Materiały źródłowe

• #1 Dysmenorrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560834/

  Dysmenorrhea is defined as pain during the menstrual cycle. […] Providing treatment options for patients affected by dysmenorrhea can significantly reduce the associated morbidity. […] Identify the etiology of primary and secondary dysmenorrhea. […] Primary dysmenorrhea is recurrent lower abdominal pain that happens during the menstrual cycle and is not associated with other diseases or underlying pathology. […] In contrast, secondary dysmenorrhea is associated with suspected or clinically identifiable pathology. […] Since the 1960s, many theories have been proposed to explain the etiology of dysmenorrhea. These theories include psychological, biochemical, and anatomical etiologies. […] The anatomical theory notes abnormal uterine position and abnormalities in the shape or length of the cervix.

• #2 Dysmenorrhea: Painful Periods | ACOG

  https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods

  Primary dysmenorrhea is the cramping pain that comes before or during a period. This pain is caused by natural chemicals called prostaglandins that are made in the lining of the uterus. Prostaglandins cause the muscles and blood vessels of the uterus to contract. On the first day of a period, the level of prostaglandins is high. As bleeding continues and the lining of the uterus is shed, the level goes down. This is why pain tends to lessen after the first few days of a period. […] […] Secondary dysmenorrhea is caused by a disorder in the reproductive organs. The pain tends to get worse over time and it often lasts longer than normal menstrual cramps. For example, the pain may begin a few days before a period starts. The pain may get worse as the period continues and may not go away after it ends. […]

• #3 Menstrual Cramps Causes and Treatments

  https://www.webmd.com/women/menstrual-pain

  Menstrual cramps are the leading cause of absenteeism in women younger than 30. […] Prostaglandins are chemicals the body makes that cause many of the symptoms associated with menstrual discomfort. The tissue that lines the uterus makes these chemicals. Prostaglandins stimulate the uterine muscles to contract. People who have high levels of prostaglandin may have more intense contractions of their uterus and more pain. Prostaglandins may also be responsible for vomiting, diarrhea, and headaches that accompany painful periods. […] If you have had menstrual pain ever since your periods started, the condition is called primary dysmenorrhea. If a physical condition such as pelvic inflammatory disease or endometriosis has developed and is causing the pain, this is called secondary dysmenorrhea. Once the medical condition is treated, the menstrual pain usually goes away.

• #4 Menstrual Cramps

  https://www.seattlechildrens.org/conditions/a-z/menstrual-cramps/

  Cramps in the lower belly or pelvis. They start during the first 1 or 2 days of a girl’s period. […] The medical name for painful cramping during a girl’s period is dysmenorrhea. Normal cramps happen in over 60% of girls. This cramping is caused by strong muscle squeezing of the uterus. This is triggered by a high prostaglandin (a hormone) level. An egg release from the ovary (ovulation) is needed to cause cramping. Therefore, the onset is most often 12 months or more after the first period. Medical causes of severe menstrual cramps include pelvic inflammatory disease (PID) and endometriosis. An ovarian cyst can also cause very bad cramping. […] Cramps happen in over 60% of girls.

• #5 Dysmenorrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560834/

  Dysmenorrhea is defined as pain during the menstrual cycle. […] Providing treatment options for patients affected by dysmenorrhea can significantly reduce the associated morbidity. […] Identify the etiology of primary and secondary dysmenorrhea. […] Primary dysmenorrhea is recurrent lower abdominal pain that happens during the menstrual cycle and is not associated with other diseases or underlying pathology. […] In contrast, secondary dysmenorrhea is associated with suspected or clinically identifiable pathology. […] Since the 1960s, many theories have been proposed to explain the etiology of dysmenorrhea. These theories include psychological, biochemical, and anatomical etiologies. […] The anatomical theory notes abnormal uterine position and abnormalities in the shape or length of the cervix.

• #6 Menstrual cramps – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/symptoms-causes/syc-20374938

  Menstrual cramps (dysmenorrhea) are throbbing or cramping pains in the lower abdomen. […] Conditions such as endometriosis or uterine fibroids can cause menstrual cramps. Treating the cause is key to reducing the pain. […] During your menstrual period, your uterus contracts to help expel its lining. Hormonelike substances (prostaglandins) involved in pain and inflammation trigger the uterine muscle contractions. Higher levels of prostaglandins are associated with more-severe menstrual cramps. […] Menstrual cramps can be caused by: Endometriosis. Tissue that acts similar to the lining of the uterus grows outside of the uterus, most commonly on fallopian tubes, ovaries or the tissue lining your pelvis. […] Uterine fibroids. These noncancerous growths in the wall of the uterus can cause pain.

• #7 Dysmenorrhea: Menstrual Cramps, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/4148-dysmenorrhea

  Dysmenorrhea is the medical term for painful menstrual periods. It happens because your uterus contracts to shed its lining. Primary dysmenorrhea refers to recurrent pain with no identifiable cause. Secondary dysmenorrhea results from conditions like endometriosis. […] Menstrual cramps happen when a chemical called prostaglandin makes your uterus contract (tighten up). During menstruation, prostaglandin levels are higher, which means your uterus contracts more strongly. This is the cramping and discomfort you feel. […] Experts aren’t entirely sure why some people have more painful periods, but they think it may be because they have higher levels of prostaglandins. […] Menstrual pain from secondary dysmenorrhea is a result of a condition affecting your reproductive organs. Conditions that can cause cramping include: Endometriosis: A condition where the tissue lining your uterus (the endometrium) grows outside of your uterus. […] If a medical condition is causing painful periods, there can be complications. For example, conditions like endometriosis or pelvic inflammatory disease can lead to infertility or ectopic pregnancy.

• #8 Menstrual pain: its origin and pathogenesis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/7001019/

  A variety of misconceptions about the etiology of dysmenorrhea have existed in the past. […] Experimental and clinical research of the last 15 years, however, has identified uterine prostaglandins as substantially contributing to the pathogenesis of primary dysmenorrhea. […] It is now known that at the end of the menstrual cycle, prostaglandins increase myometrial contractions and cause constriction of small endometrial blood vessels, with consequent tissue ischemia, endometrial disintegration, bleeding and pain. […] Dysmenorrhea may be due to tissue ischemia resulting from increased intrauterine pressure, vessel constriction and decreased uterine blood flow. […] The most compelling evidence for the „prostaglandin theory” is the success of prostaglandin synthesis inhibitors in the treatment of dysmenorrhea. […] The pain relief achieved with these drugs is accompanied by a suppression of prostaglandin synthesis and a decrease in intrauterine pressure.

