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Period Pain

Table of Contents

Period Pain

Dysmenorrhea; Menstrual Cramps; Menstrual Pain; Painful Period

Period pain affects many women, and it can be severe. The pain is most often menstrual cramps. Learn about the causes of menstrual cramps, what you can do to feel better, and when you need to see a doctor.

Pelvic Pain

Image by Anastasia Gepp/Pixabay

About

Woman in pain

Image by Paolo Chieselli

Woman in pain

Woman in pain

Image by Paolo Chieselli

What Are Painful Periods?

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. You may also have other symptoms, such as lower back pain, nausea, diarrhea, and headaches.

Period pain is not the same as premenstrual syndrome (PMS). PMS causes many different symptoms, including weight gain, bloating, irritability, and fatigue. PMS often starts one to two weeks before your period starts.

Source: MedlinePlus

Additional Materials (9)

Dysmenorrhea—What You Should Know About Diagnosis and Treatment

Video by PAINWeek/YouTube

Painful Periods, Dysmenorrhea and Endometriosis

Video by Pediatric Healthcare Professional Resources/YouTube

Primary and Secondary Dysmenorrhea / Richmond Women's Specialists

Video by HCA Virginia Health System/YouTube

Dysmenorrhea in Adolescent Girls: Classification & Diagnosis – Pediatrics | Lecturio

Video by Lecturio Medical/YouTube

Topic 46: Dysmenorrhea

Video by Association of Professors of Gynecology and Obstetrics (APGO)/YouTube

Dysmenorrhea - CRASH! Medical Review Series

Video by Paul Bolin, M.D./YouTube

Men Explain Periods

Video by As/Is/YouTube

Why do women have periods?

Video by TED-Ed/YouTube

What Causes Painful Periods? - Dr. Kevin Audlin - Mercy

Video by Mercy Medical Center - Baltimore/YouTube

4:55

Dysmenorrhea—What You Should Know About Diagnosis and Treatment

PAINWeek/YouTube

7:21

Painful Periods, Dysmenorrhea and Endometriosis

Pediatric Healthcare Professional Resources/YouTube

0:55

Primary and Secondary Dysmenorrhea / Richmond Women's Specialists

HCA Virginia Health System/YouTube

5:47

Dysmenorrhea in Adolescent Girls: Classification & Diagnosis – Pediatrics | Lecturio

Lecturio Medical/YouTube

3:25

Topic 46: Dysmenorrhea

Association of Professors of Gynecology and Obstetrics (APGO)/YouTube

22:29

Dysmenorrhea - CRASH! Medical Review Series

Paul Bolin, M.D./YouTube

3:49

Men Explain Periods

As/Is/YouTube

4:46

Why do women have periods?

TED-Ed/YouTube

1:04

What Causes Painful Periods? - Dr. Kevin Audlin - Mercy

Mercy Medical Center - Baltimore/YouTube

Causes

Period pain

Image by Javier Mur

Period pain

dysmenorrheas

Image by Javier Mur

What Causes Painful Periods?

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.

The pain can start a day or two before your period. It normally lasts for a few days, though in some women it can last longer.

You usually first start having period pain when you are younger, just after you begin getting periods. Often, as you get older, you have less pain. The pain may also get better after you have given birth.

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.

Source: MedlinePlus

Additional Materials (1)

What Causes Painful Periods? - Dr. Kevin Audlin - Mercy

Video by Mercy Medical Center - Baltimore/YouTube

1:04

What Causes Painful Periods? - Dr. Kevin Audlin - Mercy

Mercy Medical Center - Baltimore/YouTube

Diagnosis

Pelvic ultrasound

Image by TheVisualMD

Pelvic ultrasound

Pelvic ultrasound, a procedure that uses sound waves to look at organs and structures inside the pelvic region

Image by TheVisualMD

How Is the Cause of Severe Period Pain Diagnosed?

To diagnose severe period pain, your health care provider will ask you about your medical history and do a pelvic exam. You may also have an ultrasound or other imaging test. If your health care provider thinks you have secondary dysmenorrhea, you might have laparoscopy. It is a surgery that that lets your health care provider look inside your body.

