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What You Need To Know About Menstrual Cramps

Experiencing period pains? Find out what you can do about them here.
PHOTO: istockphoto

While some women are blessed with light flows and pain-free periods, most of us less fortunate do suffer from menstrual cramping, at least during some menstruation cycles. Some women have learned to accept that period pain comes with virtually every calendar month and must be endured until menopause can offer sweet relief.

But while cramps are normal menstruation symptoms, there are certainly ways to prepare for or alleviate them, as well as times when they indicate an underlying condition that your doctor will need to examine. Keep reading for more on menstrual cramps.

What are menstrual cramps and why do we have them?

Menstrual cramps, also known as dysmenorrhea, are common menstruation symptoms that occur before and during your period. They are characterized by throbbing or cramping pains in your lower abdomen and can range from mild discomfort to severe pain that can limit everyday activities.

Are there different kinds of dysmenorrhea? If so, what are they?

The American College of Obstetricians and Gynecologists (ACOG) distinguishes between primary and secondary dysmenorrhea.


Primary dysmenorrhea is what you know as menstrual cramps, pain that comes from having a menstrual period due to natural chemicals made in the lining of your uterus called prostaglandins. These usually start soon after you get your first period and may become less painful as you get older and after giving birth.

Secondary dysmenorrhea is caused by a disorder in the reproductive system, such as endometriosis or uterine fibroids. This kind of pain often lasts longer than normal menstrual cramps and tends to get worse over time.

What other period pains may I experience?

Along with menstrual cramps in the lower abdomen, you may also experience lower back and thigh pain, nausea and dizziness, headaches, and loose stool, as other menstruation symptoms.

When can I normally expect cramping to occur?

According to the Mayo Clinic, menstrual cramps often begin one to three days before your period starts, peaks about a day after the start of menstruation, and then lasts about two to three days.

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How can I alleviate menstrual cramps?

You can take over-the-counter pain relievers (best taken when you first start to feel symptoms or even when your period starts, and then as directed by your doctor). The US National Institutes of Medicine (NIH) recommend non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen and naproxen, which help relieve pain and also reduce the amount of prostaglandins produced by your uterus, lessening their effects and, as a result, your cramping.

There are a number of home remedies for menstrual cramps with varying effectiveness, but one of the most popular ones involves using heat—take a hot bath or press a heating pad or hot water bottle to your lower abdomen.

As for alternate medicine, acupuncture is also said to help relieve menstrual cramping.

Does birth control help with or worsen menstrual cramps?

Hormonal contraceptives such as the Pill can lighten periods and reduce cramping. Some forms of contraception stop ovulation entirely, which means you don’t get your periods at all. However, copper IUDs have been known to increase menstrual flow and cramping, often in the first few months after insertion, so take note of this possible side effect if you already struggle with period pains.


How can I prevent menstrual cramping?

Making lifestyle changes like exercising regularly or reducing stress will help make your periods more regular and may also reduce painful symptoms. You may want to start practicing relaxation techniques such as yoga and meditation. Getting enough sleep and rest also helps prevent period cramping.

Smoking has also been linked to menstrual cramps, so if you smoke and experience period pains, stopping the habit may benefit your uterus as well as your lungs.

What kind of pain levels are normal for dysmenorrhea? What should I do if my cramps exceed these?

Menstrual cramping pains vary from person to person, from mild discomfort to pain that interferes with everyday activities. Contact your doctor if you:

  • Receive no relief from over-the-counter pain medication
  • Get cramps that last longer than three days before and after the first day of menstruation
  • Get cramps even when you do not have your period
  • Suddenly find your cramps worsening
  • First experience severe cramping when you are over the age of 25
  • Get fevers with your menstrual cramps

What underlying conditions cause dysmenorrhea?

The following conditions may result in dysmenorrhea:

  • Endometriosis, which is when the tissue of your uterine lining is found outside the uterus, often the ovaries, fallopian tubes, behind the uterus, and even on the bladder; the endometriosis tissue breaks down and bleeds in response to hormonal changes, especially during menstruation, which can lead to pain
  • Adenomyosis, when the tissues lining your uterus grows into the uterine walls
  • Uterine fibroids, noncancerous growths in your uterine walls which can cause pain
  • Pelvic inflammatory disease, an infection of the reproductive organs which is often caused by the presence of sexually transmitted bacteria
  • Cervical stenosis, when the opening of your cervix is so small it restricts menstrual flow, which increases pressure in your uterus

What tests might my doctor do to determine the cause of menstrual cramping?

Your doctor will most likely want to review your medical history, so have information regarding your menstruation symptoms and menstrual cycles ready. Your doctor will also conduct regular pelvic exams, especially once you are sexually active. Additional exams may include ultrasounds and laparoscopies, as needed.

Does having sex while on my period or with my period approaching cause cramping?

Sex during your period should not lead to cramping; in fact, having an orgasm may help relieve cramps temporarily. During orgasm, the uterine muscles contract and blood flow increases, plus chemicals are released into the brain that help with pain tolerance, so you may find that good sex is one way to do away with period-related pains.