{"componentChunkName":"component---src-components-article-page-article-page-gatsby-container-tsx","path":"/articles/sex/does-hormonal-birth-control-reduce-cramps-and-period-pain","result":{"data":{"articleNode":{"id":"4Z5NBXnFuQgtIFlk9GKmLz","title":"Does hormonal birth control reduce cramps and period pain? ","subtitle":"Here are the hormonal and non-hormonal methods that can help. ","seoMetaTitle":"Birth Control, Cramps, & Period Pain: Comparison of Every Type of Birth Control","seoMetaDescription":"Hormonal birth control methods like the pill, the IUD, and the implant can help with cramps. Plus, non-hormonal ways to manage pain, like heat and exercise. ","openGraphTitle":"Birth control & period cramps","openGraphDescription":"Here's what the research says on each method of birth control and the effect on cramps & period pain.","slug":"sex/does-hormonal-birth-control-reduce-cramps-and-period-pain","artCredits":"Illustration by Marta Pucci","publishDate":"2019-10-17T00:00+02:00","updatedAt":"2025-11-07T09:51:50.919Z","createdAt":"2019-10-17T15:50:30.254Z","locale":"en","authors":[{"id":"78n6x61rXkWjy2EhqX67Y5","name":"Kate Wahl, PhD","headline":"Science Writer ","slug":"kate-wahl","twitter":null,"locale":"en","profileImage":{"id":"qtxav5Gv95pJazFQr4485","description":"Kate is a science writer for Clue.","file":{"contentType":"image/png","url":"//images.ctfassets.net/juauvlea4rbf/qtxav5Gv95pJazFQr4485/ebb2135ee9bb12f3c59547711b0390f7/Kate_Wahl.png"},"gatsbyImageData":{"images":{"sources":[{"srcSet":"https://images.ctfassets.net/juauvlea4rbf/qtxav5Gv95pJazFQr4485/ebb2135ee9bb12f3c59547711b0390f7/Kate_Wahl.png?w=225&h=225&q=50&fm=webp 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","slug":"birth-control"},"locale":"en"},"body":null,"bodyRichText":{"raw":"{\"data\":{},\"content\":[{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Top things to know\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-2\"},{\"data\":{},\"content\":[{\"data\":{},\"content\":[{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"As many as 90% of people who menstruate have \",\"nodeType\":\"text\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"4AmqXMvGv6Q2yusUeACMmQ\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"cramps\",\"nodeType\":\"text\"}],\"nodeType\":\"entry-hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\" or period pain.\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"}],\"nodeType\":\"list-item\"},{\"data\":{},\"content\":[{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"In general, research shows that hormonal contraceptives can help with period pain.\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"}],\"nodeType\":\"list-item\"},{\"data\":{},\"content\":[{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Other medications, heated pads, lifestyle changes, and low intensity electrical currents (yup, you read that right) can also help with period pain. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"}],\"nodeType\":\"list-item\"},{\"data\":{},\"content\":[{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"If cramps are getting in the way of your ability to live your life, you should check in with a healthcare provider.\",\"nodeType\":\"text\"},{\"data\":{},\"marks\":[{\"type\":\"bold\"}],\"value\":\" \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"}],\"nodeType\":\"list-item\"}],\"nodeType\":\"unordered-list\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Many of us experience cramps when we get our periods. The pain (called \",\"nodeType\":\"text\"},{\"data\":{},\"marks\":[{\"type\":\"italic\"}],\"value\":\"dysmenorrhea \",\"nodeType\":\"text\"},{\"data\":{},\"marks\":[],\"value\":\"by healthcare providers) usually starts in the pelvis and, for some people, radiates to the lower back and thighs. In this article, we’ll go over some different options for managing period pain, as well as conditions that could be causing it. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"5GyEHexFcrYev8oB5vXXrt\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[],\"nodeType\":\"embedded-entry-block\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Can hormonal contraceptives help my cramps and period pain? \",\"nodeType\":\"text\"}],\"nodeType\":\"heading-2\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Yes, research shows that hormonal contraceptives (containing only \",\"nodeType\":\"text\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"2YZ4yMyes0SsmnOT9w6wO9\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"progestin\",\"nodeType\":\"text\"}],\"nodeType\":\"entry-hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\" or a combination of progestin and \",\"nodeType\":\"text\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"3RKzDbEfGfZGWZfxXQK0qp\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"estrogen\",\"nodeType\":\"text\"}],\"nodeType\":\"entry-hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\") can help with period pain. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"italic\"}],\"value\":\"Keep in mind that when you are on a hormonal contraceptive, you are not experiencing a \\\"real\\\" period as part of a \",\"nodeType\":\"text\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"jYuUg4P7uoMCYcmQyQEIm\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"italic\"}],\"value\":\"menstrual cycle\",\"nodeType\":\"text\"}],\"nodeType\":\"entry-hyperlink\"},{\"data\":{},\"marks\":[{\"type\":\"italic\"}],\"value\":\". Monthly bleeding on most hormonal contraceptives is caused by different processes in your body, and is called \\\"\",\"nodeType\":\"text\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"u5s32fPrYOWYOAmCSG2sA\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"italic\"}],\"value\":\"withdrawal bleeding\",\"nodeType\":\"text\"}],\"nodeType\":\"entry-hyperlink\"},{\"data\":{},\"marks\":[{\"type\":\"italic\"}],\"value\":\".\\\" We refer to the pain you'd experience during monthly bleeding as \\\"period pain\\\" below.\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Combination contraceptive pills\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-3\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Birth control pills that contain both estrogen and progestin relieve period pain more effectively than placebos (1). Taking \",\"nodeType\":\"text\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"212cPe0AHOqoksgyyuGYiq\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"extended-cycle combination pills\",\"nodeType\":\"text\"}],\"nodeType\":\"entry-hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\" (without a break, with fewer breaks, or with shorter breaks) might improve pain better than taking pills on a regular cycle (21 days of active pills, with a 7-day break) (2). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Progestin-only contraceptive pill\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-3\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"At this time, it looks like no research has studied whether progestin-only birth control pills affect period pain. That being said, medications that contain the progestin \",\"nodeType\":\"text\"},{\"data\":{},\"marks\":[{\"type\":\"italic\"}],\"value\":\"dienogest\",\"nodeType\":\"text\"},{\"data\":{},\"marks\":[],\"value\":\" and are used to treat the gynecologic condition \",\"nodeType\":\"text\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"4IjbU27qo06A6yUqqwGyWy\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"endometriosis\",\"nodeType\":\"text\"}],\"nodeType\":\"entry-hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\" are associated with a decrease in period pain (3). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Hormonal IUD\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-3\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Studies suggest that, compared to no treatment or copper IUDs, progestin-releasing intrauterine devices decrease period pain (4,5). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"6sFHarc2kNm0Abhj5CLNqw\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[],\"nodeType\":\"embedded-entry-block\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Implant\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-3\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Using the hormonal implant, which is inserted under the skin and releases progestin, is associated with a decrease in period pain over time, in several studies (6).\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"6I0oW4f2rI2rcOC9UUr2Rl\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[],\"nodeType\":\"embedded-entry-block\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Injection/birth control shot\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-3\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"For people with \",\"nodeType\":\"text\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"4IjbU27qo06A6yUqqwGyWy\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"endometriosis\",\"nodeType\":\"text\"}],\"nodeType\":\"entry-hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\", injectable contraception containing the progestin \",\"nodeType\":\"text\"},{\"data\":{},\"marks\":[{\"type\":\"italic\"}],\"value\":\"medroxyprogesterone acetate \",\"nodeType\":\"text\"},{\"data\":{},\"marks\":[],\"value\":\"might reduce period pain as well as the implant or other medications used to manage endometriosis-related pain (7,8).  \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Vaginal ring\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-3\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"One study showed that people who use the progestin-releasing vaginal ring experience less period pain compared to their previous contraceptive method (9). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"5FzJsm5n8dmDvSQkri33DC\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[],\"nodeType\":\"embedded-entry-block\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Keep in mind that it’s hard to know what type of hormonal contraception works best for period pain, and how these treatments compare to other medical and non-medical treatments. Even if a treatment works for some or most people, it might not improve pain for you. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Non-hormonal options for managing cramps and period pain\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-2\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"There are many options beyond hormonal birth control for managing cramps and period pain. Read more here about \",\"nodeType\":\"text\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"4AmqXMvGv6Q2yusUeACMmQ\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"cramps and how to manage them\",\"nodeType\":\"text\"}],\"nodeType\":\"entry-hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\".\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Non-steroidal anti-inflammatories (NSAIDs)\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-3\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"These medications, like \",\"nodeType\":\"text\"},{\"data\":{},\"marks\":[{\"type\":\"italic\"}],\"value\":\"acetylsalicylic acid\",\"nodeType\":\"text\"},{\"data\":{},\"marks\":[],\"value\":\", reduce period pain and seem to work better than acetaminophen (10). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Heat\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-3\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Studies show that heated pads and patches work better than a placebo for improving pain and might work as well as certain NSAIDs (11). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Exercise \",\"nodeType\":\"text\"}],\"nodeType\":\"heading-3\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Regular low intensity or high intensity exercise reduce menstrual pain compared to no exercise (12). We’re still waiting on evidence about resistance training!\",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Transcutaneous electrical nerve stimulation (TENS)\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-3\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"High-frequency TENS involves stimulating the skin on the lower abdomen with electrical currents, specifically with 50 Hz to 120 Hz pulses delivered at a low intensity. This treatment works better than a placebo for reducing period pain (13). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Dietary supplements & herbal medicine\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-3\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"It looks like fenugreek, fish oil, vitamin B1, ginger, valerian, zataria, zinc sulphate, and Chinese herbal medicine might help relieve period pain (14,15). More research will help us understand better understand the relationship between these treatments and period pain better. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Are my period cramps a sign of a problem?\",\"nodeType\":\"text\"}],\"nodeType\":\"heading-2\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"As many of 90% of people who menstruate experience some period pain (16). For many people, period pain is not caused by another condition; for others it might be caused by an underlying condition like \",\"nodeType\":\"text\"},{\"data\":{\"target\":{\"sys\":{\"id\":\"4IjbU27qo06A6yUqqwGyWy\",\"type\":\"Link\",\"linkType\":\"Entry\"}}},\"content\":[{\"data\":{},\"marks\":[{\"type\":\"underline\"}],\"value\":\"endometriosis\",\"nodeType\":\"text\"}],\"nodeType\":\"entry-hyperlink\"},{\"data\":{},\"marks\":[],\"value\":\" or adenomyosis (17). \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"},{\"data\":{},\"content\":[{\"data\":{},\"marks\":[],\"value\":\"Either way, if cramps are stopping you from doing your daily activities or you want to try a new treatment for your period pain, you should check in with your healthcare provider. Tracking your pain symptoms with Clue before the appointment can help you and your healthcare provider create a care plan that is right for you. \",\"nodeType\":\"text\"}],\"nodeType\":\"paragraph\"}],\"nodeType\":\"document\"}","references":[{"__typename":"ContentfulArticle","contentful_id":"4AmqXMvGv6Q2yusUeACMmQ","title":"Period cramps 101","slug":"cycle-a-z/period-cramps-101-why-menstrual-cramps-and-pain-occur-and-how-to-relieve","sys":{"contentType":{"sys":{"type":"Link","id":"featuredImage","linkType":"ContentType"}},"type":"Entry"}},{"__typename":"ContentfulAppDownloadWidget","contentful_id":"5GyEHexFcrYev8oB5vXXrt","message":"Track your sex life and birth control method using Clue","secondaryMessage":null,"showSecondaryMessage":null,"showStarRating":true,"colour":"blue","iosUrl":null,"iosMessage":null,"iosSecondaryMessage":null,"androidMessage":null,"androidSecondaryMessage":null,"image":{"description":"","file":{"contentType":"image/png","url":"//images.ctfassets.net/juauvlea4rbf/2nxeIqA1mWcJeRotWaZTBw/32ae4b6fa009a49377c6860cb82cf085/23.png"},"gatsbyImageData":{"images":{"sources":[{"srcSet":"https://images.ctfassets.net/juauvlea4rbf/2nxeIqA1mWcJeRotWaZTBw/32ae4b6fa009a49377c6860cb82cf085/23.png?w=123&h=215&q=50&fm=webp 123w,\nhttps://images.ctfassets.net/juauvlea4rbf/2nxeIqA1mWcJeRotWaZTBw/32ae4b6fa009a49377c6860cb82cf085/23.png?w=246&h=430&q=50&fm=webp 