Source: MedlinePlus

Additional Materials (2)

Painful Periods, Dysmenorrhea and Endometriosis

Video by Pediatric Healthcare Professional Resources/YouTube

What to Expect From a Female Pelvic Ultrasound Exam

Video by RAYUS Radiology™/YouTube

7:21

Painful Periods, Dysmenorrhea and Endometriosis

Pediatric Healthcare Professional Resources/YouTube

2:19

What to Expect From a Female Pelvic Ultrasound Exam

RAYUS Radiology™/YouTube

Pelvic Exam

Pelvic Exam

Also called: Pelvic Examination, Gynecological Exam

A pelvic exam is a doctor's visual and physical examination of a woman's reproductive organs. The exam may be performed as part of a regular checkup or can be done to investigate symptoms such as abnormal bleeding, unusual vaginal discharge, or pain. Pelvic exams are also done during pregnancy check-ups.

Pelvic Exam

Also called: Pelvic Examination, Gynecological Exam

A pelvic exam is a doctor's visual and physical examination of a woman's reproductive organs. The exam may be performed as part of a regular checkup or can be done to investigate symptoms such as abnormal bleeding, unusual vaginal discharge, or pain. Pelvic exams are also done during pregnancy check-ups.

{"label":"Pelvic Exam Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A normal result means that the uterus and ovaries are normal in size and location. The uterus can be moved slightly without causing pain. The vulva, vagina, and cervix look normal with no signs of infection, inflammation, or other abnormalities.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"An abnormal result can detect various issues concerning the vulva and your internal reproductive organs \u2014 your vagina, cervix, ovaries, fallopian tubes, and uterus. If your exam does find something abnormal, you may need follow-up tests.","conditions":[]}],"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
Your result is Normal.
A normal result means that the uterus and ovaries are normal in size and location. The uterus can be moved slightly without causing pain. The vulva, vagina, and cervix look normal with no signs of infection, inflammation, or other abnormalities.
Related conditions
1. Pelvic Exam. NCI's Dictionary of Cancer Terms [accessed on Oct 03, 2021]
2. Pelvic Exam: Preparation, Process, and More. Healthline. [accessed on Oct 03, 2021]
3. What Is a Pelvic Exam? | Questions About Gynecology Exams. Planned Parenthood. [accessed on Jan 15, 2022]
4. Pelvic Exam | Michigan Medicine [accessed on Jan 15, 2022]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (10)

A cervical screening test - What can you expect?

Video by Healthchanneltv / cherishyourhealthtv/YouTube

How can I deal with the fear of getting a pelvic exam in the doctor's office?

Video by IntermountainMoms/YouTube

Dr. Doe's Pelvic Exam

Video by sexplanations/YouTube

Pelvic Exam Illustration

Line drawing showing pelvic exam procedure.

Image by National Cancer Institute / Unknown Illustrator

Pelvic Exam

Leopold maneuvers

Image by Christian Gerhard Leopold

Screening for Cancer

Common Screening Tests and American Cancer Society Recommendations Breast cancer Mammography: Women 40 and older should have a mammogram every year. Clinical breast exam (breast exam performed by a medical professional): Women age 20-40 should have one every 3 years. Women 40 and older should have one every year. Breast self-exam: Women age 20 and older should perform one each month (considered optional). If you have a family history of breast cancer, talk to your healthcare professional about what type of screening you should have, and how often.

Image by TheVisualMD

Sensitive content

This media may include sensitive content

Healthy Cervix

The cervix is the lower portion of the uterus where it joins with the top of the vagina. The opening of the the cervix into the vagina is called the external os, and can vary in appearance from a small, circular opening in women who have not given birth, to a wider, more slit-like opening in women who have had children. Human papillomavirus (HPV) is associated with an increased risk of cervical cancer. Women should be screened for cellular changes of the cervix with a pap smear as part of a regular pelvic exam. Human papillomavirus (HPV) is a large group of related viruses that are often sexually transmitted. Most infections clear up quickly and cause few problems, though HPV can cause genital warts. Infection by certain types of HPV, however, can lead to cervical cancer. In 2006, the FDA approved an HPV vaccine (Gardisil) that protects against viral types that cause most cases of cervical cancer as well as genital warts. Public health experts recommend routine vaccination for girls ages 11-12 to ensure vaccine effectiveness.

Image by TheVisualMD

Uterus and Ovaries in Ultrasound

Ovarian cancer is the deadliest of gynecologic cancers. More than 21,000 new cases of ovarian cancer are diagnosed each year, with more than 15,000 deaths; less than 20% of cases are found at an early stage, when treatment is most effective. When ovarian cancer is suspected, a doctor will typically perform a pelvic exam to check for masses or growths on the ovaries. Other diagnostic tests include a transvaginal ultrasound, which produce detailed images of the ovaries and other reproductive organs.

