Primary Dysmenorrhea (Menstrual Cramps)

Last Updated: August 16, 2022

Routine menstrual cramps are clinically called primary dysmenorrhea. Primary dysmenorrhea is menstrual pain not caused by other underlying conditions or diseases. If there is an underlying condition, such as endometriosis, that diagnosis is referred to as secondary dysmenorrhea.

Primary Dysmenorrhea (Menstrual Cramps) falls under theWomen’s HealthandPaincategories.

What are menstrual cramps?

Primary dysmenorrhea is the medical term for menstrual pain that occurs in the absence of any other underlying disease. It is generally more common in younger individuals and tends to taper off with age. Menstrual cramps affect roughly two-thirds of young women worldwide.[1][2]

What are the main signs and symptoms of menstrual cramps?

Menstrual cramping or pain usually begins a couple of days before the onset of menstruation and generally lasts for a few days after.[2][3]

These symptoms include:

How are menstrual cramps diagnosed?

Menstrual cramps are generally diagnosed via a focused medical history and a routine pelvic exam that shows a lack of abnormal findings. [3] Secondary causes, such as endometriosis, can be evaluated with ultrasound but sometimes require further testing or evaluation by a specialist.[2] Visit the American College of Obstetricians and Gynecologists to learn more about diagnosing primary dysmenorrhea and reducing menstrual pain.

What are some of the main medical treatments for menstrual cramps?

Over-the-counter Nonsteroidal anti-inflammatory drugs (NSAIDs) are the go-to treatment for menstrual cramps as they lower prostaglandin production and thus reduce cramping.[4] Check with your healthcare provider before taking NSAIDs.

For patients with significant primary dysmenorrhea (cramps not caused by another disease process), occasionally oral contraceptive pills may be recommended by a doctor as they may reduce episodes of cramping as well.

Seek medical help if menstrual pain is not relieved by NSAIDs or other self-care practices, cramps happen when you are or may be pregnant, cramps suddenly become worse, you are over 25 years of age and get severe cramps for the first time, cramps are accompanied by a fever, or you experience pain not around the time of menstruation.[2]

Have any supplements been studied for menstrual cramps?

Several supplements have been used to treat menstrual cramps including cinnamon, ginger, chamomile, fennel, omega-3 fatty acids and fish oil, Vitamin D, Vitamin E, calcium, magnesium, zinc, and boron.[5][6][7]

How could diet affect menstrual cramps?

Dieting to lose weight, skipping meals, and a low intake of antioxidants have been associated with a greater risk of menstrual cramps.[8] Higher intakes of fiber, fruits, and vegetables, and dairy products have been associated with reduced risk.[8] It should be noted, though, that studies vary in the way they assess dietary habits and in their methods for measuring menstrual pain, so more evidence is needed to support specific diets and foods for dysmenorrhea.

Are there any other treatments for menstrual cramps?

Some self-care practices may be helpful to ease menstrual pain. These include using heat, like a hot water bottle or a heating pad on the lower abdomen, exercising, taking a hot bath, or relaxing by doing yoga or meditation.[2]

What causes menstrual cramps?

Elevated prostaglandin concentrations triggered by the drop in progesterone before menstruation are thought to be the main cause of menstrual cramps. There is some less certain evidence that elevated vasopressin concentrations may also play a role in this condition.[9]