• #9 Period Pain | Menstrual Cramps | MedlinePlus

  https://medlineplus.gov/periodpain.html

  Menstruation, or period, is normal vaginal bleeding that happens as part of a woman’s monthly cycle. Many women have painful periods, also called dysmenorrhea. The pain is most often menstrual cramps, which are a throbbing, cramping pain in your lower abdomen. […] There are two types of dysmenorrhea: primary and secondary. Each type has different causes. […] Primary dysmenorrhea is the most common kind of period pain. It is period pain that is not caused by another condition. The cause is usually having too many prostaglandins, which are chemicals that your uterus makes. These chemicals make the muscles of your uterus tighten and relax, and this causes the cramps. […] Secondary dysmenorrhea often starts later in life. It is caused by conditions that affect your uterus or other reproductive organs, such as endometriosis and uterine fibroids. This kind of pain often gets worse over time. It may begin before your period starts and continue after your period ends.

• #10 Menstrual pain: its origin and pathogenesis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/7001019/

  A variety of misconceptions about the etiology of dysmenorrhea have existed in the past. […] Experimental and clinical research of the last 15 years, however, has identified uterine prostaglandins as substantially contributing to the pathogenesis of primary dysmenorrhea. […] It is now known that at the end of the menstrual cycle, prostaglandins increase myometrial contractions and cause constriction of small endometrial blood vessels, with consequent tissue ischemia, endometrial disintegration, bleeding and pain. […] Dysmenorrhea may be due to tissue ischemia resulting from increased intrauterine pressure, vessel constriction and decreased uterine blood flow. […] The most compelling evidence for the „prostaglandin theory” is the success of prostaglandin synthesis inhibitors in the treatment of dysmenorrhea. […] The pain relief achieved with these drugs is accompanied by a suppression of prostaglandin synthesis and a decrease in intrauterine pressure.

• #11 Menstrual pain: its origin and pathogenesis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/7001019/

  A variety of misconceptions about the etiology of dysmenorrhea have existed in the past. […] Experimental and clinical research of the last 15 years, however, has identified uterine prostaglandins as substantially contributing to the pathogenesis of primary dysmenorrhea. […] It is now known that at the end of the menstrual cycle, prostaglandins increase myometrial contractions and cause constriction of small endometrial blood vessels, with consequent tissue ischemia, endometrial disintegration, bleeding and pain. […] Dysmenorrhea may be due to tissue ischemia resulting from increased intrauterine pressure, vessel constriction and decreased uterine blood flow. […] The most compelling evidence for the „prostaglandin theory” is the success of prostaglandin synthesis inhibitors in the treatment of dysmenorrhea. […] The pain relief achieved with these drugs is accompanied by a suppression of prostaglandin synthesis and a decrease in intrauterine pressure.

• #12 Menstrual Cramps (Dysmenorrhea): Symptoms, Causes, Treatment, Prevention

  https://www.webmd.com/women/menstrual-cramps

  Menstrual cramps happen because of contractions in the uterus, or womb, which is a muscle. If it contracts too strongly during your menstrual cycle, it can press against nearby blood vessels. This briefly cuts off oxygen to the uterus. Its this lack of oxygen that causes your pain and cramping. […] You can also have cramps because of: […] Endometriosis, condition in which tissue that looks like the same tissue as what is lining the uterus (the endometrium) grows in places outside of the uterus […] Fibroids in your uterus […] Adenomyosis, where tissue that is similar to the tissue of your uterine lining is found within the uterine muscle […] Pelvic inflammatory disease (PID), an infection caused by bacteria that starts in the uterus and can spread to other reproductive organs […] Cervical stenosis, or a narrowing of the lower part of your uterus, caused by scarring, as well as a lack of estrogen after menopause.

• #13 Severe Menstrual Cramps: Normal vs. Severe Pain, Causes, Relief Tips

  https://www.healthline.com/health/severe-menstrual-cramps

  Menstrual cramps can range from a mild nuisance lasting a day or two to several days of unbearable pain that interferes with everyday activities. […] The pain is caused by uterine contractions that happen just before or during the onset of your period. But what makes the pain more severe for some people? […] During your period, your uterus contracts to help shed its lining. These contractions are triggered by hormone-like substances called prostaglandins. Higher levels of prostaglandins are associated with more severe menstrual cramps. […] Some people tend to have more severe menstrual cramps without any clear cause. For others, severe menstrual cramps may be a symptom of an underlying medical condition. […] Adenomyosis doesn’t always cause symptoms. When it does, you may notice severe menstrual cramps that get increasingly worse, as well as heavy or prolonged menstrual bleeding.

• #14 Dysmenorrhea: Painful Periods | ACOG

  https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods

  Primary dysmenorrhea is the cramping pain that comes before or during a period. This pain is caused by natural chemicals called prostaglandins that are made in the lining of the uterus. Prostaglandins cause the muscles and blood vessels of the uterus to contract. On the first day of a period, the level of prostaglandins is high. As bleeding continues and the lining of the uterus is shed, the level goes down. This is why pain tends to lessen after the first few days of a period. […] […] Secondary dysmenorrhea is caused by a disorder in the reproductive organs. The pain tends to get worse over time and it often lasts longer than normal menstrual cramps. For example, the pain may begin a few days before a period starts. The pain may get worse as the period continues and may not go away after it ends. […]

• #15 What Causes Period Cramps? Symptoms, Causes, & Treatments

  https://www.naturalcycles.com/cyclematters/what-causes-period-cramps

  Period cramps are caused by higher levels of a hormone-like substance called prostaglandins that make the uterus contract during our period. […] For many of us, period cramps are a side effect of our menstrual cycle, but for some individuals, the pain may be caused by an underlying condition. […] Period cramps happen when the uterus contracts as it sheds its lining. […] Period cramps are caused by higher levels of a hormone-like substance called prostaglandins, which make the muscles and blood vessels in the uterus contract. […] The pain is usually the most intense on the first day of the period because that’s when the levels of prostaglandins are the highest. […] However, some people tend to have higher levels of prostaglandins, and they are also prone to more pain associated with period cramps.

