Menstrual cramps can affect all women of child bearing age. The intensity of the cramping that occurs varies among individuals. Some women experience mild aching and cramping that is more uncomfortable than it is painful. Others may experience moderate to severe menstrual cramps that can make it difficult to perform everyday tasks such at home, school or work. Menstrual cramping is a common reason for the loss of days at school or work for many teenagers and women in their twenties.
During menstruation, some women experience cramping in the abdomen that may also radiate to the lower back. If the cramps that occur are more than just a nuisance and cause significant pain, the menstrual pain is referred to as dysmenorrhea. Menstrual cramps can occur before or during the menstruation.
Women suffering from menstrual cramps usually complain of cramping in the lower abdomen that can also radiate to the lower back. The pain can be intermittent or constant, and may be sharp, achy or dull. Other symptoms of menstrual cramps include:
- Throbbing lower abdominal pain
- Cramping sensation in the lower abdomen
- Aching pain in the lower back
- Aching pain that radiates to the upper thighs
- Loose stools
- Hot flashes
Menstrual cramps can occur without any underlying cause. Some women will experience menstrual cramps as a normal side effect of menstruation. The hormone prostaglandin triggers uterine contractions during menstruation to help shed the lining of the uterus. The higher the level of prostaglandin that is produced by the body, the more painful the menstrual cramps are.
Some women may have an underlying condition that causes cramping during menstruation. When the underlying cause is identified and treated, menstrual cramps may decrease in severity or disappear altogether. Women who experience menstrual cramps with no identifiable cause often report that the severity of the pain decreases as they age. Many women report that menstrual cramps disappear altogether after giving birth.
There are two types of menstrual cramps: primary dysmenorrhea and secondary dysmenorrhea.
- Primary dysmenorrhea describes menstrual cramping that occurs in young women when they first start to menstruate. There is no known cause for this type of menstrual cramps; however, increased levels of the hormone prostaglandin may be a key factor in the development of the condition. Menstrual cramps that occur as a result of primary dysmenorrhea will usually decrease in severity or disappear altogether over time.
- Secondary dysmenorrhea is the medical term used to describe menstrual cramps that occur later in life. Women who have no prior history of menstrual cramps and suddenly present with the condition may be suffering from an underlying problem in the reproductive tract.
Some conditions that may cause secondary dysmenorrhea include:
- Uterine fibroids
- Pelvic inflammatory disease (PID)
- Premenstrual syndrome (PMS)
- Sexually transmitted disease (STD)
- Intrauterine device (IUD)
- Adenomyosis (uterine tissue grows into uterine muscles)
- Cervical stenosis (cervical opening is constricted and impedes menstruation)
- Hormonal imbalance
There are several risk factors that have been associated with the development of menstrual cramps. Possible risk factors include:
- Younger than 20 years old
- Reaching puberty before age 11
- Heavy bleeding during menstruation
- Irregular bleeding between periods
- Family history of menstrual cramps
- Not delivering a baby
Menstrual cramps that are severe or develop after years of not having menstrual pain should be checked by a physician. Your doctor will take a medical history and perform a complete physical exam to check for any underlying conditions that may be causing menstrual cramps. A pelvic exam will be performed, during which time your doctor will check the condition of your reproductive organs and look for any abnormalities or signs of infection. Additional diagnostic tests may be ordered to help determine the root cause of menstrual cramps. Diagnostic tests may include:
- Blood tests
- Vaginal swab and culture
- Cervical swab and culture
- Laparoscopy (surgical procedure using a tiny scope to view internal organs)
- Computerized tomography (CT scan)
- Magnetic resonance imaging (MRI)
- Hysteroscopy (tiny telescope that looks for fibroids and polyps)
Menstrual cramps can usually be treated by your physician. Treatment will depend on the underlying cause. Surgical procedures that treat the underlying condition, such as the removal of fibroids, cysts or endometrial scar tissue, may result in a significant decrease in the severity of menstrual cramps.
When menstrual cramps are a result of a hormonal imbalance, birth control hormones can be prescribed to help restore a normal balance and eliminate cramping. These hormones are available in the form of oral birth control pills, injections, a skin patch or as a device implanted under the skin.
For menstrual cramps that are of undetermined origin, doctors often recommend the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen as needed to treat pain. If menstrual cramps do not respond to treatment with over-the-counter varieties, prescription NSAIDs may be used.
There are several home remedies that can help ease the pain of menstrual cramps. Home remedies are safe, natural methods that can alleviate pain temporarily and can be used in conjunction with any prescribed medications. Some examples of home remedies include:
- Heat applied to the lower abdomen with a heating pad, hot towel or moist heat pack.
- Drinking decaffeinated tea, soup or other hot beverages.
- Eating 6 to 7 small meals frequently throughout the day rather than 3 large meals.
- Limit sugar, salt, caffeine and alcohol.
- Increase your intake of whole grains and fresh produce.
- Supplement your diet with vitamin B6 and magnesium.
- Elevate your legs while lying down
- Lie on your side and bend your knees up to your chest
- Take a warm bath
- Use your fingertips to gently massage your lower abdomen in a circular motion.
- Relax with meditation or yoga.
- Exercise mildly to increase blood flow to the abdomen.
Menstrual cramps are not usually a cause for alarm. Most women who suffer from the condition will feel better after 2 to 3 days and will not require additional treatment. If you develop menstrual cramps that interfere with your day and prevent you from participating in your normal daily activities you should contact your doctor. If you have never suffered from menstrual cramps in the past and you develop cramping associated with menstruation, schedule an appointment with your doctor to rule out other possible underlying causes. Contact your doctor immediately if you have menstrual cramps and experience any of the following:
- Heavy bleeding
- Vaginal discharge with a strong odor
- Pelvic pain or tenderness
- Severe pelvic pain that comes on suddenly
- If your period is more than one week late
- If you pass blood clots