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Information from Your Family Doctor
Painful Menstrual Periods
Am Fam Physician. 2021 Aug ;104(2):online.
See related article on dysmenorrhea
Why do some people have painful periods?
Many people have some crampy pain with their periods, especially as teenagers. The pain often is low in the pelvis and starts just before your period or at the beginning of your period. It often lasts one to three days. The pain can be bad enough to keep you from doing things you normally do.
Painful periods usually do not mean that anything is seriously wrong. Sometimes, though, painful periods can be caused by an infection, cysts, or other problems. Pain can also be caused by a condition called endometriosis (say: en-doe-me-tree-oh-sis). This happens when the lining of the uterus grows outside of the uterus.
How are painful periods treated?
The most common way to treat painful periods is to take medicines called nonsteroidal anti-inflammatory drugs (NSAIDs). Examples of NSAIDs include ibuprofen (some brand names: Motrin, Advil) or naproxen (one brand name: Aleve). You can buy these medicines without a prescription.
Your doctor might also recommend that you try taking birth control pills or getting a birth control shot (brand name: Depo-Provera) or an intrauterine device (IUD; one brand name: Mirena) An IUD is a small T-shaped device that your doctor inserts into your uterus.
These medicines can make your periods less painful. You also can try exercising for 45 to 60 minutes at least three days per week or using a heating pad to help make the pain better. Ask your doctor about other treatments that may help.
What if these treatments don't work?
If the pain with your periods does not get a lot better after taking NSAIDs or birth control pills, your doctor might want to do a pelvic examination and an ultrasound. Your doctor also may want you to see another doctor who can do a minor surgery called laparoscopy (say: lap-uh-rah-ska-pee). These are ways for doctors to see whether you have endometriosis.
How can I tell if I have a more serious problem?
Tell your doctor if you have any of these symptoms:
Your painful periods started after your teenage years
You have pain at times other than the first couple of days of your period
You have unusual vaginal discharge, odor, or bleeding
Medicine does not make your pain go away
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
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