• #16 Dysmenorrhea: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/253812-overview

  Dysmenorrhea can be divided into two broad categories: primary and secondary. […] Primary dysmenorrhea is defined as menstrual pain that is not associated with macroscopic pelvic pathology (ie, occurs in the absence of pelvic disease). […] Secondary dysmenorrhea is defined as menstrual pain resulting from anatomic or macroscopic pelvic pathology, as is seen in women with endometriosis or chronic pelvic inflammatory disease. […] The following risk factors are associated with more severe episodes of dysmenorrhea: Earlier age at menarche, Long menstrual periods, Heavy menstrual flow, Smoking, Positive family history. […] Some (not all) studies have found obesity and alcohol consumption to be associated with dysmenorrhea. […] Risk factors for primary dysmenorrhea include the following: Early age at menarche ( 12 years), Nulliparity, Heavy or prolonged menstrual flow, Smoking, Positive family history, Obesity.

• #17 Period cramps 101

  https://helloclue.com/articles/cycle-a-z/period-cramps-101-why-menstrual-cramps-and-pain-occur-and-how-to-relieve

  Period cramps are most likely caused by high levels of prostaglandins compounds released from the uterine lining before your period. […] Period cramps can be primary or secondary. Primary dysmenorrhea (the clinical word for painful periods) is pain caused by the period itself. Secondary dysmenorrhea is period pain with another root cause, such as a health condition like endometriosis. […] Period cramps most likely happen because the uterus releases chemicals called prostaglandins before the menstrual period. Prostaglandins help the uterus contract and relax so the uterine lining can detach and flow out of your body. High levels of prostaglandins can cause strong uterine contractions. These contractions reduce blood flow and oxygen to the uterus, which may increase pain. […] People are more likely to have painful periods if they experience heavy, long, or irregular bleeding. Starting your first menstrual period at an earlier age (before age 12) may also increase your risk of cramps. Other factors that have been associated with painful periods include smoking, having a body mass index (BMI) under 20, being under age 30, and having a pelvic infection.

• #18 Period Pain | Menstrual Cramps | MedlinePlus

  https://medlineplus.gov/periodpain.html

  Menstruation, or period, is normal vaginal bleeding that happens as part of a woman’s monthly cycle. Many women have painful periods, also called dysmenorrhea. The pain is most often menstrual cramps, which are a throbbing, cramping pain in your lower abdomen. […] There are two types of dysmenorrhea: primary and secondary. Each type has different causes. […] Primary dysmenorrhea is the most common kind of period pain. It is period pain that is not caused by another condition. The cause is usually having too many prostaglandins, which are chemicals that your uterus makes. These chemicals make the muscles of your uterus tighten and relax, and this causes the cramps. […] Secondary dysmenorrhea often starts later in life. It is caused by conditions that affect your uterus or other reproductive organs, such as endometriosis and uterine fibroids. This kind of pain often gets worse over time. It may begin before your period starts and continue after your period ends.

• #19 Dysmenorrhea: Painful Periods | ACOG

  https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods

  Some of the conditions that can cause secondary dysmenorrhea include the following: Endometriosis happens when tissue similar to the lining of the uterus grows in other areas of the body, such as on the ovaries and fallopian tubes, behind the uterus, and on the bladder. Like the lining of the uterus, this tissue breaks down and bleeds in response to changes in hormones. This bleeding can cause pain, especially around the time of a period. […] […] Fibroids are growths that form on the outside, on the inside, or in the walls of the uterus. Fibroids located in the wall of the uterus can cause pain. […] […] Adenomyosis develops when tissue that normally lines the uterus begins to grow in the muscle wall of the uterus. This condition is more common in older women who have had children. […] […] Certain defects that a woman is born with can result in pain during menstruation. […] […] Some medical conditions can flare up during a period and cause pain. These conditions include Crohns disease and urinary disorders.

• #20 Dysmenorrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560834/

  According to multiple other studies, the biochemical theory has the most substantial evidence. […] Primary Dysmenorrhea: Prostaglandins (PGs) are thought to be the main cause of dysmenorrhea. […] Higher levels of PGs have been noted in the menstrual fluid and endometrial tissue of women with dysmenorrhea. […] Endometrial shedding begins due to the decreasing hormone levels in the menstrual cycle. […] PGs cause uterine contractions, and the intensity of the cramps is proportionate to the amount of PGs released. […] Secondary dysmenorrhea is menstrual pain due to an underlying disease, disorder, or structural abnormality within or outside the uterus. […] There are many common causes of secondary dysmenorrhea, including endometriosis, large cesarean scar niche, fibroids, adenomyosis, endometrial polyps, interstitial cystitis, pelvic inflammatory disease, and possibly the use of an intrauterine contraceptive system.

• #21 Dysmenorrhea: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/253812-overview

  Risk factors for secondary dysmenorrhea include the following: Leiomyomata (fibroids), PID, Tubo-ovarian abscess, Ovarian torsion, Endometriosis. […] Almost any process that can affect the pelvic viscera can produce cyclic pelvic pain. […] Elevated prostaglandins may also play a role in secondary dysmenorrhea, but by definition, concomitant pelvic pathology must be present. […] Uterine leiomyomata are benign tumors of the uterine musculature that are a common cause of dysmenorrhea because they enlarge when stimulated by estrogen. […] PID is an infection of the uterus and fallopian tubes, with or without ovarian or parametrial involvement. […] Endometriosis is the presence of endometriumlike tissue found outside of the uterus, most commonly in the ovaries. […] Adenomyosis is defined as an invasion of myometrium by uterine adrenal glands. […] IUCDs (IUDs) may cause bladder or uterine perforation.

• #22 Dysmenorrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560834/

  Up to 29% of women with dysmenorrhea may have endometriosis. […] Adenomyosis is another common underlying disease that is associated with secondary dysmenorrhea. […] The pathophysiology of primary dysmenorrhea is not fully understood. […] Nevertheless, the identified cause is believed due to the hypersecretion of PGs from the uterine inner lining. […] PGs cause pain by increasing uterine contractions and uterine pressure. […] Endometriosis and adenomyosis are the most common causes of secondary dysmenorrhea in premenopausal women.

