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Causes

By Mayo Clinic staff

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Illustration showing female reproductive organs Female reproductive organs

During menstrual periods, your uterus contracts to help expel its lining. Prostaglandins, hormone-like substances involved in pain and inflammation, trigger the uterine muscle contractions. Higher levels of prostaglandins are associated with more severe menstrual cramps.

Many experts believe that severe contractions constrict the blood vessels feeding the uterus. The resulting pain can be compared to the angina that occurs when blocked coronary arteries starve portions of the heart of food and oxygen.

Menstrual cramps also may be caused by:

  • Endometriosis. In this painful condition, the type of tissue that lines your uterus becomes implanted outside your uterus, most commonly on your fallopian tubes, ovaries or the tissue lining your pelvis.
  • Uterine fibroids. These noncancerous tumors and growths in the wall of the uterus rarely may be the cause of pain.
  • Adenomyosis. In this condition, the tissue that lines your uterus begins to grow into the muscular walls of the uterus.
  • Pelvic inflammatory disease (PID). This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.
  • Cervical stenosis. In some women, the opening of the cervix may be so small that it impedes menstrual flow, causing a painful increase of pressure within the uterus.
Risk factors Symptoms
References
  1. Lentz GM. Primary and secondary dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder: Etiology, diagnosis and management. In: Katz VL, et al. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby Elsevier; 2007. http://www.mdconsult.com/das/book/body/123257502-3/810739333/1524/245.html#4-u1.0-B978-0-323-02951-3..50039-X--cesec1_1158. Accessed March 2, 2009.
  2. Banikarim C. Primary dysmenorrhea in adolescents. http://www.uptodate.com/home/index.html. Accessed March 2, 2009.
  3. Dysmenorrhea. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp046.cfm. Accessed March 2, 2009.
  4. Smith RP, et al. Pathogenesis, clinical manifestations and diagnosis of primary dysmenorrhea in adult women. http://www.uptodate.com/home/index.html. Accessed March 2, 2009.
  5. Endometriosis and adenomyosis. In: Kumar V, et al. Robbins and Cotran Pathologic Basis of Disease. 7th ed. Philadelphia, Pa.: Elsevier Saunders; 2005. http://www.mdconsult.com/das/book/body/123257502-5/810836639/1249/260.html#4-u1.0-B0-7216-0187-1..50026-2--cesec79_3198. Accessed March 2, 2009.
  6. Peipert JF, et al. Complications of pelvic inflammatory disease. http://www.uptodate.com/home/index.html. Accessed March 2, 2009.
  7. Ultrasound imaging of the pelvis. Radiological Society of North America. http://www.radiologyinfo.org/en/info.cfm?PG=pelvus. Accessed March 3, 2009.
  8. CT: Abdomen and pelvis. Radiological Society of North America. http://www.radiologyinfo.org/en/info.cfm?PG=abdominct. Accessed March 3, 2009.
  9. MRI of the body (chest, abdomen, pelvis). Radiological Society of North America. http://www.radiologyinfo.org/en/info.cfm?PG=bodymr. Accessed March 3, 2009.
  10. Hysteroscopy. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp084.cfm. Accessed March 3, 2009.
  11. Laparoscopy. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp061.cfm. Accessed March 3, 2009.
  12. Smith RP, et al. Treatment of primary dysmenorrhea in adult women. http://www.uptodate.com/home/index.html. Accessed March 3, 2009.
  13. Dysmenorrhea. In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-1-4160-2450-7..50117-1--cesec17&uniq=123506366&isbn=978-1-4160-2450-7&sid=811308126#lpState=open&lpTab=contentsTab&content=4-u1.0-B978-1-4160-2450-7..50117-1--cesec17%3Btype%3DbookPage%3Bisbn%3D978-1-4160-2450-7. Accessed March 3, 2009.
  14. Mind-body medicine: An overview. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/whatiscam/mind-body/mindbody.htm. Accessed March 3, 2009.
  15. An introduction to acupuncture. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/acupuncture/introduction.htm. Accessed March 3, 2009.
  16. Nasir LS. Dysmenorrhea. In: Rakel RE, et al. Conn's Current Therapy. 60th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/123506366-5/811342293/1621/527.html#4-u1.0-B978-1-4160-4435-2..50267-3--cesec6_4271. Accessed March 3, 2009.

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May 1, 2009

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