Image by TheVisualMD

Sensitive content

This media may include sensitive content

Pap Test: Pap Smear (Pap Test)

A Pap smear, also called a Pap test, is a procedure to test for cervical cancer as well as a number of different types of infections. The test involves collecting cells from the cervix. A speculum is inserted into the vagina, and samples of cervical cells are collected and examined under a microscope for abnormalities. Detecting cervical cancer early with a Pap smear gives women a greater chance of being cured. A Pap smear can also detect changes in cervical cells that suggest cancer may develop in the future. The Pap smear is usually done in conjunction with a pelvic exam. In women over 30, the Pap smear may be combined with a test for human papillomavirus (HPV), a common sexually transmitted infection that may cause cervical cancer in some women.

Image by TheVisualMD

Women's Health Checkup

Doctors Examining Pregnant Woman

Image by Israel Defense Forces

2:13

A cervical screening test - What can you expect?

Healthchanneltv / cherishyourhealthtv/YouTube

2:21

How can I deal with the fear of getting a pelvic exam in the doctor's office?

IntermountainMoms/YouTube

5:45

Dr. Doe's Pelvic Exam

sexplanations/YouTube

Pelvic Exam Illustration

National Cancer Institute / Unknown Illustrator

Pelvic Exam

Christian Gerhard Leopold

Screening for Cancer

TheVisualMD

Sensitive content

This media may include sensitive content

Healthy Cervix

TheVisualMD

Uterus and Ovaries in Ultrasound

TheVisualMD

Sensitive content

This media may include sensitive content

Pap Test: Pap Smear (Pap Test)

TheVisualMD

Women's Health Checkup

Israel Defense Forces

Pelvic Ultrasound - Female

Pelvic Ultrasound - Female

Also called: Gynecological Scan, Gynecologic Ultrasound, Female Pelvic Scan, Female Pelvic Sonography, Transabdominal Female Pelvic Ultrasound, Transvaginal Ultrasound, Endovaginal Ultrasound

A female pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a woman’s pelvis, including the uterus, cervix, fallopian tubes, ovaries, vagina, and bladder.

Pelvic Ultrasound - Female

Also called: Gynecological Scan, Gynecologic Ultrasound, Female Pelvic Scan, Female Pelvic Sonography, Transabdominal Female Pelvic Ultrasound, Transvaginal Ultrasound, Endovaginal Ultrasound

A female pelvic ultrasound is a test that uses an ultrasound machine to assess the size, shape, and location of the organs and tissues inside a woman’s pelvis, including the uterus, cervix, fallopian tubes, ovaries, vagina, and bladder.

{"label":"Pelvic Ultrasound - Female Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"This means that your uterus, ovaries, and bladder are of a normal shape and size, without any abnormal masses or tissues.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"A problem or abnormality was detected during your pelvic ultrasound, either in your uterus, ovaries, fallopian tubes, or bladder. Talk to your doctor to know what this result means in your specific case.","conditions":["Fibroid tumors","Cysts","Ovarian torsion","Pelvic masses","Pelvic inflammatory disease","Ectopic pregnancy","Miscarriage","Free liquid in the pelvic cavity","Endometrial hyperplasia"]}],"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
Your result is Normal.
This means that your uterus, ovaries, and bladder are of a normal shape and size, without any abnormal masses or tissues.
Related conditions
Your doctor may want to order a female pelvic ultrasound to diagnose and assist in the treatment of a wide variety of conditions, such as:
- Abnormalities in the structure of the uterus and endometrium (lining of the uterus)
- Abnormalities in the structure of the ovaries
- Growths such as fibroid tumors, cysts, and other types of tumors within the pelvis
- Pelvic inflammatory disease (PID, which is an infection of your uterus, fallopian tubes, or ovaries)
- Ectopic pregnancy (pregnancy that occurs outside of the uterus)
- Abnormal bleeding or pelvic pain
- Postmenopausal bleeding
- Find an intrauterine contraceptive device (IUD)
- As part of the work-up for infertility and assisted reproduction techniques
A normal result means that your uterus, ovaries, and bladder are of a normal shape and size, without any abnormal masses or tissues.
An abnormal result indicates that a problem was detected, including but not limited to:
- Fibroid tumors
- Cysts
- Ovarian torsion
- Pelvic masses
- Pelvic inflammatory disease
- Ectopic pregnancy
- Miscarriage
- Free liquid in the pelvic cavity
- Endometrial hyperplasia, which is a thickening of the endometrium
1. Pelvic Ultrasound: Purpose, Procedure, Risks, Results [accessed on Dec 27, 2018]
2. Pelvic Ultrasound [accessed on Dec 27, 2018]
3. Pelvic Ultrasound | Johns Hopkins Medicine Health Library [accessed on Dec 27, 2018]
4. Transvaginal Ultrasound: Purpose, Procedure, and Results [accessed on Dec 27, 2018]
5. Pelvic Ultrasound - StatPearls - NCBI Bookshelf [accessed on Dec 27, 2018]
6. HEM Ultrasound | Female Pelvic Ultrasound [accessed on Dec 27, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (1)

