ZocdocAnswersHow can I alleviate very painful periods due to primary dysmenorrhea?

Question

How can I alleviate very painful periods due to primary dysmenorrhea?

I am a 24 year old woman who has been menstruating since 11, with extremely painful periods since 12. NSAIDs are moderately helpful (especially for later cramping) but essentially nothing helps with first day cramps. I tend to get severe leg cramps as well, and often vomit. I have tried hormonal birth control, acupuncture, homeopathic and herbal treatment, etc. The only partial solution that I have found some relief with is taking a mid-sized dose of anti-anxiety medication (lorazepam) which reduces pain, but leaves me drugged-feeling and extremely drowsy. What other methods or treatments might help with this significant issue?

Answer

This is quite unfortunate that you have had these unpleasant symptoms for so long without good relief. It also sounds like you have tried a number of different remedies without much effect. I would make sure that you are optimizing all the possible non-drug interventions that you can. These include paying attention to your sleep cycle, diet, and exercise, as these can all greatly impact your symptoms. If you have neglected these elements, then they may make the difference for you. Next, I would make sure that you are taking the NSAIDS before your symptoms start - usually in dysmenorrhea you should start the NSAIDS 2-3 days before the symptoms typically begin, as starting them after symptoms is less effective. NSAIDS and birth control pills are definitely the best treatment for primary dysmenorrhea. For some, alternative medicine approaches are helpful, but this is highly variable from person to person, so it is hard to make a recommendation. The incidence of endometriosis in women who fail to have relief of symptoms with optimal diet, exercise together with NSAIDS and birth control pills is very high. Therefore, many OB GYN doctors will recommend a diagnostic procedure to look for endometriosis in cases like yours.

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