial cells depends on the hormonal background of a woman. If it is unbalanced, there is a rapid growth of the endometrium, as a result of which its cells attack and affect other organs: the muscular layer of the uterus, the internal genital area, the genitourinary system, and the pelvic organs. In some cases, endometrial cells extend beyond the uterine cavity – the peritoneal or intestinal mucosa. 

Wherever the endometrial cell lives, it will perform its function – to menstruate. And accordingly, when a small cell gives micro-menstruation, an inflammatory process occurs. From here, symptoms familiar to many women appear as pain, heaviness, and adhesions.


Symptoms of dysmenorrhea

The main symptom of dysmenorrhea is a pain in the lower abdomen. It may appear a few days before the onset of menstruation or during it. 

In addition, a woman may be concerned about: 

  • Metabolic and endocrine symptoms (severe weakness, joint pain, swelling, feeling of “cotton” legs, vomiting, fever, fainting, decreased memory and performance);
  • Vegetative symptoms (feeling hot, sweating, dry mouth, frequent urination);
  • Vascular symptoms (pain in the heart, tachycardia, numbness of the arms and legs);
  • Emotional and mental symptoms (drowsiness, irritability, bad mood, insomnia). 

Greek scientists E. Deligeoglu and D.I. Arvantinos 1996 developed a system for assessing dysmenorrhea by severity. It looks like this: 

Diagnostic methods

Several stages of the examination will be required to find out the cause of painful menstruation. Each of them is very important, and going through all the points will help create a complete and detailed picture of your condition: 

  • Consultation with a gynecologist (history taking, examination, palpation of the mammary glands);
  • Taking a smear (for microflora, cytology, latent infections, bakposev); 
  • Laboratory tests (it is very important to know not only the results of a general and biochemical blood test but also to keep in mind the level of sex hormones, oxidative stress, and vitamin D);
  • Instrumental examination (ultrasound of the pelvic organs on the 3rd-5th day of the cycle, colposcopy).  

When to go to the gynecologist

We recommend that our patients undergo a complete check-up of women’s health once a year:

  • Check the level and balance of hormones.
  • Do ultrasound diagnostics.
  • Take smears and laboratory tests.

This approach will help to identify and eliminate various problems in your body in the early stages. 

In addition, do not be afraid to seek qualified help if something bothers you. Menstruation in all women proceeds individually, so any unpleasant symptom requires attention and diagnosis. 

The effectiveness of the study will be higher if the gynecologist knows the field of anti-aging medicine. Such specialists in working with patients use a purely individual and, at the same time, integrated approach. 


Medical treatment

Treatment with medications may depend on the results of the diagnosis; look like this:

  • Reducing pain with antispasmodics;
  • Alignment of metabolism;
  • Elimination of the consequences of oxidative stress;
  • Suppression of glycation;
  • Replenishment of vitamin deficiency;
  • Anti-inflammatory therapy;
  • Sedatives (magnesium B6). 

Tips for Reducing Menstrual Pain

In addition to following all the appointments of a gynecologist, there are general recommendations that will help ease the course of “critical days”:

  • Take the day off from work or school to spend the first days of your period at home. You need rest and bed rest.
  • Eliminate unhealthy and indigestible foods from your diet.
  • Avoid stress and psycho-emotional stress. Not only physical but also inner peace is important to you.
  • Sleep at least 8-9 hours.

Possible complications of dysmenorrhea

If time does not pay attention to the symptoms and allow the cause of dysmenorrhea to progress, it can eventually lead to chronic gynecological diseases. 

Accordingly, your condition will worsen, and treatment will take longer. 


Pay attention to the following points to keep painful periods from ruining your life. Their timely observance will help to avoid unbearable pain and poor health:

  • Visit a gynecologist every 5-6 months;
  • Do not put off for “later” the treatment of endocrine and gynecological problems;
  • Avoid unprotected intercourse, as well as curettage of the uterine cavity;
  • Find out your family history from the female line. If someone from close relatives was diagnosed with endometriosis or had painful periods, then with a high probability this problem may concern you.  

Brief conclusions

Dysmenorrhea is one of the most common diseases in which a woman cannot work, go to school, or study at a university. According to WHO, about ⅓ of women with dysmenorrhea lose their ability to work within 1-3 days every month. And among all the reasons for the absence of girls in school, this pathology does take the first place. 

Thus, any pain, including menstrual pain, requires immediate diagnosis and treatment. This will help make a woman’s life easier and return her social activity, good health, and performance. 


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