Menstrual Cramps

Menstrual cramps, also called Dysmenorrhea, are pain or discomfort in the lower abdomen just before or during a menstrual period.

Dysmenorrhea can be either primary or secondary. Primary dysmenorrhea usually starts 1 to 2 years after your first period, but it may start earlier. Secondary dysmenorrhea results from a specific disease or disorder.

Secondary dysmenorrhea tends to be caused by the following:

Endometriosis (tissue from the uterus growing outside the uterus)
Pelvic inflammatory disease (PID), a bacterial infection that enters the uterus and may spread to the fallopian tubes, ovaries, and other tissues in the pelvic region; may be sexually transmitted.
Cervical stenosis (narrowing of the opening to the uterus)
Tumors, also called fibroids or cysts in the uterus.
Intrauterine devices (IUDs) can cause cramping pain during menstruation.

Other symptoms of dysmenorrhea include:

A dull ache in your lower abdomen
Headache
Nausea
Loose bowel movements or diarrhea
Discomfort in the inner part or front of the thighs

About 10-15% of women with menstruation cramps have symptoms severe enough to interfere with their normal activities.

Diagnosing Dysmenorrhea

Your healthcare provider may do a physical and pelvic exam. You may have blood tests and cultures, and you may need an ultrasound scan of your pelvis to check your uterus and ovaries.

Menstrual cramps are often relieved by nonprescription pain relievers such as acetaminophen (Tylenol), aspirin, or ibuprofen (an anti-inflammatory).

Your physician may prescribe birth control pills for treatment of dysmenorrhea. They decrease cramping by decreasing prostaglandin production. If the pills relieve the pain, you may take them even if you do not need them for birth control.

In primary dysmenorrhea the pain begins shortly before or at the start of a period and usually lasts 1 to 3 days. In secondary dysmenorrhea the pain may begin several days before and last throughout your period.

Menstrual cramps are common during the late teens and early 20's. They often get better after age 25 and are less common after childbirth. Even though the cramps are painful, they will not hurt the uterus or your ability to have children.

Having your period should not stop you from doing most of the things you normally do. Charting the length and frequency of your periods will help you to understand better what is normal for you. See your healthcare provider if there are any sudden changes in your normal periods, such as much heavier or lighter flow, a much shorter or longer time between periods, or any unusual pain or clotting.

In addition, you can:

Take aspirin, acetaminophen, ibuprofen, or naproxen to relieve discomfort
Use a heating pad or hot water bottle on your lower back or abdomen or soak in a warm (not hot) tub
Gently massage your lower abdomen or lower back
Do pelvic tilt exercises to help relieve menstrual pain
- Stand with your feet about a foot apart and your knees bent. Place your hands on your hips near the hip bone. Rock your pelvis forward and back 10 to 15 times. This can also be done while lying on your back with your knees bent. Tilt the abdomen upward keeping the buttocks on the floor and then press the small of your back to the floor.
Avoid standing for a long time or walking on hard pavement
Avoid foods and beverages that contain caffeine, like coffee, tea, colas, and chocolate, just before or during your period

Schedule an appointment now if your menstrual pain is severe.