Dysmenorrhea, which can be classified as primary dysmenorrhea or secondary dysmenorrhea, is the medical term for difficult menstrual cramps and painful periods that are the most common part of your cycle. These include cramps before periods, diarrhea during periods and cramps after periods.


Menstrual flow can vary a lot from one woman to another, and can also change over time during a woman’s reproductive years. Some women have no cramps at all, some have some mild ones that 2 ibuprofen pills can alleviate, and some women live with cramps so severe, that they have to take a sick day from work. The cramps usually occur in your lower belly and back. They may lessen over time or even disappear altogether after the birth of your first child. Painful cramps (the medical term for it is dysmenorrhea), are the leading cause of missed school for young women, and they are in the top five reasons for missing work.

Dysmenorrhea occurs because your uterus is a muscle that contracts to some degree throughout your cycle. If the contractions are too strong, they put pressure on blood vessels and temporarily cut off oxygen to your uterus. This lack of oxygen causes the pain and menstrual cramps.

Symptoms of Dysmenorrhea

Your Forest Hills, Queens specialist will classify your cramps as primary dysmenorrhea or secondary dysmenorrhea. Primary dysmenorrhea (painful periods in young women) is directly related to their cycle. Symptoms of primary dysmenorrhea include:

  • Onset shortly after menarche — usually within six months, but possibly up to two years
  • Normal duration of 48 to 72 hours, often starting several hours before your normal flow
  • Cramping or labor-like pains
  • Constant abdominal aching, radiating to your back, hips or thighs
  • Feeling of pressure in your belly
  • Unremarkable pelvic examresults

Secondary dysmenorrhea occurs in women often between the ages of 30 to 45, indicating a problem or organic disease in your reproductive organs. Symptoms of secondary dysmenorrhea include:

  • Symptoms beginning in your 20s or 30, with no previous painful cycles
  • Heavy menstrual flow or irregular bleeding
  • Pelvic abnormality on exam
  • Poor response to NSAIDs or oral contraceptives
  • Infertility
  • Painful intercourse
  • Vaginal discharge

When either form of dysmenorrhea is particularly severe, you may suffer from an upset stomach with possible vomiting and diarrhea during your period. If any of these symptoms continue to be severe, don’t respond to normal over-the-counter medications, adversely affect your quality of life or have a sudden onset, make an appointment with your gynecologist in Queens, NYC.

Reasons for Secondary Dysmenorrhea

Many different structural issues or organic diseases may contribute to secondary dysmenorrhea, such as:

  • Endometriosis, which is when uterine lining tissue can be found outside your uterus
  • Pelvic inflammatory disease (PID), which occurs when an infection spreads from your uterus to other reproductive organs
  • Stenosis or narrowing of your cervix, usually caused by scarring or lack of estrogen at menopause
  • Uterine Fibroids
  • Adenomyosis, a condition in which the inner lining of the uterus (the endometrium) breaks through the muscle wall of the uterus
  • Ovarian cysts or tumors
  • Uterine polyps
  • Intrauterine adhesions
  • Intrauterine device
  • Transverse vaginal septum, a rare congenital malformation of the uterine structure
  • Pelvic congestion syndrome, which involves chronic varicose veins in your abdomen
  • Allen-Masters syndrome, which is pelvic pain and flow due to a laceration of the broad uterine ligament, often during delivery

Prognosis for primary dysmenorrhea is usually very good. Most of the time the symptoms can be treated with over-the-counter medications like non-steroidal anti-inflammatory drugs (NSAIDs). The outlook for secondary dysmenorrhea depends on the medical cause of your menstrual cramps.


Amenorrhea is the cessation of the menstrual flow. It usually occurs due to pregnancy, a problem with your reproductive organs or improper hormone levels. If it’s one of the latter reasons, infertility and osteoporosis issues may occur at the same time. There could be a variety of reasons that can lead to amenorrhea, including breastfeeding, menopause, contraceptives, other medications, low body weight, excessive exercise, stress, uterine scarring, and structural abnormalities, etc.. Symptoms can include:

  • Milky nipple discharge
  • Absence of menstrual flow
  • Hair loss
  • Headache
  • Vision changes
  • Excess facial hair
  • Pelvic pain
  • Acne

 Diagnosis for Dysmenorrhea and Amenorrhea

Some of the same tests are conducted for both dysmenorrhea and amenorrhea. The goal is to determine the underlying reasons or to rule out organic or structural causes. Your Forest Hills, Queens gynecologist may request any combination of the following:

  • Blood count with differential
  • Gonococcal and chlamydial cultures
  • Urinalysis
  • Stool culture
  • Cancer antigen 125
  • Ultrasound
  • MRI
  • Laparoscopy
  • Hysteroscopy
  • Dilation and curettage
  • Pregnancy test
  • Thyroid function test
  • Ovary function test
  • Prolactin test
  • Male hormone tests
  • CT scan

This is a long list, but your doctor doesn’t require all these. However, the exact nature of your dysmenorrhea or amenorrhea must be determined for effective treatment. The best OB/GYNs in NYC that are part of the Forest Hills Medical Services team know how to narrow down your diagnosis.

Amenorrhea and Dysmenorrhea Treatments

If you are not pregnant, amenorrhea might be the result of lifestyle decisions. You may be exercising too much, eating too little or feeling too much stress. Reduce how much you exercise. Increase the amount of food you eat, and consume a balanced diet. Lower your daily life stress or conflicts. Personal trainers, nutritionists, and counselors can help.

Treatment for dysmenorrhea depends on whether it’s primary or secondary in nature. If it’s secondary dysmenorrhea, your gynecologist in Queens, NYC works with you to resolve the underlying issues. If primary dysmenorrhea is the diagnosis, you can take aspirin, acetaminophen, ibuprofen, or naproxen to relieve your symptoms. Other helpful tips include:

  • Heat from a heating pad or hot water bottle on your lower back or stomach
  • Rest
  • Avoid caffeine and salt
  • Stop using tobacco and alcohol
  • Massage
  • Regular exercise

Forest Hills Medical Services is a comprehensive clinical practice. We believe that how you are treated at our office is just as important as the medical care you receive. We are dedicated to providing the highest quality obstetrics and gynecology with warmth and compassion. Our physicians are easy to talk to and our entire staff is friendly and attentive to your needs. We do our best to make a positive, long-term impact on our patients’ lives through preventive care and education.

The best gynecologists in Queens who are part of the Forest Hills Medical Services team are renowned for their extensive skills in diagnosing and treating dysmenorrhea. We will listen to all your concerns and together we will come up with the dysmenorrhea treatment plan that works for you and your unique circumstances.

Call FHMS to meet our staff in our state-of-the-art offices and be heard.

Gynecologists Dr. James Gohar (OBGYN Doctor), Dr Nithya Gopal and Maris Huffman, NP
Forest Hills Medical Services
108-16 63rd Rd
Forest Hills, NY 11375
1 (646) 472-5893