What to Expect From a Female Pelvic Ultrasound Exam

Video by RAYUS Radiology™/YouTube

2:19

What to Expect From a Female Pelvic Ultrasound Exam

RAYUS Radiology™/YouTube

Laparoscopy

Laparoscopy

Also called: Diagnostic Laparoscopy, Exploratory Laparoscopy

A laparoscopy is surgery that lets a surgeon see your organs without making a large cut in your body. It is used to diagnose and treat conditions that develop in your belly or pelvis.

Laparoscopy

Also called: Diagnostic Laparoscopy, Exploratory Laparoscopy

A laparoscopy is surgery that lets a surgeon see your organs without making a large cut in your body. It is used to diagnose and treat conditions that develop in your belly or pelvis.

{"label":"Laparoscopy Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A normal result means that the examined site was found to have a normal shape and size, without any abnormal masses or tissues.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"An abnormal result indicates that a problem was detected in the examined area.","conditions":["Endometriosis","Fibroids","Ovarian cysts","Ectopic pregnancy","Congenital organ anomalies","Adhesions","Noncancerous tumors","Cancer","Inflammation","Infections","Fluid in the abdominal or pelvic cavities"]}],"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
Your result is Normal.
A normal result means that the examined site was found to have a normal shape and size, without any abnormal masses or tissues.
Related conditions
A laparoscopy is a type of surgery that lets a surgeon look inside your body without making a large incision (cut). It's used to help diagnose and sometimes treat conditions that develop in your belly or pelvis.
To do a laparoscopy, a surgeon makes a small cut near your belly button that's usually a half-inch long or less. The surgeon inserts a long, thin tube with a camera through the cut and into your body. This tube is called a laparoscope. The camera sends images from inside your body to a video monitor. This allows the surgeon to see inside your body.
The surgeon may make one or two other small cuts in your belly for inserting special surgical tools into your body. Using these tools, the surgeon can remove samples of tissue to check for signs of disease (a biopsy).
Sometimes during a laparoscopy, the surgeon will use these tools to do procedures to treat certain problems. For example, if a laparoscopy finds a tumor, the surgeon may remove it completely during the same surgery. Many common surgical treatments can be done with laparoscopic surgery.
Laparoscopy is sometimes called "minimally invasive surgery" or "keyhole surgery," because it requires smaller cuts than traditional, "open" surgery. The use of smaller cuts has several benefits, including:
- Shorter hospital stays
- Less pain
- Faster recovery and smaller scars
Laparoscopy is used to help diagnose the cause of symptoms in the belly or pelvis. It's usually done if imaging tests, such as x-rays, ultrasounds, and MRI scans, haven't provided enough information to confirm a diagnosis.
The test is often used to help diagnose:
- Digestive diseases
- Urinary disorders
- Disorders in the female reproductive system, which includes the uterus, ovaries, and fallopian tubes
A surgeon uses laparoscopy to:
- Examine organs and glands to look for:
  Abnormal growths, such as cysts and tumors (cancerous and not cancerous)
  Scar tissue and adhesions
  Bleeding
  Infections
- Collect tissue samples to check for disease
- Find out if a known cancer has spread in the body
There are many reasons why you may need a laparoscopy, including if:
- You have pain or other symptoms in your belly or pelvis and imaging tests haven't been able to find the cause.
- You've been in a serious accident or have been wounded and may have organ injuries.
- You have cancer and your health care provider needs to know if it has spread to other parts of your body. This information helps choose your treatment.
- You've had abnormal liver tests and your provider doesn't know why.
If you're female, you may need a laparoscopy to:
- Find out what's causing problems getting pregnant
- Diagnose symptoms that may involve your reproductive organs, including:
  Pelvic inflammatory disease (PID)
  Endometriosis
  Ectopic pregnancy
  Uterine fibroids
  Ovarian cysts
Laparoscopy is usually done in a hospital or an outpatient clinic. In general, it includes these steps:
- You'll wear a hospital gown and lay on an operating table.
- Usually, you will have general anesthesia, which is medicine to make you sleep during the surgery. The medicine is injected into your bloodstream through an intravenous (IV) line that's inserted into a vein. You may also inhale a gas from a mask to make you sleep.
- To do the laparoscopy, the surgeon will:
  Make a small cut near your belly button
  Put carbon dioxide gas into your belly to open up space between your organs so it's easier to see them
  Insert the laparoscope and small camera into your belly
  Move the laparoscope to look at your organs and glands on a computer screen
- If you need to have a biopsy or another procedure, the surgeon may need to make more small cuts to insert surgical tools.
- When the surgeon is done, the tools and most of the gas will be removed from your body, and the small incisions will be closed and bandaged.
- After surgery, you will be moved to a recovery room. In most cases, you'll be able to go home after a few hours, but that depends on what procedures were done during the laparoscopy. Before you leave, you'll get information about what to expect over the next few days at home.
1. Laparoscopy: MedlinePlus Medical Test [accessed on Mar 09, 2023]
2. Diagnostic laparoscopy: MedlinePlus Medical Encyclopedia [accessed on Dec 21, 2018]
3. Pelvic Laparoscopy: Purpose, Procedure, and Recovery [accessed on Dec 20, 2018]
4. Female Pelvic Laparoscopy Procedure | Cleveland Clinic [accessed on Dec 20, 2018]
5. Gynecologic Laparoscopy: Purpose, Procedure, and Risks [accessed on Dec 20, 2018]
6. Laparoscopy: Purpose, Preparation, Procedure, and Recovery [accessed on Dec 20, 2018]
7. Laparoscopic Surgery: Purpose, Procedure, and Benefits [accessed on Dec 20, 2018]
8. https://www.acog.org/~/media/For%20Patients/faq136.pdf [accessed on Dec 20, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (12)