246w,\nhttps://images.ctfassets.net/juauvlea4rbf/2nxeIqA1mWcJeRotWaZTBw/32ae4b6fa009a49377c6860cb82cf085/23.png?w=492&h=860&q=50&fm=webp 492w","sizes":"(min-width: 492px) 492px, 100vw","type":"image/webp"}]},"layout":"constrained","backgroundColor":"#c8c8c8","width":492,"height":860.0000000000001}},"iosImage":null,"androidImage":null,"sys":{"contentType":{"sys":{"type":"Link","linkType":"ContentType","id":"appDownloadWidget"}}}},{"__typename":"ContentfulArticle","contentful_id":"2YZ4yMyes0SsmnOT9w6wO9","title":"Progestins 101","slug":"sex/progestins-101","sys":{"contentType":{"sys":{"type":"Link","id":"featuredImage","linkType":"ContentType"}},"type":"Entry"}},{"__typename":"ContentfulArticle","contentful_id":"3RKzDbEfGfZGWZfxXQK0qp","title":"Estrogen 101: Levels throughout the cycle","slug":"cycle-a-z/estrogen-101","sys":{"contentType":{"sys":{"type":"Link","id":"featuredImage","linkType":"ContentType"}},"type":"Entry"}},{"__typename":"ContentfulArticle","contentful_id":"jYuUg4P7uoMCYcmQyQEIm","title":"What are the phases of the menstrual cycle?","slug":"cycle-a-z/the-menstrual-cycle-more-than-just-the-period","sys":{"contentType":{"sys":{"type":"Link","id":"featuredImage","linkType":"ContentType"}},"type":"Entry"}},{"__typename":"ContentfulArticle","contentful_id":"u5s32fPrYOWYOAmCSG2sA","title":"Do you still get your period on hormonal birth control? 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Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002120.pub3/information\n2. Edelman A, Micks E, Gallo MF, Jensen JT, Grimes DA. Continuous or extended cycle vs. cyclic use of combined hormonal contraceptives for contraception. Cochrane Database Syst Rev [Internet]. 2014 [cited 2019 Sep 24];(7). Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004695.pub3/abstract\n3. Strowitzki T, Marr J, Gerlinger C, Faustmann T, Seitz C. Dienogest is as effective as leuprolide acetate in treating the painful symptoms of endometriosis: a 24-week, randomized, multicentre, open-label trial. Hum Reprod. 2010 Mar 1;25(3):633–41.\n4. Bahamondes L, Petta CA, Fernandes A, Monteiro I. Use of the levonorgestrel-releasing intrauterine system in women with endometriosis, chronic pelvic pain and dysmenorrhea. Contraception. 2007;75(6):S134–9.\n5. Kelekci S, Kelekci KH, Yilmaz B. Effects of levonorgestrel-releasing intrauterine system and T380A intrauterine copper device on dysmenorrhea and days of bleeding in women with and without adenomyosis. Contraception. 2012 Nov 1;86(5):458–63.\n6. Mansour D, Korver T, Marintcheva-Petrova M, Fraser IS. The effects of Implanon® on menstrual bleeding patterns. Eur J Contracept Reprod Health Care. 2008 Jan;13(sup1):13–28.\n7. Schlaff WD, Carson SA, Luciano A, Ross D, Bergqvist A. Subcutaneous injection of depot medroxyprogesterone acetate compared with leuprolide acetate in the treatment of endometriosis-associated pain. Fertil Steril. 2006 Feb;85(2):314–25.\n8. Walch K, Unfried G, Huber J, Kurz C, van Trotsenburg M, Pernicka E, et al. Implanon® versus medroxyprogesterone acetate: effects on pain scores in patients with symptomatic endometriosis — a pilot study. Contraception. 2009 Jan;79(1):29–34.\n9. Roumen FJME, Berg MMT op ten, Hoomans EHM. The combined contraceptive vaginal ring (NuvaRing®): First experience in daily clinical practice in The Netherlands. Eur J Contracept Reprod Health Care. 2006 Mar 1;11(1):14–22.\n10. Marjoribanks J, Ayeleke RO, Farquhar C, Proctor M. Nonsteroidal anti‐inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev [Internet]. 2015 [cited 2019 Sep 25];(7). Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001751.pub3/full\n11. Burnett M, Lemyre M. No. 345-primary dysmenorrhea consensus guideline. J Obstet Gynaecol Can. 2017;39(7):585–95.\n12. Armour M, Ee CC, Naidoo D, Ayati Z, Chalmers KJ, Steel KA, et al. Exercise for dysmenorrhoea. Cochrane Database Syst Rev [Internet]. 2019 [cited 2019 Sep 25];(9). Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004142.pub4/full\n13. Proctor M, Farquhar C, Stones W, He L, Zhu X, Brown J. Transcutaneous electrical nerve stimulation for primary dysmenorrhoea. Cochrane Database Syst Rev [Internet]. 2002 [cited 2019 Sep 25];(1). Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002123/full\n14. Pattanittum P, Kunyanone N, Brown J, Sangkomkamhang US, Barnes J, Seyfoddin V, et al. Dietary supplements for dysmenorrhoea. Cochrane Database Syst Rev [Internet]. 2016 [cited 2019 Sep 25];(3). Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002124.pub2/full\n15. Zhu X, Proctor M, Bensoussan A, Wu E, Smith CA. Chinese herbal medicine for primary dysmenorrhoea. Cochrane Database Syst Rev [Internet]. 2008 [cited 2019 Sep 25];(2). Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005288.pub3/full\n16. Jamieson DJ, Steege JF. The prevalence of dysmenorrhea, dyspareunia, pelvic pain, and irritable bowel syndrome in primary Care Practices. Obstet Gynecol. 1996 Jan 1;87(1):55–8.\n17. Osayande AS, Mehulic S. Diagnosis and Initial Management of Dysmenorrhea. 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