Dysmenorrhea

For a lay person:

Dysmenorrhea is painful periods: cramping in the lower abdomen, sometimes spreading to the back and thighs, usually starting just before or at the beginning of a period. It is very common, especially in younger women.

For a trained medical person:

Primary dysmenorrhea is prostaglandin-mediated and begins soon after menarche; NSAIDs and hormonal contraception are first-line. Secondary dysmenorrhea — new onset, later onset or progressive pain — suggests endometriosis, adenomyosis, fibroids or pelvic inflammatory disease and needs investigation.

In Chinese medicine:

Classed as painful menstruation (痛經). Pain before or at the start of the period that is worse with pressure is read as excess — Liver Qi Stagnation, Blood Stasis, Cold or Damp-Heat. Dull pain at the end of the period that eases with pressure is read as deficiency — Qi and Blood, or Liver and Kidney Yin.

When to get help: See a doctor if period pain is new, getting worse, or comes with heavy bleeding, pain during sex or bleeding between periods.