Anti-Reflux Laparoscopy Heartburn Surgery Medical PreOp® Patient Education

Video by PreOp.com Patient Engagement - Patient Education/YouTube

Sleeve Gastrectomy at Duke Center for Metabolic and Weight Loss Surgery

Video by Duke Health/YouTube

Gallstones and Surgical Removal of Gallbladder (Cholecystectomy) Animation.

Video by Alila Medical Media/YouTube

Surgeon Performing Laparoscopic Kidney Transplant

This photograph shows the posterior view of two surgeons performing laparoscopic kidney transplant surgery with a view of the patient's abdomen on the monitor. Laparoscopy is a a minimally invasive procedure which requires only small incisions and has replaced conventional operations for kidney removal that used to require a larger opening and therefore longer recovery time. The procedure for living donors involves inserting a special needle into the abdominal cavity to fill it up with gas and create space. A metal tube with a camera, called a laparoscope, is inserted through a two-inch incision in the skin. Surgical instruments can be inserted through the laparoscope, and the surgeon can watch his progress in removing the kidney on a video monitor above the patient. With laparoscopic surgery, donors feel less pain after the transplant, and are able to return to their daily routine sooner.

Image by TheVisualMD

Laparoscopic stomach surgery

Doctors Ronald Post (left) and John Smear (center) and Physician's Assistant Debra Blackshire perform laparoscopic stomach surgery at Langley Air Force Base, Va., on Jan. 31, 2005. The surgery will involve the removal of the gall bladder to help alleviate acid reflux disease.

Image by Samuel Bendet, US Air Force

Illustration of Laparoscopy

Laparoscopy (from Ancient Greek λαπάρα (lapara), meaning 'flank, side', and σκοπέω (skopeo), meaning 'to see') is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.

Image by Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.

Laparoscopic Cholecystectomy

X-ray of organs during a laprasopic cholecystectomy. The picture shows the liver on top, the biliary tree within the liver, and the cystic duct going from the gall bladder to the common bile duct, which then goes down to duodenum.

Image by HenrikP

Sensitive content

This media may include sensitive content

Uterus

Female reproductive organs: Uterus, Fallopian tubes, ovaries (laparoscopic view)

Image by Hic et nunc

Sleeve Gastrectomy

Image Caption : Sleeve gastrectomy

Image by Stevenfruitsmaak at en.wikipedia derivative work: Jan Friberg (talk)

Laparoscopic Surgery (Keyhole Surgery)

Fleet Surgical Team 5 performs laparoscopic surgery

Image by U.S. Navy photo by Mass Communication Specialist Seaman Paul Polach

Abdominal Quadrant Regions

There are (a) nine abdominal regions and (b) four abdominal quadrants in the peritoneal cavity.

