October 22, 2018
Woman Suffering from Stomachache on Sofa

Menstrual Cramps: Causes and Treatments

by Berkeley Wellness  

Menstrual cramps—also known as dysmenorrhea—usually do not indicate any serious condition, but the pain can be severe enough to interfere with everyday activities. The key symptoms are pain in the lower abdomen or back, fatigue, nausea, diarrhea, vomiting, and occasional headaches.

The pain usually comes right before menstruation starts, and may last up to three days. It chiefly affects women 25 years of age and under. For reasons not well understood, dysmenorrhea tends to become less severe with age, especially after the birth of a child. However, for some women, it can become worse or continue until menopause.

What causes menstrual cramps?

The cramps come from uterine spasms, which are most powerful at this time and temporarily deprive the uterus of oxygen. These spasms are triggered by prostaglandins, hormonelike substances that, in some women, are released in excess during menstruation. Although menstrual cramps can cause emotional distress, dysmenorrhea is not psychological in origin.

Women who have a heavy menstrual flow and a family history of dysmenorrhea may be at increased risk for menstrual cramps, but there’s no agreement about key risk factors. In some instances painful menstruation is caused by an underlying gynecological problem, such as endometriosis, uterine fibroids, pelvic inflammatory disease, or a pelvic tumor.

What if you do nothing?

For most women, cramps are not severe and end within a few days after the start of the menstrual cycle. Home remedies may help provide relief. If cramps are incapacitating, you should seek treatment from your doctor.

Home remedies for menstrual cramps

For centuries women have relied on home cures for cramps—hot drinks, massage, stretching exercises, keeping warm. No specific exercise for relieving dysmenorrhea exists, and there is no scientific evidence that any of the old tried-and-true remedies really work. Yet personal experience cannot be discounted. Different things work or don’t work for different people. Here are some common self-help measures:

  • Take a bath. The hot water may help relax the uterus.
  • Apply heat. Placing a heating pad or hot water bottle on the lower abdomen may relieve the discomfort of cramps.
  • Exercise several times daily. Walking, swimming, running, bicycling, and other aerobic activities may help diminish cramping symptoms by inhibiting prostaglandin release and contributing to the release of endorphins, the body’s own natural pain relievers.
  • Take a pain reliever. Acetaminophen may be effective in relieving the mild to moderate headache and the backache that often accompany menstrual cramps. NSAIDs (aspirin, ibuprofen, or naproxen), also may be effective. Follow label directions. If you usually have menstrual cramps, you may want to begin taking an NSAID (as an anti-prostaglandin) the day before you expect a period and to continue for a day or two. People respond differently to each medication, so you may need to try different types to find one that works best for you.
  • Try an alternative treatment. Several things may help improve pain, including massage and transcutaneous nerve stimulation (TENS). OTC portable units are available in drug stores. It may be worth a try if nothing else has helped.
  • See if there is a dietary connection. Some women complain that certain foods and beverages—including coffee and tea, chocolate, and soda—induce or intensify cramps. There is no scientific evidence for this, but you can see if avoiding any of them helps.

How to prevent menstrual cramps

Get plenty of rest. If you find that you are prone to regular cramping during menstruation and you become unusually tired or nervous, napping occasionally during the day and maintaining regular sleeping patterns may prevent or help reduce the severity of cramping.

When to call your doctor about menstrual cramps

Contact your doctor if you don’t get relief after trying the various self-treatments. Also contact your doctor if you experience painful cramping that lasts longer than three days, or if any cramping occurs in between your menstrual periods.

What your doctor will do

Your doctor will take a detailed medical history and do a pelvic exam to uncover possible causes of recurrent, painful menstruation. Your doctor may prescribe a more powerful antiprostaglandin medication or an oral contraceptive. Oral contraceptives are a highly effective treatment for cramps, since they prevent ovulation, and thus stop high levels of prostaglandin production. Birth control pills also reduce the thickness of the uterine lining during the menstrual cycle, which cuts down on menstrual flow. They are available only by prescription and must be taken on a regular basis, not just when symptoms appear. Smokers and women over 35 who have high blood pressure or other risk factors for cardiovascular disease may be advised not to take birth control pills.

Also see Vaginal Odor: Causes and Remedies.