Examine Database: Primary Dysmenorrhea (Menstrual Cramps)
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  1. ^Armour M, Parry K, Manohar N, Holmes K, Ferfolja T, Curry C, MacMillan F, Smith CAThe Prevalence and Academic Impact of Dysmenorrhea in 21,573 Young Women: A Systematic Review and Meta-AnalysisJ Womens Health (Larchmt).(2019 Aug)
  2. ^The content of this page was partially adapted from MedlinePlus of the National Library of Medicine
  3. ^A S CocoPrimary dysmenorrheaAm Fam Physician.(1999 Aug)
  4. ^Marjoribanks J, Ayeleke RO, Farquhar C, Proctor MNonsteroidal anti-inflammatory drugs for dysmenorrhoeaCochrane Database Syst Rev.(2015 Jul 30)
  5. ^Z Harel, F M Biro, R K Kottenhahn, S L RosenthalSupplementation with omega-3 polyunsaturated fatty acids in the management of dysmenorrhea in adolescentsAm J Obstet Gynecol.(1996 Apr)
  6. ^Maedeh Sharghi, Shabnam Malekpour Mansurkhani, Damoon Ashtary Larky, Wesam Kooti, Mehdi Niksefat, Mohammad Firoozbakht, Masoud Behzadifar, Milad Azami, Karo Servatyari, Leila JouybariAn update and systematic review on the treatment of primary dysmenorrheaJBRA Assist Reprod.(2019 Jan 31)
  7. ^Marzieh Saei Ghare Naz, Zahra Kiani, Farzaneh Rashidi Fakari, Vida Ghasemi, Masoumeh Abed, Giti OzgoliThe Effect of Micronutrients on Pain Management of Primary Dysmenorrhea: a Systematic Review and Meta-AnalysisJ Caring Sci.(2020 Mar 1)
  8. ^Zahra Bajalan, Zainab Alimoradi, Farnoosh MoafiNutrition as a Potential Factor of Primary Dysmenorrhea: A Systematic Review of Observational StudiesGynecol Obstet Invest.(2019)
  9. ^Zofia Barcikowska, Elżbieta Rajkowska-Labon, Magdalena Emilia Grzybowska, Rita Hansdorfer-Korzon, Katarzyna ZorenaInflammatory Markers in Dysmenorrhea and Therapeutic OptionsInt J Environ Res Public Health.(2020 Feb 13)
  10. ^Osayande AS, Mehulic SDiagnosis and initial management of dysmenorrheaAm Fam Physician.(2014 Mar 1)
  11. ^Armour M, Ee CC, Naidoo D, Ayati Z, Chalmers KJ, Steel KA, de Manincor MJ, Delshad EExercise for dysmenorrhoeaCochrane Database Syst Rev.(2019 Sep 20)
  12. ^Dawood MYPrimary dysmenorrhea: advances in pathogenesis and managementObstet Gynecol.(2006 Aug)
Examine Database References
  1. Dysmenorrhea Symptoms - Apay SE, Arslan S, Akpinar RB, Celebioglu AEffect of aromatherapy massage on dysmenorrhea in Turkish studentsPain Manag Nurs.(2012 Dec)
  2. Dysmenorrhea Symptoms - Ziaei S, Zakeri M, Kazemnejad AA randomised controlled trial of vitamin E in the treatment of primary dysmenorrhoeaBJOG.(2005 Apr)
  3. Dysmenorrhea Symptoms - Kashanian M, Lakeh MM, Ghasemi A, Noori SEvaluation of the effect of vitamin E on pelvic pain reduction in women suffering from primary dysmenorrheaJ Reprod Med.(2013 Jan-Feb)
  4. Dysmenorrhea Symptoms - Ziaei S, Faghihzadeh S, Sohrabvand F, Lamyian M, Emamgholy TA randomised placebo-controlled trial to determine the effect of vitamin E in treatment of primary dysmenorrhoeaBJOG.(2001 Nov)
  5. Dysmenorrhea Symptoms - Nikkhah S, Dolatian M, Naghii MR, Zaeri F, Taheri SMEffects of boron supplementation on the severity and duration of pain in primary dysmenorrheaComplement Ther Clin Pract.(2015 May)
  6. Dysmenorrhea Symptoms - Ozgoli G, Goli M, Moattar FComparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrheaJ Altern Complement Med.(2009 Feb)
  7. PMS Symptoms - Khayat S, Kheirkhah M, Behboodi Moghadam Z, Fanaei H, Kasaeian A, Javadimehr MEffect of treatment with ginger on the severity of premenstrual syndrome symptomsISRN Obstet Gynecol.(2014 May 4)
  8. Dysmenorrhea Symptoms - Jenabi E, Fereidoony BEffect of Achillea Millefolium on Relief of Primary Dysmenorrhea: A Double-Blind Randomized Clinical Trial.J Pediatr Adolesc Gynecol.(2015-Oct)
  9. Cramps - Mirabi P, Namdari M, Alamolhoda S, Mojab FThe Effect of Melissa Officinalis Extract on the Severity of Primary DysmenorrhaIran J Pharm Res.(2017 Winter)
  10. Cramps - Bahrami A, Avan A, Sadeghnia HR, Esmaeili H, Tayefi M, Ghasemi F, Nejati Salehkhani F, Arabpour-Dahoue M, Rastgar-Moghadam A, Ferns GA, Bahrami-Taghanaki H, Ghayour-Mobarhan MHigh dose vitamin D supplementation can improve menstrual problems, dysmenorrhea, and premenstrual syndrome in adolescentsGynecol Endocrinol.(2018 Aug)
  11. Pain - Mirabi P, Dolatian M, Mojab F, Majd HAEffects of valerian on the severity and systemic manifestations of dysmenorrheaInt J Gynaecol Obstet.(2011 Dec)
  12. PMS Symptoms - He Z, Chen R, Zhou Y, Geng L, Zhang Z, Chen S, Yao Y, Lu J, Lin STreatment for premenstrual syndrome with Vitex agnus castus: A prospective, randomized, multi-center placebo controlled study in ChinaMaturitas.(2009 May 20)
  13. PMS Symptoms - Masoumi SZ, Ataollahi M, Oshvandi KEffect of Combined Use of Calcium and Vitamin B6 on Premenstrual Syndrome Symptoms: a Randomized Clinical TrialJ Caring Sci.(2016 Mar 1)
  14. PMS Symptoms - Penland JG, Johnson PEDietary calcium and manganese effects on menstrual cycle symptomsAm J Obstet Gynecol.(1993 May)
  15. PMS Symptoms - Yonkers KA, Pearlstein TB, Gotman NA pilot study to compare fluoxetine, calcium, and placebo in the treatment of premenstrual syndromeJ Clin Psychopharmacol.(2013 Oct)
  16. PMS Symptoms - Sampalis F, Bunea R, Pelland MF, Kowalski O, Duguet N, Dupuis SEvaluation of the effects of Neptune Krill Oil on the management of premenstrual syndrome and dysmenorrheaAltern Med Rev.(2003 May)
  17. PMS Symptoms - Tamborini A, Taurelle RValue of standardized Ginkgo biloba extract (EGb 761) in the management of congestive symptoms of premenstrual syndromeRev Fr Gynecol Obstet.(1993 Jul-Sep)
  18. Estrogen - Fukui H, Toyoshima K, Komaki RPsychological and neuroendocrinological effects of odor of saffron (Crocus sativus)Phytomedicine.(2011 Jun 15)