Image by OpenStax College

Ultrasound of Pelvis and Abdomen

Image by TheVisualMD

4:14

Anti-Reflux Laparoscopy Heartburn Surgery Medical PreOp® Patient Education

PreOp.com Patient Engagement - Patient Education/YouTube

2:06

Sleeve Gastrectomy at Duke Center for Metabolic and Weight Loss Surgery

Duke Health/YouTube

3:06

Gallstones and Surgical Removal of Gallbladder (Cholecystectomy) Animation.

Alila Medical Media/YouTube

Surgeon Performing Laparoscopic Kidney Transplant

TheVisualMD

Laparoscopic stomach surgery

Samuel Bendet, US Air Force

Illustration of Laparoscopy

Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.

Laparoscopic Cholecystectomy

HenrikP

Sensitive content

This media may include sensitive content

Uterus

Hic et nunc

Sleeve Gastrectomy

Stevenfruitsmaak at en.wikipedia derivative work: Jan Friberg (talk)

Laparoscopic Surgery (Keyhole Surgery)

U.S. Navy photo by Mass Communication Specialist Seaman Paul Polach

Abdominal Quadrant Regions

OpenStax College

Ultrasound of Pelvis and Abdomen

TheVisualMD

Management

Beat Stress with Mindful Awareness

Image by TheVisualMD

Beat Stress with Mindful Awareness

Meditation, yoga, group therapy—find the area of focus that helps you overcome stress. What is mindful awareness? It is, at heart, a catch-all term for many activities that emphasize focus on your physical, mental and emotional being. Yoga, various forms of meditation, tai chi, positive visualization, and different kinds of therapy all have in common the goal of quieting the mind, paying attention to the body, and restoring the spirit. That may sound unscientific, or even antiscientific, when in fact the scientific evidence for the benefits of mindful awareness practices are growing by the day. Group Therapy: One of the most stressed out populations in the modern world, military combat veterans with post-traumatic stress disorder, were found to benefit from a group therapy structure that required them to share their experiences with other vets. Groups of 9 to 11 troops spent a total of 60 or more hours together over 18 weeks, discussing their wartime memories and other aspects of their lives. Each gave two 2 ½-hour talks about their experience, and listened to recordings of their presentations 10 times. An impressive 81 percent of participants showed “clinically significant improvement” in stress symptoms after the group experience, an effect that remained steady six months after the group adjourned. For some, just hearing that others had frozen under fire or felt helpless alleviated the guilt or shame they had felt about doing the same. The power of group counseling is often in discovering that others who have faced the same kind of stress you face have found ways to cope, and are working to improve, just as you are. Meditation: In a study, 133 healthy adults volunteered to learn meditation techniques to reduce stress. They took a variety of mood and psychological assessments. Then they learned a simple meditation technique involving focusing on a single, meaningful word, called a mantra. The students met four times for one hour each meeting in small groups, and were instructed to practice the meditation for 15-20 minutes twice a day. After the instruction period, student scores on the mood and psychological assessments improved. Their perceived stress, mood states, anxiety inventory and brief symptom inventory scores all improved. Those who had practiced most frequently had the greatest improvement. Yoga: Emotionally distressed women volunteered to participate in a 3-month yoga program to relieve stress. The subjects took multiple assessment tools to measure their perceived stress, anxiety, mood, relative depression, well-being, physical status and more. Their levels of salivary cortisol, the stress hormone, were also measured. They met twice a week for a 90-minute Iyengar yoga class. Compared with volunteers who had been put on a waiting list for the class, the yoga students showed pronounced improvements in all of the assessment areas measured. Their cortisol levels dropped after participation in a class, and those who had suffered from headache or back pain reported significant pain relief. Choosing a Practice: Mindful awareness is about your individual mind, stressors and lifestyle. Find an approach that appeals to you, and see if you can sit in on a class or group meeting before committing to an intervention. The medical establishment has not always accepted the notion that some of these practices could improve your health and longevity. But all of that is changing in the face of compelling research about the connections between the mind and body.

Image by TheVisualMD

What Can I Do About Period Pain?

To help ease your period pain, you can try

Using a heating pad or hot water bottle on your lower abdomen
Getting some exercise
Taking a hot bath
Doing relaxation techniques, including yoga and meditation

You might also try taking over-the-counter pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include ibuprofen and naproxen. Besides relieving pain, NSAIDs reduce the amount of prostaglandins that your uterus makes and lessen their effects. This helps to lessen the cramps. You can take NSAIDs when you first have symptoms, or when your period starts. You can keep taking them for a few days. You should not take NSAIDS if you have ulcers or other stomach problems, bleeding problems, or liver disease. You should also not take them if you are allergic to aspirin. Always check with your health care provider if you are not sure whether or not you should take NSAIDs.

