Menstruation is the normal vaginal bleeding as part of women monthly cycle. During this process uterus sheds its lining once in a month and can have normal pain, cramps and discomfort. However, the pain and discomfort might get worse in certain individuals which is known as Dysmenorrhea. (1, 2)

Types of Menstruation Pain

Based on the pathophysiology menstruation pain can be classified in two categories, primary and secondary dysmenorrhea. Primary dysmenorrhea is menstruation pain caused without any underlying disease while secondary dysmenorrhea is the pain caused by some sort of infection or disease. (3)

The common cause of secondary dysmenorrhea is endometriosis, fibroids (myomas), adenomyosis, endometrial polyps, pelvic inflammatory disease, and the use of an intrauterine contraceptive device. (3)

The primary dysmenorrhea can occur during the start of the period and continues for the rest of the life during every period however secondary dysmenorrhea onset later in life due to some identifiable infections and disease. (4)

Causes of Menstrual Pain

Primarily, dysmenorrhea is caused by the chemical imbalance in women during period. The production of uterus prostaglandin is the responsible for the dysmenorrhea which controls the contraction of uterus. Women having severe dysmenorrhea are found to be have higher concentration of prostaglandin in their menstrual fluids and these concentrations are higher during first two days of menstruation. (3, 4)

Prostaglandin may have some role in secondary dysmenorrhea however other causes must be identified depending upon the pelvic disease (3). The common causes of secondary dysmenorrhea are:

Endometriosis: It is the condition in which lining similar to uterus (womb)grows outside the uterus. These lining of uterus is called as endometrium. In this condition the tissues can be found in fallopian tubes, ovaries and intestines which may cause complicate conception. (5, 6)

Adenomyosis: It is a condition in which the inner lining of the uterus breaks through the inner wall of the uterus. Sometimes, it may cause prolonged menstrual bleeding, cramps and pain during intercourse. (6)

Pelvic inflammatory disease (PID): It is the infection of female reproductive organ and it is causes by the transmission of sexually transmitted bacteria from vagina to uterus (womb), fallopian tubes or ovaries. It is often caused by the STDs like chlamydia and gonorrhea. (6, 7)

Fibroids: It is the abnormal non-cancerous growth in or on the women’s uterus. It may cause heavy menstrual bleeding and prolonged period and pelvic pain. (6)

Cervical Stenosis: It is the condition in which the cervix is so small or narrow that in interfere with menstrual flow and causes increase in pressure inside uterus and causes pain.

Symptoms of Dysmenorrhea (6, 8)

  • Aching pain in your stomach
  • A feeling of pressure in your abdomen
  • Pain in your hips, lower back, and inner thighs
  • Upset stomach
  • Vomiting
  • Loose stools

When to See Doctor

If you have severe or abnormal menstrual cramps and pain for more than 2-3 days, and interferes with the ability to perform basic activities, it might indicate underlying medical condition. You should talk to your gynecologist about menstrual cramps since any form of dysmenorrhea is treatable. (5, 6, 8)

Sudden onset of pelvic pain and cramps might indicate presence of infection. Prolonged duration of infection might damage the reproductive organ and may result in fertility in some cases.

If you have these symptoms, you need to consult your gynecologists immediately:

  • Sudden Pain
  • Severe Pelvic Pain
  • Fever
  • Foul Smelling Discharge
  • Dizziness, fainting or near fainting

Home Remedies To Relieve Menstruation Pain

The remedies depend upon the severity of dysmenorrhea, the normal menstrual cramps and pelvic pain can be relieved using home remedies however, medical consultation is needed in case of secondary dysmenorrhea.

Some of the home remedies of dysmenorrhea includes:

Inclusion of Herbs in Diet

Herbs with anti-inflammatory and antispasmodic properties can help in relieving the swelling and pain associated with menstruation.

Chamomile Tea: Traditionally chamomile has been known to used in the treatment of fever, inflammation, muscle spasms, menstrual disorders. Study found that the use of chamomile tea helps in relieving menstruation associated pain, cramps and swelling.

Ginger: In one of the study conducted on university students in 2005-06, it is found out that the effect of ginger is as effective as the other medications like mefenamic acid and ibuprofen in relieving menstruation pain associated with primary dysmenorrhea.

Cinnamon: In a study conducted by Ilam University of Medical Sciences on female students, it is observed that cinnamon is effective in lowering the menstruation bleeding and relieving from pain and cramps without any harmful side effects.

Dill: In a study conducted by Qom University of Medical Sciences of Iran in 2011 on group of students, it is observed that dill is as effective as mefenamic acid in relieving the pain associated with primary dysmenorrhea.


Curcumin, the active compound present in turmeric have several scientifically proven health benefits. The anti-inflammatory and antioxidant properties of turmeric makes it potent herbal medicine. In a study it is found that the consumption of curcumin helps in reducing the severity of premenstrual syndrome (PMS).

Massaging with essential Oils

Massaging for 20 minutes is very much effective in relieving the menstrual pain. In one of the studies on women suffering with endometriosis, it is found out that the massage therapy indeed helped in relieving the menstrual pain than placebo.

Applying Heat

Applying heat to abdomen and lower back may be considered as effective in relieving menstruation associated pain. In as study it is found out that heat patch containing iron chip is as effective as ibuprofen against primary dysmenorrhea.

Avoid Certain Foods

It’s better to avoid certain food items which may cause bloating, water retention and inflammation during periods. Some of the food includes:

  • Alcohol
  • Caffeine
  • Carbonated beverages
  • Fatty foods
  • Salty foods

Reducing intake of these foods may alleviate the menstruation pain.


Menstruation pain is very much normal however it may get severe in certain women and cause discomfort and may lead to incapacities to do basic work. The pain associated with primary dysmenorrhea can be treated in home with certain medications and remedies. In case of secondary dysmenorrhea need immediate medical intervention.