MENSTRUAL CRAMPS

Dysmenorrhea, or menstrual cramps, refers to discomfort or pain in the lower abdomen, or back, just before or during a period. The pain of primary dysmenorrhea is a result of cramping or contractions of the uterus caused by hormonal or chemical changes during menstruation. Sensitivity to or excessive production of a group of chemicals called prostaglandins decreases blood flow to the lining of the uterus. As a result, painful cramping occurs. Sometimes a disease or condition (such as endometriosis, fibroids, infection, or abnormal pregnancy) may cause painful periods known as secondary dysmenorrhea.

Any woman can have problems with painful cramps during her period. Women who are at the highest risk for dysmenorrhea are women who smoke, are overweight, drink alcohol during their periods, or started their period before age 11.

The pain of dysmenorrhea may be cramps that come and go or a dull ache that is constant. In primary dysmenorrhea, the pain usually starts shortly before or during the menstrual period. It may peak after 24 hours and subside after 2 days. The pain of secondary dysmenorrhea may begin several days before and last throughout the period.

Other symptoms include headache, nausea, constipation or diarrhea, a dull lower backache, discomfort in the inner part of the thighs, and an urge to urinate frequently, weakness, and feeling tired. About 10 to 15 percent of women may have dysmenorrhea severe enough to interfere with their normal activities.

To help prevent primary dysmenorrhea:

exercise regularly to improve blood flow
eat a diet rich in whole grains and green leafy vegetables
drink plenty of fluids
avoid smoking
avoid excessive use of alcohol, (alcohol prolongs the pain) and
avoid stimulants, sedatives, and mind-altering drugs.

Treatment may include nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve menstrual pain. Any of these drugs should be started the first day of the period, or if periods are regular and the start of the period is known, then start the day before. Doing this may prevent the pain.

Non-steroidal anti-inflammatory drugs (NSAIDs) should be taken with food or milk to prevent stomach upset. NSAIDs should not be taken by anyone who has been diagnosed with asthma, ulcer disease, or a bleeding disorder. Taking NSAIDs increases the risk of bleeding with trauma, dental work, surgery, or if taking blood thinners (anticoagulants).

To relieve discomfort:

use a heating pad or hot water bottle on your abdomen or lower back
take hot baths or showers
do gentle abdominal massage
do pelvic tilt exercises
avoid prolonged standing or walking on hard pavement
avoid foods and beverages that contain caffeine (such as coffee, tea, colas, and chocolate) just before and during your period
have yearly checkups, including a pap test, and
follow the advice of your healthcare provider

Call your provider if the pain is severe or your discomfort lasts longer than 2 or 3 days. Also call your doctor if the pain is not at the time of your normal period or does not seem like normal menstrual cramping.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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