It may also help to get enough rest and avoid using alcohol and tobacco.

Source: MedlinePlus

Additional Materials (3)

How to deal with period pain | NHS

Video by NHS/YouTube

Period pain? Try these remedies

Video by Mayo Clinic/YouTube

Period Pain Relief: What Works? [Dr. Claudia]

Video by Babylon/YouTube

1:45

How to deal with period pain | NHS

NHS/YouTube

0:56

Period pain? Try these remedies

Mayo Clinic/YouTube

1:56

Period Pain Relief: What Works? [Dr. Claudia]

Babylon/YouTube

When to See a Doctor

Drawing of a woman and a doctor seated at a table and talking in the doctor's office. The doctor is taking notes

Image by NIDDK Image Library

Drawing of a woman and a doctor seated at a table and talking in the doctor's office. The doctor is taking notes

Image by NIDDK Image Library

When Should I Get Medical Help for My Period Pain?

For many women, some pain during your period is normal. However, you should contact your health care provider if

NSAIDs and self-care measures don't help, and the pain interferes with your life
Your cramps suddenly get worse
You are over 25 and you get severe cramps for the first time
You have a fever with your period pain
You have the pain even when you are not getting your period

Source: MedlinePlus

Additional Materials (3)

Period Pain Relief: What Works? [Dr. Claudia]

Video by Babylon/YouTube

Dysmenorrhea—What You Should Know About Diagnosis and Treatment

Video by PAINWeek/YouTube

Painful Periods, Dysmenorrhea and Endometriosis

Video by Pediatric Healthcare Professional Resources/YouTube

1:56

Period Pain Relief: What Works? [Dr. Claudia]

Babylon/YouTube

4:55

Dysmenorrhea—What You Should Know About Diagnosis and Treatment

PAINWeek/YouTube

7:21

Painful Periods, Dysmenorrhea and Endometriosis

Pediatric Healthcare Professional Resources/YouTube

Severe Period Pain

Female Pelvis Showing Intrauterine Device within Uterus

Image by TheVisualMD

Female Pelvis Showing Intrauterine Device within Uterus

Three-dimensional visualization reconstructed from scanned human data. Anteriolateral view of female pelvis and reproductive organs, showing proper placement of an intrauterine device (IUD) within the uterus.. An IUD is a female mechanical and/or hormonal contraceptive that is believed to primarily work by providing a mechanical barrier as well as thickening the cervical mucus, making it more difficult for sperm to reach the egg; it may also irritate the uterus to make it unreceptive to implantation and/or affect the affect the way the sperm and egg move. There are two kinds of IUDs available: a copper IUD, which can remain in place for up to 10 years, and a progesterone IUD, which is replaced yearly. An IUD is only available with a prescription and must be inserted by a doctor. It has a failure rate of 1 - 2% and offers no protection against STDs.

Image by TheVisualMD

What Are Treatments for Severe Period Pain?

If your period pain is primary dysmenorrhea and you need medical treatment, your health care provider might suggest using hormonal birth control, such as the pill, patch, ring, or IUD. Another treatment option might be prescription pain relievers.

If you have secondary dysmenorrhea, your treatment depends upon the condition that is causing the problem. In some cases, you may need surgery.

Source: MedlinePlus

Additional Materials (6)

Dysmenorrhea—What You Should Know About Diagnosis and Treatment

Video by PAINWeek/YouTube

Primary and Secondary Dysmenorrhea / Richmond Women's Specialists

Video by HCA Virginia Health System/YouTube

Topic 46: Dysmenorrhea

Video by Association of Professors of Gynecology and Obstetrics (APGO)/YouTube

Intrauterine device

X Intrauterine Device (IUD)

Image by Blausen.com staff (2014). \"Medical gallery of Blausen Medical 2014\". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436

Birth Control Patch

Birth Control Patch

Image by Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014"

Female Pelvis Showing Contraceptive Ring within Vagina

Three-dimensional visualization reconstructed from scanned human data. Anterior view of female pelvis and reproductive organs, showing proper placement of a contraceptive ring within the vagina. A contraceptive ring is a female hormonal contraceptive device that is inserted into the vagina; it releases hormones that stop the ovary from releasing an egg, so that pregnancy does not occur. It also causes the cervical mucous to thicken, making it more difficult for sperm to enter the uterus, and changes the lining of the uterus, preventing implantation of a fertilized egg. The contraceptive ring is only available with a prescription. When used correctly, it has a failure rate of 1 - 2%. It offers no protection against STDs.

