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What Causes Painful Menstrual Periods?

Painful menstruation is also called dysmenorrhea. Menstrual cramps are pains in a woman’s lower abdomen that occur when her menstrual period begins (or just before) and may continue for two to three days. They may be throbbing or aching and can be dull or sharp. Symptoms can range in severity from a mild annoyance to severe pain that interferes with normal activities.

What are the causes?

It’s not always possible to identify the cause of painful menstrual periods. Some people are just at a higher risk of having painful periods.

These risks include:

  • being under age 20
  • having a family history of painful periods
  • smoking
  • having heavy bleeding with periods
  • having irregular periods
  • never having had a baby
  • reaching puberty before age 11

A hormone called prostaglandin triggers muscle contractions in your uterus that expel the lining. These contractions can cause pain and inflammation. The level of prostaglandin rises right before menstruation begins.

When to call a doctor

If menstrual pain is interfering with your ability to perform basic tasks each month, it may be time to talk to a gynecologist.

Talk to your doctor about your symptoms and if you experience any of the following:

  • continuing pain after IUD placement
  • at least three painful menstrual periods
  • passing blood clots
  • cramping accompanied by diarrhea and nausea
  • pelvic pain when not menstruating

Sudden cramping or pelvic pain could be signs of infection. An untreated infection can cause scar tissue that damages the pelvic organs and may lead to infertility.

If you have symptoms of an infection, seek prompt medical attention:

  • fever
  • severe pelvic pain
  • sudden pain, especially if you may be pregnant
  • foul-smelling vaginal discharge

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