• #23 7 Reasons for Painful Periods and Menstrual Cramps

  https://www.everydayhealth.com/pictures/reasons-your-period-might-painful/

  What causes period cramps? Most women ask this question at some time in their life. […] But what causes cramps during your period? Menstrual cramps are generally categorized as primary dysmenorrhea, caused by the elevated production of prostaglandins, hormones produced by the uterus that cause it to contract. […] According to the Mayo Clinic, conditions like endometriosis and pelvic inflammatory disease are associated with menstrual cramps. […] Endometriosis is a condition in which endometrium-like tissue is found outside the uterus on other structures throughout the pelvis. […] According to Ken R. Sinervo, MD, the medical director of the Center for Endometriosis Care in Atlanta, We dont really know why endometriosis causes menstrual pain. […] Adenomyosis is like endometriosis, except instead of the endometrium implanting itself outside of the uterus, it is found embedded deep within the uterine muscle.

• #24 Endometriosis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/10857-endometriosis

  There are many symptoms of endometriosis, but the most common is pelvic pain. […] Symptoms of endometriosis include: Very painful menstrual cramps. […] Healthcare providers don’t know for sure what causes endometriosis. […] Researchers are looking for a connection between endometriosis and conditions like retrograde menstruation, immune system conditions and hormone disorders as possible factors that may lead to the condition. […] Endometriosis is one of the leading causes of infertility. Endometriosis causes tissue to grow in places where it doesn’t belong. This can interfere with how a sperm and egg move to meet each other at conception. […] Over time, the endometrial-like tissue that grows outside of your uterus can cause cysts, adhesions and scar tissue. This can cause you to experience long-term, severe pain, especially during your period. Many people with endometriosis also have difficulties getting pregnant.

• #25 Dysmenorrhea: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/253812-overview

  Risk factors for secondary dysmenorrhea include the following: Leiomyomata (fibroids), PID, Tubo-ovarian abscess, Ovarian torsion, Endometriosis. […] Almost any process that can affect the pelvic viscera can produce cyclic pelvic pain. […] Elevated prostaglandins may also play a role in secondary dysmenorrhea, but by definition, concomitant pelvic pathology must be present. […] Uterine leiomyomata are benign tumors of the uterine musculature that are a common cause of dysmenorrhea because they enlarge when stimulated by estrogen. […] PID is an infection of the uterus and fallopian tubes, with or without ovarian or parametrial involvement. […] Endometriosis is the presence of endometriumlike tissue found outside of the uterus, most commonly in the ovaries. […] Adenomyosis is defined as an invasion of myometrium by uterine adrenal glands. […] IUCDs (IUDs) may cause bladder or uterine perforation.

• #26

  https://www.intimaterose.com/blogs/womens-health/causes-of-painful-menstrual-cramps?srsltid=AfmBOoqE-7gqkLSEyR9NkpAajAIXtMXJ0oyaIN3ndmt-g0bwKo3VM9nt

  Painful period cramps and heavy menstrual bleeding are also common symptoms of uterine fibroids. Due to the heavy menstrual bleeding, the uterine muscles are required to work harder to expel the blood clots that can form, often resulting in secondary dysmenorrhea. […] Painful period cramps that are caused by secondary dysmenorrhea, however, may need some further investigation.

• #27 9 causes of severe menstrual cramps | HealthShots

  https://www.healthshots.com/intimate-health/menstruation/severe-menstrual-cramps-causes/

  Fibroids are non-cancerous growths that develop inside or outside of the uterus. Symptoms range from heavy bleeding, prolonged menstrual periods, back pain, leg pain, and constipation to severe cramps. […] PID is an infection of the female reproductive organs often caused by sexually transmitted infections (STIs), such as chlamydia and gonorrhea. A study published by the Journal of the American Academy of PAs found that it can result in chronic pelvic pain, including severe menstrual cramps. […] Adenomyosis occurs when the endometrial tissue grows into the muscular wall of the uterus. This can cause the uterus to grow to two to three times its normal size and become tender, leading to heavy bleeding and painful period cramps. […] An IUD, particularly a copper IUD, can cause more intense menstrual cramps, especially during the first few months after insertion. The device might increase the production of prostaglandins or cause an inflammatory response in the uterus.

• #28 Menstrual cramps – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/symptoms-causes/syc-20374938

  Adenomyosis. The tissue that lines your uterus begins to grow into the muscular walls of the uterus. […] Pelvic inflammatory disease. This infection of the female reproductive organs is usually caused by sexually transmitted bacteria. […] Cervical stenosis. In some women, the opening of the cervix is small enough to impede menstrual flow, causing a painful increase of pressure within the uterus.

• #29 Dysmenorrhea: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/253812-overview

  Risk factors for secondary dysmenorrhea include the following: Leiomyomata (fibroids), PID, Tubo-ovarian abscess, Ovarian torsion, Endometriosis. […] Almost any process that can affect the pelvic viscera can produce cyclic pelvic pain. […] Elevated prostaglandins may also play a role in secondary dysmenorrhea, but by definition, concomitant pelvic pathology must be present. […] Uterine leiomyomata are benign tumors of the uterine musculature that are a common cause of dysmenorrhea because they enlarge when stimulated by estrogen. […] PID is an infection of the uterus and fallopian tubes, with or without ovarian or parametrial involvement. […] Endometriosis is the presence of endometriumlike tissue found outside of the uterus, most commonly in the ovaries. […] Adenomyosis is defined as an invasion of myometrium by uterine adrenal glands. […] IUCDs (IUDs) may cause bladder or uterine perforation.

• #30 9 causes of severe menstrual cramps | HealthShots

  https://www.healthshots.com/intimate-health/menstruation/severe-menstrual-cramps-causes/

  Fibroids are non-cancerous growths that develop inside or outside of the uterus. Symptoms range from heavy bleeding, prolonged menstrual periods, back pain, leg pain, and constipation to severe cramps. […] PID is an infection of the female reproductive organs often caused by sexually transmitted infections (STIs), such as chlamydia and gonorrhea. A study published by the Journal of the American Academy of PAs found that it can result in chronic pelvic pain, including severe menstrual cramps. […] Adenomyosis occurs when the endometrial tissue grows into the muscular wall of the uterus. This can cause the uterus to grow to two to three times its normal size and become tender, leading to heavy bleeding and painful period cramps. […] An IUD, particularly a copper IUD, can cause more intense menstrual cramps, especially during the first few months after insertion. The device might increase the production of prostaglandins or cause an inflammatory response in the uterus.

