Painful Menstrual Cramps

What Causes Menstrual Pain?

Menstrual pain can have various causes, ranging in severity from 'worrying' to 'very serious'.  Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.

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Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms.  In order to diagnose menstrual pain, we could:

  • Research the topic
  • Find a doctor with the time
  • Use a diagnostic computer system.
The process is the same, whichever method is used.

Step 1: List all Possible Causes

We begin by identifying the disease conditions which have "menstrual pain" as a symptom.  Here are eight of many possibilities (more below):
  • Endometrial Polyps
  • Adenomyosis
  • Adrenal Fatigue
  • Fibroids
  • Endometriosis
  • Ovarian Cysts
  • IUD Complications
  • Cervical Narrowing

Step 2: Build a Symptom Checklist

We then identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
darker/redder skin color
very weak urine stream
adverse reaction to stress
suspected adrenal insufficiency
often/always feeling unusually cold
prednisone use
late term miscarriage
intermittent abdominal fullness
ovarian cysts
morning sickness
uterine fibroids
dizziness when standing up
... and more than 70 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of menstrual pain:
Cause Probability Status
Cervical Narrowing 95% Confirm
Fibroids 25% Unlikely
Adrenal Fatigue 14% Unlikely
Endometriosis 0% Ruled out
Ovarian Cysts 0% Ruled out
IUD Complications 0% Ruled out
Adenomyosis 0% Ruled out
Endometrial Polyps 0% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate being premenopausal or being perimenopausal, The Analyst™ will ask further questions including this one:
Do you suffer from painful menstrual cramps (painful menstruation)?
Possible responses:
→ Never had them / don't know
→ Probably had them/minor episode(s) now resolved
→ Major episode(s) now resolved
→ Current minor/occasional problem
→ Current major/regular problem
Based on your response to this question, which may indicate either history of painful menstrual cramps or painful menstrual cramps, The Analyst™ will consider possibilities such as:
Ovarian Cysts

Ovarian cysts can cause symptoms resembling painful menstrual periods when the cyst grows to a larger size.  A history of painful menstrual cramps can indicate hormonal problems or imbalances which can increase the risk of ovarian cysts.

EFA (Essential Fatty Acid) Type 3 Requirement

In a double-blind placebo-controlled study among a group of girls suffering from dysmenorrhea, it was found that the symptoms could be significantly reduced by dietary supplementation with omega-3 fatty acids.  This particular study used fish oil. [ American Journal of Obstetrics & Gynecology, April 1996;174(4): pp.1335-1338]


Endometriosis is the most common cause of menstrual cramps.

Low Adrenal Function / Adrenal Insufficiency

Dysmenorrhea caused by ovarian dysfunction may disappear when low doses of cortisol are used to improve adrenal influence on ovarian function. [The Safe Uses of Cortisol, William Mck. Jefferies, MD 1996, p.157]

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