Image by TheVisualMD

4:55

Dysmenorrhea—What You Should Know About Diagnosis and Treatment

PAINWeek/YouTube

0:55

Primary and Secondary Dysmenorrhea / Richmond Women's Specialists

HCA Virginia Health System/YouTube

3:25

Topic 46: Dysmenorrhea

Association of Professors of Gynecology and Obstetrics (APGO)/YouTube

Intrauterine device

Blausen.com staff (2014). \"Medical gallery of Blausen Medical 2014\". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436

Birth Control Patch

Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014"

Female Pelvis Showing Contraceptive Ring within Vagina

TheVisualMD

What to Know

Period pain

Image by Saranya7

Period pain

Dysmenorrhea

Image by Saranya7

Period Problem: Menstrual Pain (Dysmenorrhea)

Pain that you get with your menstrual period is called dysmenorrhea (dis-men-uh-REE-uh). Pain is the most common problem women have with their periods. More than half of women who have periods get some pain around their period. Some women may get just a feeling of heaviness in the abdomen or tugging in the pelvic area. Other women experience severe cramps different from premenstrual syndrome (PMS) pain.

A majority of period pain can be relieved by over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen, ibuprofen, or aspirin. Starting an over-the-counter NSAID medicine when your period first starts may also lessen heavy menstrual bleeding and help control the pain better.

There are two types of dysmenorrhea:

Primary dysmenorrhea. This is the most common type of dysmenorrhea. The pain is usually caused by contractions of the uterus (womb). The uterus contracts during your period to help the uterine lining leave the body. Teens may get dysmenorrhea soon after they get their first period. For most women, primary dysmenorrhea gets less painful as they get older. But some women get severe menstrual pain. Your risk for dysmenorrhea may be higher if you:
- Got your first period before age 11
- Have longer or heavier periods
- Smoke
- Have high levels of stress

Secondary dysmenorrhea. This type of dysmenorrhea is usually caused by another health problem. Pain from secondary dysmenorrhea usually gets worse as you get older. It also lasts longer than normal menstrual cramps. Problems that cause secondary dysmenorrhea include:
- Endometriosis. This condition happens when the lining of the uterus grows outside of the uterus where it does not belong. In response to monthly changes in levels of the hormone estrogen, this lining breaks down and bleeds outside of the uterus and can cause swelling and pain.
- Uterine fibroids. Fibroids are tumors that grow in or on the wall of the uterus. They are almost always not cancerous. Some women with fibroids experience pelvic pain and vaginal bleeding at times when they do not have their period.
- Ovarian cysts. Cysts are fluid-filled sacs on the ovary. Ovarian cysts usually don’t cause any symptoms, but some can cause pain during your period or at ovulation.

When to see your doctor

Talk to your doctor or nurse if over-the-counter pain medicine, such as ibuprofen or naproxen, does not help or if the pain interferes with daily activities like work or school. Your doctor or nurse will ask you questions and do some tests, including possibly a physical exam, to rule out any other health problem. Keeping track of your symptoms and periods in a diary or calendar can help your doctor or nurse diagnose any health problems.

See your doctor to rule out other health problems if:

You have blood clots in your menstrual flow that are larger than a quarter.
Your pain happens at times other than just before your period or during your period.

Treatment depends on what is causing your pain. Your doctor may prescribe hormonal birth control, such as a hormonal intrauterine device (IUD), the pill, shot, or vaginal ring, to help with pain from endometriosis, fibroids, or ovarian cysts. Hormonal birth control is sometimes prescribed by doctors for women’s health concerns other than preventing pregnancy. You may also need surgery, as a last resort, if one of these conditions is causing your pain.

Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services

Additional Materials (3)

Primary and Secondary Dysmenorrhea / Richmond Women's Specialists

Video by HCA Virginia Health System/YouTube

Painful Periods

Video by UMass Memorial Health/YouTube

What Causes Painful Periods? - Dr. Kevin Audlin - Mercy

Video by Mercy Medical Center - Baltimore/YouTube

0:55

Primary and Secondary Dysmenorrhea / Richmond Women's Specialists

HCA Virginia Health System/YouTube

1:31

Painful Periods

UMass Memorial Health/YouTube

1:04

What Causes Painful Periods? - Dr. Kevin Audlin - Mercy

Mercy Medical Center - Baltimore/YouTube

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Period Pain

Period pain affects many women, and it can be severe. The pain is most often menstrual cramps. Learn about the causes of menstrual cramps, what you can do to feel better, and when you need to see a doctor.

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