• #31 Menstrual cramps – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/symptoms-causes/syc-20374938

  Menstrual cramps (dysmenorrhea) are throbbing or cramping pains in the lower abdomen. […] Conditions such as endometriosis or uterine fibroids can cause menstrual cramps. Treating the cause is key to reducing the pain. […] During your menstrual period, your uterus contracts to help expel its lining. Hormonelike substances (prostaglandins) involved in pain and inflammation trigger the uterine muscle contractions. Higher levels of prostaglandins are associated with more-severe menstrual cramps. […] Menstrual cramps can be caused by: Endometriosis. Tissue that acts similar to the lining of the uterus grows outside of the uterus, most commonly on fallopian tubes, ovaries or the tissue lining your pelvis. […] Uterine fibroids. These noncancerous growths in the wall of the uterus can cause pain.

• #32 Dysmenorrhea: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/253812-overview

  Risk factors for secondary dysmenorrhea include the following: Leiomyomata (fibroids), PID, Tubo-ovarian abscess, Ovarian torsion, Endometriosis. […] Almost any process that can affect the pelvic viscera can produce cyclic pelvic pain. […] Elevated prostaglandins may also play a role in secondary dysmenorrhea, but by definition, concomitant pelvic pathology must be present. […] Uterine leiomyomata are benign tumors of the uterine musculature that are a common cause of dysmenorrhea because they enlarge when stimulated by estrogen. […] PID is an infection of the uterus and fallopian tubes, with or without ovarian or parametrial involvement. […] Endometriosis is the presence of endometriumlike tissue found outside of the uterus, most commonly in the ovaries. […] Adenomyosis is defined as an invasion of myometrium by uterine adrenal glands. […] IUCDs (IUDs) may cause bladder or uterine perforation.

• #33 Painful Menstrual Periods: Causes, Treatments & More

  https://www.healthline.com/health/painful-menstrual-periods

  Fibroids in the uterus. Fibroids are noncancerous tumors that can put pressure on the uterus or cause abnormal menstruation and pain, though they often don’t cause symptoms. […] Pelvic inflammatory disease (PID). PID is an infection of the uterus, fallopian tubes, or ovaries often caused by sexually transmitted bacteria that cause inflammation of the reproductive organs and pain. […] Adenomyosis. This is a rare condition in which the uterine lining grows into the muscular wall of the uterus, causing inflammation, pressure, and pain. It can also cause longer or heavier periods. […] Cervical stenosis. Cervical stenosis is a rare condition in which the cervix is so small or narrow that it slows menstrual flow, causing an increase of pressure inside the uterus that causes pain.

• #34 Menstrual cramps – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/symptoms-causes/syc-20374938

  Adenomyosis. The tissue that lines your uterus begins to grow into the muscular walls of the uterus. […] Pelvic inflammatory disease. This infection of the female reproductive organs is usually caused by sexually transmitted bacteria. […] Cervical stenosis. In some women, the opening of the cervix is small enough to impede menstrual flow, causing a painful increase of pressure within the uterus.

• #35 Why Are My Period Cramps So Bad? 7 Causes for Severe Period Cramps and How to Find Relief

  https://www.unitypoint.org/news-and-articles/7-causes-for-severe-period-cramps

  Severe period cramps, also known as dysmenorrhea, affect millions of women worldwide. […] Period cramps happen when the uterus, and blood vessels inside the uterus, contract to shed the uterine lining. These contractions can be painful and create pressure in the lower abdomen and pelvic area. […] Adenomyosis is when the uterine lining grows into the uterine muscle and causes intense cramps. […] Cervical stenosis happens when the cervix is narrowed and obstructs period flow, causing pressure and pain. […] Endometriosis happens when endometrial tissue grows outside the uterus and causes painful cramps during menstruation. […] Fibroids are common, non-cancerous growths in the uterus that make cramps feel worse. […] High levels of prostaglandins cause inflammation and lead to more intense, painful cramps.

• #36 Menstrual Cramps – Women’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/women-s-health-issues/menstrual-disorders-and-abnormal-vaginal-bleeding/menstrual-cramps

  IUDs that release copper are often associated with painful periods. Those that release a progestin (a synthetic form of the female hormone progesterone) usually do not cause painful periods. […] In a few women, pain occurs because the passageway through the cervix (cervical canal) is narrow. A narrow cervical canal (cervical stenosis) may develop after a procedure, as when a precancerous condition (dysplasia) of the cervix is treated.

• #37 Menstrual Cramps Causes and Treatments

  https://www.webmd.com/women/menstrual-pain

  Other menstrual-type cramps can be caused by conditions of the reproductive tract, such as the following: Endometriosis — tissue similar to uterine tissue grows outside the uterus. Fibroids and adenomyosis — noncancerous (benign) growths in the uterus. Infections in the reproductive organs. Abnormal pregnancy, such as an ectopic pregnancy (pregnancy in the tubes, outside the uterus). IUD (intrauterine device) used for birth control. Ovarian cyst. Narrow cervix.

• #38 Painful Menstrual Periods: Causes, Treatments & More

  https://www.healthline.com/health/painful-menstrual-periods

  Fibroids in the uterus. Fibroids are noncancerous tumors that can put pressure on the uterus or cause abnormal menstruation and pain, though they often don’t cause symptoms. […] Pelvic inflammatory disease (PID). PID is an infection of the uterus, fallopian tubes, or ovaries often caused by sexually transmitted bacteria that cause inflammation of the reproductive organs and pain. […] Adenomyosis. This is a rare condition in which the uterine lining grows into the muscular wall of the uterus, causing inflammation, pressure, and pain. It can also cause longer or heavier periods. […] Cervical stenosis. Cervical stenosis is a rare condition in which the cervix is so small or narrow that it slows menstrual flow, causing an increase of pressure inside the uterus that causes pain.

