Periods - painful (adolescent)
Key points
- Primary dysmenorrhea in adolescents usually begins 2 to 3 years following the onset of menses.
- A history and physical examination by the health care provider will often differentiate between functional dysmenorrhea and those rare cases associated with a medical condition.
- This includes over-the-counter medications such as aspirin, nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen (available over-the-counter or in prescription strengths), and prescription-only medications such as indomethacin.
- Mild analgesics are usually effective in treating dysmenorrhea and oral contraceptives generally control severe cases.
Alternative names
Dysmenorrhea in the adolescent; Adolescent dysmenorrhea; Menstrual pain - adolescent; Painful menstrual periods - adolescent
Definition
Dysmenorrhea is defined as painful menses.
Causes, incidence, and risk factors
Primary dysmenorrhea in adolescents usually begins 2 to 3 years following the onset of menses. It consists of crampy lower abdominal pain that generally begins several hours prior to the onset of a menstrual period, but may begin as much as 1 or 2 days in advance.
The pain lasts 1 or more days into the period and then subsides. Pain may be mild to severe, and may be associated with nausea and vomiting and changes in bowel habits (either constipation or diarrhea). Primary dysmenorrhea is caused by prostaglandin-induced uterine contractions.
Dysmenorrhea is a common gynecological complaint in adolescents, but the majority of cases are not associated with a disease, and the physical examination is normal. Dysmenorrhea has been reported to be significantly increased among mothers and sisters of women with dysmenorrhea.
Abnormal conditions associated with secondary dysmenorrhea include endometriosis, pelvic inflammatory disease, vaginal agenesis, and others. Secondary dysmenorrhea most commonly begins in women in their 20s. Increasing frequency of sexually transmitted diseases among adolescents has increased the percentage of dysmenorrhea cases associated with disease.
Symptoms
- Lower abdominal crampy pain that occurs before the beginning of the menstrual period and lasts 1 or 2 days into the period
- Nausea
- Vomiting
- Diarrhea
- Constipation
Signs and tests
A history and physical examination by the health care provider will often differentiate between functional dysmenorrhea and those rare cases associated with a medical condition. Younger adolescents who have not become sexually active may require a pelvic examination (performed through the rectum rather than through the vagina).
Treatment
Initial treatment is focused on relief of pain. Anti-inflammatory medications can be helpful. This includes over-the-counter medications such as aspirin, nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen (available over-the-counter or in prescription strengths), and prescription-only medications such as indomethacin.
In some severe cases, and with disorders such as endometriosis, oral contraceptives can be helpful. They are used in this case to regulate the hormone levels in the body (they may be prescribed even for girls who are not sexually active).
Frequently asked questions
What are the risk factors for periods?
Primary dysmenorrhea in adolescents usually begins 2 to 3 years following the onset of menses. It consists of crampy lower abdominal pain that generally begins several hours prior to the onset of a menstrual period, but may begin as much as 1 or 2 days in advance. The pain lasts 1 or more days into the period and then subsides. Pain may be mild to severe, and may be associated with nausea and vomiting and changes in bowel habits (either constipation or diarrhea). Primary dysmenorrhea is caused by prostaglandin-induced uterine contractions.
What are the symptoms of periods?
- Lower abdominal crampy pain that occurs before the beginning of the menstrual period and lasts 1 or 2 days into the period
- Nausea
- Vomiting
- Diarrhea
- Constipation
How are periods treated?
Initial treatment is focused on relief of pain. Anti-inflammatory medications can be helpful. This includes over-the-counter medications such as aspirin, nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen (available over-the-counter or in prescription strengths), and prescription-only medications such as indomethacin. In some severe cases, and with disorders such as endometriosis, oral contraceptives can be helpful. They are used in this case to regulate the hormone levels in the body (they may be prescribed even for girls who are not sexually active).
Written and revised by
David Cohen, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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