How to Identify Signs of Secondary Dysmenorrhea

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1Considering Your Symptoms

2Identifying Potential Causes of Pain

3Seeking Medical Help

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Secondary dysmenorrhea is when you have menstrual cramps that are caused by an underlying condition, such as a reproductive disease, a structural abnormality, or an intrauterine birth control device. This type of menstrual pain is often more severe and longer lasting than the cramps caused by your period alone. Without a medical exam, it can be difficult to determine whether or not the pain you are having is caused by primary or secondary dysmenorrhea. However, there are some signs that may help you to determine if your menstrual cramps are caused by secondary dysmenorrhea.

Steps

Method 1

Method 1 of 3:

Considering Your Symptoms

1. 
   1
   Think about when you get cramps. Women who have secondary dysmenorrhea may get cramps starting a few days before the start of their period. The cramps may also last longer than normal menstrual cramps, such as past the end of the period.

   • Cramps that are caused by primary dysmenorrhea may start about one or two days before your period begins and they can last for just a few hours or up to a few days. However, they should not extend past the end of your period.
2. 
   2
   Rate your pain. You may have noticed an increase in the severity of your menstrual cramps over time and this may also indicate that your cramps are due to secondary dysmenorrhea. For example, you might have had cramps that were relatively mild as a teenager, but your cramps might have become more severe as an adult.

   • Pain from primary dysmenorrhea may be mild to severe. The pain is often located in the abdomen, lower back, and thighs.
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3. 
   3
   Note other symptoms along with your cramps. Women who experience menstrual cramps from primary dysmenorrhea often complain of other symptoms. However, women who have secondary dysmenorrhea may not experience these other symptoms. Symptoms that may indicate that you are experiencing primary dysmenorrhea may include:

   • nausea
   • vomiting
   • fatigue
   • diarrhea
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Method 2

Method 2 of 3:

Identifying Potential Causes of Pain

1. 
   1
   Check for symptoms of endometriosis. Endometriosis is when endometrial tissue grows outside of the uterus. The tissue may grow around the uterus or even spread to other parts of your abdomen. Painful periods and cramps that last for several days are the main symptom of this condition, but symptoms can also include:

   • Pain when you have sex.
   • Pain when you have a bowel movement or urinate, especially during your period.
   • Excessive bleeding during your period or between periods.
   • Infertility.
   • Other less serious symptoms, such as bloating, diarrhea or constipation, nausea, and fatigue.
2. 
   2
   Identify signs of adenomyosis. Adenomyosis is a condition that causes endometrial glands to grow too deeply within the uterine muscular wall. This can lead to an enlarged uterus, painful periods, and other symptoms as well. Some women with adenomyosis have no symptoms, but symptoms may include:

   • Periods that are heavy or that last a long time.
   • Stabbing pain in your pelvis or severe cramps.
   • Cramps that worsen as you get older.
   • Pain during sex.
   • Blood clots that you pass during your period.
   • Swelling in your abdomen due to an enlarged uterus.
3. 
   3
   Watch for symptoms of pelvic inflammatory disease. Pelvic inflammatory disease often results from a sexually transmitted disease and it causes an infection of a woman’s reproductive organs. This condition can cause painful cramps. Other symptoms of pelvic inflammatory disease may include:

   • Pelvic pain.
   • Fever.
   • Foul smelling discharge coming from your vagina.
   • Pain and/or bleeding during sex.
   • A burning sensation during urination.
   • Bleeding between your periods.
4. 
   4
   Look for symptoms of cervical stenosis. Cervical stenosis is when the opening of the cervix is narrower than is normal. Some women who are past menopause may have cervical stenosis without any symptoms. However, symptoms of cervical stenosis may include:

   • Not having a period.
   • Having painful periods.
   • Having abnormal bleeding, such as between periods.
   • Infertility.
   • A lump in the pelvic area caused by a bulge in the uterus.
5. 
   5
   Check for signs of fibroids. Uterine fibroids are muscular tumors that grow in the uterine walls. They are often benign and cause no symptoms. However, tumors, cysts, and malformations can also cause secondary dysmenorrhea, which is why it is important to talk to your gynecologist if you have a sudden onset of severe or ongoing menstrual cramps.. If you do have symptoms of uterine fibroids, then some of the symptoms may include:

   • Bleeding heavily during your period.
   • Having an enlarged abdomen and/or a feeling of fullness in your lower abdomen.
   • Urinating frequently.
   • Experiencing pain during sex.
   • Having pain in your lower back.
   • Having difficulty giving birth or requiring a cesarean section.
   • Being infertile (rare).
6. 
   6
   Be aware that IUDs can cause secondary dysmenorrhea. Intrauterine devices, also known as IUDs can also cause secondary dysmenorrhea. If you have one of these birth control devices and it is causing you severe pain, then talk to your gynecologist.

   • Copper IUDs are more likely to cause severe pain than other types of IUDs.
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Method 3

Method 3 of 3:

Seeking Medical Help

1. 
   1
   Make an appointment with your gynecologist. If you suspect that you are having menstrual pain because of secondary dysmenorrhea, then make an appointment with a gynecologist right away. Secondary dysmenorrhea can indicate that you have a serious medical problem that requires prompt treatment.
2. 
   2
   Provide a thorough health history. Your gynecologist will take a thorough health history and ask questions about your current condition as well. It is important to provide honest answers to these questions. Some of the questions your doctor may ask might include:

   • When did you have your first period?
   • When did your symptoms start?
   • Does anything make your symptoms worse or better?
   • How is the pain affecting your daily life? Is it interfering with your normal daily activities?
3. 
   3
   Undergo a physical exam. After taking a thorough health history, your doctor will also need to do a physical exam. As part of this exam, your doctor will examine your vagina, vulva, and cervix to check for masses and abnormalities. Your doctor will also examine your abdomen for signs of swelling.

   • Depending on the findings of the exam, your doctor may decide to run blood tests or imaging tests. These tests can provide your doctor with additional information to help him or her make a diagnosis.
4. 
   4
   Share any red flag symptoms you have noticed. Some symptoms may indicate a serious problem and you should share these with your doctor right away. Call or visit your doctor right away if you have had:

   • a sudden onset of pain
   • pain that does has not gone away
   • a fever
   • vaginal discharge
   • swelling of your stomach
   • suddenly heavy menses (this could be a sign for a thyroid disorder)
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