• #39 What Causes Period Cramps? Symptoms, Causes, & Treatments

  https://www.naturalcycles.com/cyclematters/what-causes-period-cramps

  These are some things that are related to a higher risk of painful period cramps: having heavier periods and periods that last longer than seven days, having irregular periods, being under the age of 30, going through puberty at age 11 or younger, having a family history of painful period cramps, being a smoker is linked to more period cramps. […] Secondary dysmenorrhea is when period cramps or pains are caused by an underlying medical condition. […] Some studies suggest that this type of period pain affects around 10% of women, but more research is needed since it’s often underdiagnosed. […] There are a few different conditions that can cause painful periods: endometriosis, uterine fibroids, adenomyosis, pelvic inflammatory disease (PID), cervical stenosis.

• #40 Dysmenorrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560834/

  According to multiple other studies, the biochemical theory has the most substantial evidence. […] Primary Dysmenorrhea: Prostaglandins (PGs) are thought to be the main cause of dysmenorrhea. […] Higher levels of PGs have been noted in the menstrual fluid and endometrial tissue of women with dysmenorrhea. […] Endometrial shedding begins due to the decreasing hormone levels in the menstrual cycle. […] PGs cause uterine contractions, and the intensity of the cramps is proportionate to the amount of PGs released. […] Secondary dysmenorrhea is menstrual pain due to an underlying disease, disorder, or structural abnormality within or outside the uterus. […] There are many common causes of secondary dysmenorrhea, including endometriosis, large cesarean scar niche, fibroids, adenomyosis, endometrial polyps, interstitial cystitis, pelvic inflammatory disease, and possibly the use of an intrauterine contraceptive system.

• #41 Menstrual pain: its origin and pathogenesis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/7001019/

  A variety of misconceptions about the etiology of dysmenorrhea have existed in the past. […] Experimental and clinical research of the last 15 years, however, has identified uterine prostaglandins as substantially contributing to the pathogenesis of primary dysmenorrhea. […] It is now known that at the end of the menstrual cycle, prostaglandins increase myometrial contractions and cause constriction of small endometrial blood vessels, with consequent tissue ischemia, endometrial disintegration, bleeding and pain. […] Dysmenorrhea may be due to tissue ischemia resulting from increased intrauterine pressure, vessel constriction and decreased uterine blood flow. […] The most compelling evidence for the „prostaglandin theory” is the success of prostaglandin synthesis inhibitors in the treatment of dysmenorrhea. […] The pain relief achieved with these drugs is accompanied by a suppression of prostaglandin synthesis and a decrease in intrauterine pressure.

• #42 Painful Periods — also called “cramps” or “dysmenorrhea” – CemCOR

  http://cemcor.ubc.ca/resources/painful-periods

  Painful periods are known as cramps (or in medical terms as dysmenorrhea). This section looks at what causes cramps, and how to control the pain yourself using inexpensive, over-the-counter medicines. […] The purpose of cramps is to help get rid of the lining of the uterus at the end of a menstrual cycle that did not lead to pregnancy. Menstrual cramps are caused by high levels of prostaglandins, a hormone that commonly signals your body that there is an injury. When prostaglandin levels are high, they increase the normal squeezing or contraction of the muscle in the wall of the uterus. […] Prostaglandins are made within the uterus, both in the muscle and the endometrial uterine lining. Prostaglandin production increases in response to increased pressure inside the uterus and to changes in hormonal levels at the end of the menstrual cycle.

• #43 Dysmenorrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560834/

  According to multiple other studies, the biochemical theory has the most substantial evidence. […] Primary Dysmenorrhea: Prostaglandins (PGs) are thought to be the main cause of dysmenorrhea. […] Higher levels of PGs have been noted in the menstrual fluid and endometrial tissue of women with dysmenorrhea. […] Endometrial shedding begins due to the decreasing hormone levels in the menstrual cycle. […] PGs cause uterine contractions, and the intensity of the cramps is proportionate to the amount of PGs released. […] Secondary dysmenorrhea is menstrual pain due to an underlying disease, disorder, or structural abnormality within or outside the uterus. […] There are many common causes of secondary dysmenorrhea, including endometriosis, large cesarean scar niche, fibroids, adenomyosis, endometrial polyps, interstitial cystitis, pelvic inflammatory disease, and possibly the use of an intrauterine contraceptive system.

• #44 Menstrual pain: its origin and pathogenesis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/7001019/

  A variety of misconceptions about the etiology of dysmenorrhea have existed in the past. […] Experimental and clinical research of the last 15 years, however, has identified uterine prostaglandins as substantially contributing to the pathogenesis of primary dysmenorrhea. […] It is now known that at the end of the menstrual cycle, prostaglandins increase myometrial contractions and cause constriction of small endometrial blood vessels, with consequent tissue ischemia, endometrial disintegration, bleeding and pain. […] Dysmenorrhea may be due to tissue ischemia resulting from increased intrauterine pressure, vessel constriction and decreased uterine blood flow. […] The most compelling evidence for the „prostaglandin theory” is the success of prostaglandin synthesis inhibitors in the treatment of dysmenorrhea. […] The pain relief achieved with these drugs is accompanied by a suppression of prostaglandin synthesis and a decrease in intrauterine pressure.

• #45 Menstrual pain: its origin and pathogenesis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/7001019/

  A variety of misconceptions about the etiology of dysmenorrhea have existed in the past. […] Experimental and clinical research of the last 15 years, however, has identified uterine prostaglandins as substantially contributing to the pathogenesis of primary dysmenorrhea. […] It is now known that at the end of the menstrual cycle, prostaglandins increase myometrial contractions and cause constriction of small endometrial blood vessels, with consequent tissue ischemia, endometrial disintegration, bleeding and pain. […] Dysmenorrhea may be due to tissue ischemia resulting from increased intrauterine pressure, vessel constriction and decreased uterine blood flow. […] The most compelling evidence for the „prostaglandin theory” is the success of prostaglandin synthesis inhibitors in the treatment of dysmenorrhea. […] The pain relief achieved with these drugs is accompanied by a suppression of prostaglandin synthesis and a decrease in intrauterine pressure.

