Your Guide to Menstrual Cramps
Dysmenorrhea is the medical term for the painful cramps that may occur immediately before or during the menstrual period. There are two types of dysmenorrhea: primary dysmenorrhea and secondary dysmenorrhea.
Primary dysmenorrhea is another name for common menstrual cramps. Cramps usually begin one to two years after a woman starts getting her period. Pain usually is felt in the lower abdomen or back. They can be mild to severe. Common menstrual cramps often start shortly before or at the onset of the period and continue one to three days. They usually become less painful as a woman ages and may stop entirely after the woman has her first baby.
Secondary dysmenorrhea is pain caused by a disorder in the woman's reproductive organs. These cramps usually begin earlier in the menstrual cycle and last longer than common menstrual cramps.
What Are the Symptoms of Menstrual Cramps?
The symptoms of menstrual cramps include:
- Aching pain in the abdomen (Pain can be severe at times.)
- Feeling of pressure in the abdomen
- Pain in the hips, lower back, and inner thighs
When cramps are severe, symptoms may include:
- Upset stomach, sometimes with vomiting
- Loose stools
What Causes Common Menstrual Cramps?
Menstrual cramps are caused by contractions in the uterus, which is a muscle. The uterus, the hollow, pear-shaped organ where a baby grows, contracts throughout a woman's menstrual cycle. If the uterus contracts too strongly, it can press against nearby blood vessels, cutting off the supply of oxygen to the muscle tissue of the uterus. Pain results when part of a muscle briefly loses its supply of oxygen.
How Can I Relieve Mild Menstrual Cramps?
To relieve mild menstrual cramps:
- Take aspirin or another pain reliever, such as Tylenol (acetaminophen), Motrin (ibuprofen) or Aleve (naproxen). (Note: For best relief, you must take these medications as soon as bleeding or cramping starts.)
- Place a heating pad or hot water bottle on your lower back or abdomen. Taking a warm bath may also provide some relief.
To relieve menstrual cramps, you should also:
- Rest when needed.
- Avoid foods that contain caffeine and salt.
- Avoid smoking and drinking alcohol.
- Massage your lower back and abdomen.
Women who exercise regularly often have less menstrual pain. To help prevent cramps, make exercise a part of your weekly routine.
If these steps do not relieve pain, your health care provider can order medications for you, including:
- Ibuprofen (higher dose than is available over the counter) or other prescription pain relievers
- Oral contraceptives (Women taking birth control pills have less menstrual pain.)
How Do Problems With Reproductive Organs Cause Menstrual Cramps?
When a woman has a disease in her reproductive organs, cramping can be a problem. This type of cramping is called secondary dysmenorrhea. Conditions that can cause secondary dysmenorrhea include:
- Endometriosis, a condition in which the tissue lining the uterus (the endometrium) is found outside of the uterus
- Pelvic inflammatory disease, an infection caused by bacteria that starts in the uterus and can spread to other reproductive organs
- Stenosis (narrowing) of the cervix, the lower part of the uterus (the hollow, pear-shaped organ where a baby grows), often caused by scarring
- Tumors (also called "fibroids"), or growths on the inner wall of the uterus
How Do I Know If My Menstrual Cramps Are Normal?
If you have severe or unusual menstrual cramps, or cramping that lasts for more than two or three days, contact your health care provider. Menstrual cramps, whatever the cause, can be treated, so it's important to get checked.
How Will my Doctor Detect Menstrual Cramps?
First, you will be asked to describe your symptoms and menstrual cycles. Your provider also will perform a pelvic exam in which he or she will insert a speculum in order to see into your vagina and cervix. A small sample of vaginal fluid may be taken for testing. Your provider will then insert his or her fingers into the vagina to examine your uterus and ovaries to feel for any abnormalities.
If the cramping you are having is not common menstrual cramps, further tests may be needed. If a medical problem is found, treatments will be discussed.
If you use tampons and develop the following symptoms, get medical attention immediately:
- Fever over 102 F
- Dizziness, fainting or near fainting
- A rash that looks like a sunburn
These are symptoms of a condition called toxic shock syndrome (TSS), which can be life-threatening.