Menstrual Cramps

Menstrual cramps are pains felt in the abdominal or pelvic area by women during their menstrual periods. They can be felt before or during menstrual period, but are not the same as premenstrual syndrome (PMS). PMS is a group of symptoms related to a woman's menstrual cycle that usually occurs a week or two before the period starts and ends when the period starts. Menstrual cramps usually start the day a woman's menstrual period starts, and may last as long as the entire period.

The medical term for menstrual cramps is dysmenorrhea. Menstrual cramps vary from very mild to quite severe. Severe dysmenorrhea can interfere with a woman's daily activities.

What causes menstrual cramps?

Dysmenorrhea can be either primary or secondary. Primary dysmenorrhea usually begins within a few years after a woman starts her period, usually decreasing in intensity with age. Secondary dysmenorrhea has an underlying pathological cause, such as endometriosis, pelvic inflammatory disease, cervical stenosis, uterine fibroids, or a change in uterine position.

Menstrual cramps are caused by uterine contractions. During your period, you are building up your uterine lining in preparation for possible pregnancy. If pregnancy does not occur, a thick uterine lining is not needed, so it is shed at the beginning of the next cycle. When the old uterine lining breaks down, molecular compounds called prostaglandins are released; and these prostaglandins cause uterine contractions. Severity of cramps is related to the prostaglandin level at that time.

What are the symptoms?

Symptoms of dysmenorrhea include:

• Cramping pain or discomfort in the lower abdomen
• Headache
• Nausea and sometimes vomiting
• Loose stools
• Pain that radiates to the lower back and thighs
• Dizziness
• Sweating

How can I prevent menstrual cramps?

• Get plenty of sleep. Your body may be more vulnerable to pain if you are tired.
• Exercise regularly. This can stimulate blood flow and ease menstrual pain.
• Include whole grains and green leafy vegetables in your diet.
• Drink plenty of fluids.
• Avoid smoking cigarettes and excessive alcohol use.

What can I do when I have menstrual cramps?

Secondary dysmenorrhea treatment is aimed at resolving the underlying cause. Call your healthcare provider if your cramps are not before or during your period, are extremely severe, last longer than 2 to 3 days, or otherwise do not seem like normal menstrual cramps.

Primary dymenorrhea can be treated in several ways:

• Taking an over-the-counter NSAID (non-steroidal anti-inflammatory) such as ibuprofen or naproxen.
• Oral contraceptives can decrease cramping by lowering prostaglandin production.
• Rest in bed with a heating pad.
• Gently massage your abdomen or lower back.
• Avoid caffeinated beverages right before and during your period.

Will I always have menstrual cramps?

Menstrual cramps usually become less severe over time, but they may not go away completely. Primary dysmenorrhea is rare after childbirth. With secondary dysmenorrhea, prognosis depends on treatment of the underlying cause.