• #46 DYSMENORRHEA: PERIOD PAIN CAUSES, MANAGEMENT & WHEN TO SEE A DOCTOR | Mya Care

  https://myacare.com/blog/dysmenorrhea-period-pain-causes-management-when-to-see-a-doctor

  Period pain that arises from menstrual cramps each month is known as dysmenorrhea. […] The cause of abdominal cramping and heightened pain during menstruation is not actually officially known yet. In any event, a few factors have been implicated in potentially causing dysmenorrhea, such as hormonal fluctuations, prostaglandins, inflammation, and the state of the vaginal microbiome. […] Prostaglandins are chemical messengers that tend to trigger an inflammatory response in the body. […] The data regarding dysmenorrhea is not conclusive and sometimes shows mixed results, with a common trend for excessive prostaglandins and inflammation. […] During the menstrual cycle, the immune system responds to the changing levels of sex hormones and becomes more or less inflammatory, depending on what phase the cycle is in.

• #47 Menstrual Cramps | Causes | Symptoms | Diagnosis | Treatment | Prevention

  https://www.icliniq.com/articles/womens-health/menstrual-cramp

  Menstrual cramps are caused mainly by an excess production of prostaglandinshormone-like compounds released from the endometrium (uterine lying) as it prepares to be shed. Prostaglandins help in the contraction and relaxation of the uterus so that the endometrium can be shed from the body. Contraction of the uterus is a necessary part of the process, but when it happens in excess, it causes pain in the uterus. In addition, during strong contractions, the blood flow is reduced, and the oxygen supply to the uterus muscle tissue decreases, causing pain. […] Inflammation may play a role in menstrual cramps. Inflamed tissue tends to produce increased levels of prostaglandins. People experiencing more menstrual pain have also been shown to have increased inflammatory markers in the blood. Inflammation has also been seen to worsen other premenstrual symptoms, including mood changes.

• #48 Painful Periods — also called “cramps” or “dysmenorrhea” – CemCOR

  http://cemcor.ubc.ca/resources/painful-periods

  Prostaglandin levels are also increased when menstrual cycle hormones are out of balance. The current medical understanding is that cramps only occur in ovulatory cycles. […] It is thought that the normally dropping levels of progesterone before flow trigger the production of prostaglandins. What is less known is that estrogen levels similarly decrease before flow and also trigger prostaglandin release. […] Cramps are therefore also likely related to the imbalance that occurs when estrogen levels increase, and progesterone levels are too low for the estrogen levels (as happen in the teens and during perimenopause).

• #49 5 Reasons for Painful Periods and Menstrual Cramps | Vascular Specialist Check-up

  https://www.cvmus.com/blog/5-reasons-painful-periods-and-menstrual-cramps

  Do you experience pain during your period? Youre not alone: this problem affects around 80% of people who menstruate. Mild to moderate pain during this part of your cycle is normal. But for some people, severe period cramps are a monthly occurrence. […] Here are five possible causes for severe menstrual cramps and what you can do about them. […] One common reason for painful period cramps is your genetic makeup. If several people in your family struggle with painful periods, you have a higher risk of experiencing severe cramping as well. […] People who begin menstruating at a young age have a higher risk of painful period cramps. So if you got your first period when you were 11 years old or younger, that could be the cause behind your painful menstrual cramps. […] The first few years of menstruation are usually the most difficult. If youre a teenager or child who started your period in the last few years, painful cramps are a rather common experience. This is especially true if your cycle is irregular.

• #50 Dysmenorrhea: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/253812-overview

  Dysmenorrhea can be divided into two broad categories: primary and secondary. […] Primary dysmenorrhea is defined as menstrual pain that is not associated with macroscopic pelvic pathology (ie, occurs in the absence of pelvic disease). […] Secondary dysmenorrhea is defined as menstrual pain resulting from anatomic or macroscopic pelvic pathology, as is seen in women with endometriosis or chronic pelvic inflammatory disease. […] The following risk factors are associated with more severe episodes of dysmenorrhea: Earlier age at menarche, Long menstrual periods, Heavy menstrual flow, Smoking, Positive family history. […] Some (not all) studies have found obesity and alcohol consumption to be associated with dysmenorrhea. […] Risk factors for primary dysmenorrhea include the following: Early age at menarche ( 12 years), Nulliparity, Heavy or prolonged menstrual flow, Smoking, Positive family history, Obesity.

• #51 Menstrual cramps – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/diagnosis-treatment/drc-20374944

  Your health care provider may also recommend certain tests, including: […] Laparoscopy. Although not usually necessary to diagnose menstrual cramps, laparoscopy can help detect an underlying condition, such as endometriosis, adhesions, fibroids, ovarian cysts and ectopic pregnancy. […] If your menstrual cramps are caused by a disorder such as endometriosis or fibroids, surgery to correct the problem might help your symptoms. […] Psychological stress might increase your risk of menstrual cramps and their severity. […] Some studies have found that acupuncture helps relieve menstrual cramps. […] TENS might work by raising the threshold for pain signals and stimulating the release of your body’s natural painkillers (endorphins). […] Although research on acupressure and menstrual cramps is limited, it appears that acupressure may be more effective than a placebo in easing menstrual cramps.

• #52 Period cramps 101

  https://helloclue.com/articles/cycle-a-z/period-cramps-101-why-menstrual-cramps-and-pain-occur-and-how-to-relieve

  Period cramps are most likely caused by high levels of prostaglandins compounds released from the uterine lining before your period. […] Period cramps can be primary or secondary. Primary dysmenorrhea (the clinical word for painful periods) is pain caused by the period itself. Secondary dysmenorrhea is period pain with another root cause, such as a health condition like endometriosis. […] Period cramps most likely happen because the uterus releases chemicals called prostaglandins before the menstrual period. Prostaglandins help the uterus contract and relax so the uterine lining can detach and flow out of your body. High levels of prostaglandins can cause strong uterine contractions. These contractions reduce blood flow and oxygen to the uterus, which may increase pain. […] People are more likely to have painful periods if they experience heavy, long, or irregular bleeding. Starting your first menstrual period at an earlier age (before age 12) may also increase your risk of cramps. Other factors that have been associated with painful periods include smoking, having a body mass index (BMI) under 20, being under age 30, and having a pelvic infection.

