Menstrual cramps, also known as dysmenorrhea or period pains, are painful sensations felt in the lower abdomen that can occur both before and during a woman’s menstrual period. The pain ranges from dull and annoying to severe and extreme. Menstrual cramps tend to begin after an egg is released from the ovaries and travels down the fallopian tube (ovulation).
There are two primary types of these difficult or painful periods – primary and secondary dysmenorrhea:
- Primary dysmenorrhea is the most common type and is characterized by pain in the lower abdomen and lower back pain beginning 1-2 days before the period and lasting from 2-4 days. There is no underlying problem that is causing the pain
- Secondary dysmenorrhea is characterized by cramping pains that are due to an identifiable medical problem such as endometriosis, uterine fibroids, or pelvic inflammatory disease.
Who gets menstrual cramps?
About half of women experience menstrual cramps, and about 15% describe the pain as severe. It has been shown that women who do not exercise experience more painful menstrual cramps.
Certain psychological factors such as emotional stress may also increase the likelihood of having uncomfortable menstrual cramps. Additional risk factors for these cramps include:
- Being younger than 20 years of age
- Starting puberty at age 11 or younger
- Menorrhagia – heavy bleeding during periods
- Never given birth.
What causes menstrual cramps?
During each menstrual period, if there is no sperm to fertilize the egg, the uterus contracts to expel its lining. This process is driven by the release of hormone-like substances called prostaglandins, which is associated with pain and inflammation in higher levels. These uterine contractions cause most of the pain felt during menstrual cramps because the contractions inhibit blood flow to the lining of the uterus (the endometrium).
In addition, substances known as leukotrienes are also elevated during menstruation, and they may be the cause of menstrual cramps.
Women with delayed sleep phase syndrome are more likely to report irregular menstrual cycles and premenstrual symptoms, as well as menstrual cramps, according to researchers from Northwestern University in Chicago, USA.
Several underlying medical conditions are also capable of causing menstrual cramps. These include:
- Endometriosis – the tissue that lines the uterus develops outside the uterus
- Uterine fibroids – noncancerous tumors and growths in the wall of the uterus
- Adenomyosis – the tissue that lines your uterus grows into the muscular walls of the uterus
- Pelvic inflammatory disease (PID) – a sexually transmitted infection caused by a bacterium
- Cervical stenosis – the opening of the cervix is small and limits menstrual flow.
The symptoms of menstrual cramps?
Symptoms of menstrual cramps include:
- Dull, throbbing, cramping pain in the lower abdomen
- Pain in the lower back and thighs
- Loose stools
- Bloating in the belly area
- Lightheadedness – feeling faint.
Diagnosis of menstrual cramps
Most women are able to identify menstrual cramps without the help of a physician. In cases of extreme pain or when underlying conditions may be contributing to the pain, a doctor may order images of the abdominal area, uterus, cervix, vagina, and fallopian tubes. These may include:
- Computerized tomography (CT) scan
- Magnetic resonance imaging (MRI)
Treatments for menstrual cramps
Over-the-counter medication is available to treat most cases of menstrual cramps. These medications are often called anti-prostaglandins, and they reduce cramping in the uterus, make period flow lighter, and relieve discomfort. Many of these medications also contain pain killers such as ibuprofen or naproxen, which are types of nonsteroidal anti-inflammatory drugs (NSAIDs).
NSAIDs are also used alone to reduce menstrual cramp pain.
Sometimes, physicians will prescribe hormonal birth control pills. These medicines will prevent ovulation and reduce the severity of menstrual cramps. 97% of physicians in a poll said that continuous oral contraceptive therapy to suppress menstruation is, in fact, medically safe and acceptable – even though many women do not know this, a study found.
Researchers at Imperial College London found that chamomile tea helps relieve menstrual pains.
Chinese herbal medicines have been found to help women with menstrual cramps, according to a study.
Menstrual cramps that are due to underlying medical conditions such as endometriosis or fibroids may require surgery to remove the abnormal tissue. Surgery may help to reduce some menstrual cramp symptoms but carries additional risks.
Additional treatments that have been suggested to relieve menstrual cramp pain include:
- Soaking in a hot bath
- Using a heating pad on your lower abdomen
- Transcutaneous electrical nerve stimulation (TENS)
- Dietary supplements (such as vitamin E, thiamin and omega-3).
Women with menstrual cramps should not only get adequate rest and sleep, but also regular exercise.
Prevention of menstrual cramps
You may be able to prevent menstrual cramps. Recommended preventive measures include:
- Eating fruits and vegetables and limiting intake of fat, alcohol, caffeine, salt, and sweets
- Exercising regularly
- Reducing stress
- Quitting smoking
- Yoga or relaxation therapy
- Acupuncture or acupressure.