Dysmenorrhoea
Dysmenorrhoea is the medical term for painful periods. Cramping pain in the lower abdomen, typically starting a day or two before bleeding and lasting through the first days of a cycle, is how most women experience it. It is one of the most common gynaecological complaints among adolescent and young adult women.
Key points
- High levels of prostaglandins produced by the uterus during menstruation trigger the muscle contractions behind primary cramping pain.
- The ache from cramping often spreads into the lower back and thighs, sometimes bringing nausea, headache or tiredness along with it.
- Unlike the primary form, secondary dysmenorrhoea has an identifiable cause such as endometriosis and tends to worsen rather than ease over time.
- Mefenamic acid blocks prostaglandin production directly, while a progestogen such as dydrogesterone can help when hormonal irregularity or endometriosis is involved.
What drives the pain
Primary dysmenorrhoea, the most common form, occurs when the uterus produces high levels of prostaglandins during menstruation. These chemicals trigger muscle contractions and reduce blood flow, causing the cramping sensation. The pain can radiate to the lower back and thighs and may come with nausea, headache, or fatigue.
Secondary dysmenorrhoea has an underlying cause, such as endometriosis, fibroids, or adenomyosis, and tends to worsen over time rather than easing with age.
Managing menstrual pain
Anti-inflammatory medicines that block prostaglandin production are the most effective first-line approach. Mefenamic acid works in exactly this way and is widely used for period pain. For women whose dysmenorrhoea is linked to hormonal irregularity or conditions such as endometriosis, a progestogen like dydrogesterone may help regulate the cycle and reduce cramping. Both options sit within women’s health and pain management care.
Alongside medicines, heat applied to the lower abdomen, gentle movement, and staying well-hydrated can ease milder symptoms. Severe pain that interrupts daily life, or pain that is worsening cycle by cycle, warrants a medical review to rule out secondary causes.