• #53 5 Reasons for Painful Periods and Menstrual Cramps | Vascular Specialist Check-up

  https://www.cvmus.com/blog/5-reasons-painful-periods-and-menstrual-cramps

  Heavy smokers face a higher risk of painful cramps during their menstrual cycles. […] Abnormally painful periods can often be a sign of an underlying condition. A few potential causes for severe cramping include: Endometriosis, Fibroids in your uterus, Cervical stenosis, Pelvic inflammatory disease, Adenomyosis, Polycystic ovary syndrome. […] In some cases, painful periods and menstrual cramps can be a sign of a serious underlying condition. Severe menstrual cramps can also signify a higher risk of vascular conditions such as high blood pressure or heart disease. […] When it comes to severe menstrual cramps, there can be several different causes. Some are unavoidable, such as your age or genetics, while others you can potentially change, such as smoking.

• #54 Dysmenorrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560834/

  Up to 29% of women with dysmenorrhea may have endometriosis. […] Adenomyosis is another common underlying disease that is associated with secondary dysmenorrhea. […] The pathophysiology of primary dysmenorrhea is not fully understood. […] Nevertheless, the identified cause is believed due to the hypersecretion of PGs from the uterine inner lining. […] PGs cause pain by increasing uterine contractions and uterine pressure. […] Endometriosis and adenomyosis are the most common causes of secondary dysmenorrhea in premenopausal women.

• #55 Period Pain: Types, Causes, and Treatments

  https://www.health.com/condition/menstruation/period-pain

  Most menstruating people experience some level of pain during that time of the month. Normally, you can blame that discomfort on what’s going on with your uterus. […] The clinical term for period pain is dysmenorrhea. Dysmenorrhea comes in two types: Primary and secondary. […] Primary dysmenorrhea, the cramping pain that comes before and during a period, is caused by changes in your body’s natural chemicals. Those chemicals, called prostaglandins, are made in the uterus lining. Prostaglandins cause the uterine muscles to contract, which helps the uterine lining shed through the vagina during menstrual bleeding. […] But in cases of primary dysmenorrhea, the body may produce more prostaglandins than normal. More prostaglandins cause more contractions and painful cramps. […] Secondary dysmenorrhea is period pain caused by an underlying health condition, such as uterine fibroids, tumors, endometriosis, pelvic inflammatory disease, adenomyosis, or uterine polyps. […] In the case of secondary dysmenorrhea, the pain typically gets worse over time. Additionally, the pain may last longer than regular period cramps.

• #56 Menstrual cramps – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/diagnosis-treatment/drc-20374944

  Your health care provider may also recommend certain tests, including: […] Laparoscopy. Although not usually necessary to diagnose menstrual cramps, laparoscopy can help detect an underlying condition, such as endometriosis, adhesions, fibroids, ovarian cysts and ectopic pregnancy. […] If your menstrual cramps are caused by a disorder such as endometriosis or fibroids, surgery to correct the problem might help your symptoms. […] Psychological stress might increase your risk of menstrual cramps and their severity. […] Some studies have found that acupuncture helps relieve menstrual cramps. […] TENS might work by raising the threshold for pain signals and stimulating the release of your body’s natural painkillers (endorphins). […] Although research on acupressure and menstrual cramps is limited, it appears that acupressure may be more effective than a placebo in easing menstrual cramps.

• #57

  https://asktia.com/article/painful-period-cramps/

  Uterine Fibroids are noncancerous growths that form on the inside, on the outside, or in the walls of the uterus. […] Adenomyosis develops when tissue that normally lines the uterus grows into the muscle wall of the uterus. […] Pelvic Inflammatory Disease is an infection in the reproductive organs that originates as a sexually transmitted infection (STI) that goes untreated. […] Cervical Stenosis is when the opening of the cervix is small enough to hinder menstrual blood flow, which can cause pressure to increase within the uterus. […] Other Conditions like Crohns Disease and urinary disorders can flare during menstruation and cause pain. […] If painful cramps are being caused by a secondary source, like endometriosis or fibroids, surgery might reduce symptoms. […] Another possible treatment for fibroids and adenomyosis (and the secondary dysmenorrhea they cause) is uterine artery embolization, a procedure that cuts off blood supply to those growths. […] If endometriosis is the most likely cause of period pain, your provider might recommend a medication that works on the gonadotropin-releasing hormone (GnRH).

• #58 Severe Menstrual Cramps: Normal vs. Severe Pain, Causes, Relief Tips

  https://www.healthline.com/health/severe-menstrual-cramps

  An IUD is a small birth control device that’s inserted into your uterus. […] They can occasionally cause side effects, including severe menstrual cramps. […] If you have very painful menstrual cramps or cramps that last longer than two or three days, make an appointment with your healthcare provider. […] Severe menstrual cramps are typically hard to treat on your own, but these tips may help while you work with your healthcare provider to narrow down an underlying cause. […] You don’t have to power through severe menstrual cramps. If your pain interferes with your ability to go on about your day or lasts longer than two or three days, talk to your healthcare provider. They can help you get to the bottom of what’s causing your severe cramps and recommend a plan to keep the pain under control.

• #59 Severe Menstrual Pain is NOT Normal | Center for Women’s Health | OHSU

  https://www.ohsu.edu/womens-health/severe-menstrual-pain-not-normal

  Severe Menstrual Pain is NOT Normal […] Painful periods that impact your daily functioning aren’t normal. This could be a sign of endometriosis, a disease where tissue normally found in the lining of your uterus grows elsewhere in your abdomen. […] The cause is unknown. „We know some of the risk factors, including a family history of endometriosis and starting menstruation young or continuing to menstruate well past 50,” Dr. Ecker says. […] The most important thing to know is that pelvic pain, whatever the cause, isn’t normal. If pain is impacting your life, talk to your doctor. Whether or not it’s endometriosis, you don’t have to suffer.

• #60 Painful Periods — also called “cramps” or “dysmenorrhea” – CemCOR

  http://cemcor.ubc.ca/resources/painful-periods

  Prostaglandin levels are also increased when menstrual cycle hormones are out of balance. The current medical understanding is that cramps only occur in ovulatory cycles. […] It is thought that the normally dropping levels of progesterone before flow trigger the production of prostaglandins. What is less known is that estrogen levels similarly decrease before flow and also trigger prostaglandin release. […] Cramps are therefore also likely related to the imbalance that occurs when estrogen levels increase, and progesterone levels are too low for the estrogen levels (as happen in the teens and during perimenopause).

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