Dysmenorrhea

• Dysmenorrhea

  Severe and frequent menstrual cramps & pain during the period

  • Painful stomach cramps which can radiate to the sides and down the thighs
  • Pelvic pain (more cramping rather than aching in quality)
• Causes of Dysmenorrhea

  • Primary Dysmenorrhea, existing from the beginning of the periods (involves prostaglandin release)
• When to refer for Dysmenorrhea

  • Severe period pain
  • Unusual period pattern change - heavier than usual or irregular
  • Women >30 with new/ worsening symptoms (suspect endometriosis)
  • Vaginal bleeding post menopause (suspect cancer)
• Treatments for Dysmenorrhea

  • Paracetamol
  • Ibuprofen - oral treatment
  • Ibuprofen unsuitable if Asthma (sensitive to aspirin/ ibuprofen), history of stomach ulcers, liver/kidney problems
  • Ibuprofen LYSINE - (Feminax Express), Very quick acting due to the salt formulation LYSINE. Take 1 or 2 tablets every 4 hours, no more than 6 in 24 hours. Suitable for children >12yrs old.
  • Naproxen 250mg - (Feminax Ultra)
  • 1st Day: Take one tablet at onset, then take a further tablet after 6-8 hours
  • 2nd Day: Take one tablet every 6-8 hrs if needed
  • 3rd Day: Take one tablet every 6-8 hrs if needed
  • Swallow whole with water/ with or after food
  • Maximum THREE tablets daily
  • No more than 3 days treatment in ONE month
  • Women aged 15-50 yrs only
  • Avoid in patients on Anticoagulants/ Steroids
  • Not in pregnancy/breastfeeding
• NSAID-s/e can include Gl ulceration, bleeding, perforation. Common s/e include, nausea, vomiting, diarrhoea, Gl upset.
• Counselling for Dysmenorrhea


  • Hot water bottle - placed on the tummy, helps to ease cramping pain
  • Stopping smoking
  • Mild Exercise & Massage of tummy area
  • TENS-delivering a small electrical current to the tummy muscles helps to relieve the pain