Menstrual Cramps – Symptoms, Causes, Diagnosis & Treatment

Menstrual Cramps: Menstrual pain or cramps are pains in your lower abdomen that happen when your menstrual period begins (or just before).

This pain may continue for 2 to 3 days. Cramps may be throbbing or aching, and they can be dull or sharp.

Menstrual cramps are the leading cause of absenteeism in women younger than 30. Although over half of people who have menstrual periods feel some discomfort, 10% are temporarily disabled by symptoms.

Symptoms of Menstrual Pain

Symptoms of menstrual cramps include:

  • Throbbing or cramping pain in your lower abdomen that can be intense
  • Pain that starts 1 to 3 days before your period, peaks 24 hours after the onset of your period and subsides in 2 to 3 days
  • Dull, continuous ache
  • Pain that radiates to your lower back and thighs

Some women also have:

  • Nausea
  • Loose stools
  • Headache
  • Dizziness

Causes of Menstrual Pain

During your menstrual period, your uterus contracts to help expel its lining. Hormonelike substances (prostaglandins) involved in pain and inflammation trigger uterine muscle contractions. Higher levels of prostaglandins are associated with more severe menstrual cramps.

Menstrual cramps can be caused by:

  • Endometriosis. The tissue that lines your uterus becomes implanted outside your uterus, most commonly on your fallopian tubes, ovaries or the tissue lining your pelvis.
  • Uterine fibroids. These noncancerous growths in the wall of the uterus can cause pain.
  • Adenomyosis. The tissue that lines your uterus begins to grow into the muscular walls of the uterus.
  • Pelvic inflammatory disease. This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.
  • Cervical stenosis. In some women, the opening of the cervix is small enough to impede menstrual flow, causing a painful increase of pressure within the uterus.

Risk factors

You might be at risk of menstrual cramps if:

  • You’re younger than age 30
  • You started puberty early, at age 11 or younger
  • You bleed heavily during periods (menorrhagia)
  • You have irregular menstrual bleeding (metrorrhagia)
  • You have a family history of menstrual cramps (dysmenorrhea)
  • You smoke

Home Remedies to Stop Period Pain

Dealing with cramps every month can be as frustrating as it is painful. Luckily, there are many remedies that might help you relieve period cramps.

It’s important to remember that these techniques won’t always work, especially for chronic conditions, but they can offer relief for mild to moderate period pain.

1. Drink more water

Bloating can cause discomfort and make menstrual cramps worse. Drinking water can reduce bloating during your period and alleviate some of the pain it causes.

Also, drinking hot water can increase blood flow throughout your body and relax your muscles. This can lessen cramps caused by uterine contractions.

2. Enjoy herbal teas

Herbal teas have anti-inflammatory properties and antispasmodic compounds that can reduce the muscle spasms in the uterus that cause cramping.

Drinking chamomile, fennel, or ginger tea is an easy, natural way to relieve menstrual cramps. Plus, herbal teas can have other benefits like stress relief and helping with insomnia.

3. Eat anti-inflammatory foods

Some foods can offer natural relief for cramps and they taste great. Anti-inflammatory foods can help promote blood flow and relax your uterus.

Try eating berries, tomatoes, pineapples, and spices like turmeric, ginger, or garlic. Leafy green vegetables, almonds, walnuts, and fatty fish, like salmon, can also help reduce inflammation.

4. Skip the treats

While a brownie or french fries might sound delicious, foods high in sugar, trans fat, and salt can cause bloating and inflammation, which makes muscle pain and cramps worse.

Grab a banana or another piece of fruit to fight sugar cravings, or go for unsalted nuts if you want something more savory.

5. Reach for decaf

Caffeine causes your blood vessels to narrow. This can constrict your uterus, making cramps more painful. If you need your coffee fix, switch to decaf during your period.

If you rely on caffeine to beat the afternoon slump, eat a snack high in protein or take a quick 10-minute walk to boost your energy.

6. Try dietary supplements

Vitamin D can help your body absorb calcium and reduce inflammation. Other supplements, including omega-3, vitamin E, and magnesium, can help reduce inflammation and might even make your periods less painful.

For best results, take supplements every day, not just during your period. Also, because some supplements interact with medications, be sure to ask your doctor before taking anything new.

7. Apply heat

A little heat can help your muscles relax, improve blood flow and relieve tension. Try sitting with a heating pad, taking a hot shower, or relaxing in a hot bath.

8. Exercise

If you’re in pain, exercise might be the last thing on your mind. But even gentle exercise releases endorphins that make you feel happy, reduce pain and relax your muscles. Fifteen minutes of yoga, light stretching, or walking might be all you need to feel better.

9. Reduce stress

Stress may make cramps worse. Use stress-relief techniques like meditation, deep breathing, yoga, or your own favorite way to relieve stress.

If you’re not sure how to relieve stress, try guided imagery. Simply close your eyes, take a deep breath and imagine a calm, safe place that’s significant to you. Stay focused on this space for at least a few minutes while you take slow, deep breaths.

10. Try massage therapy

One study found that massage therapy significantly reduced menstrual pain in women with endometriosis. Massages may reduce uterine spasms by relaxing the uterus.

In order to most effectively manage period cramps, massage therapy should focus on the abdominal area. But a full body massage that reduces your overall stress may also help to relieve menstrual cramps.

11. Take over-the-counter (OTC) medicines

The hormone prostaglandin can cause muscle contractions and pain. Anti-inflammatory medicines like ibuprofen can provide fast-acting relief by reducing the number of prostaglandins in your body. For best results, only take OTC medicines when you start to feel cramps.

12. Try alternative medicine

Some people find relief with alternative medicine practices like acupuncture and acupressure. Acupuncture is a practice that stimulates the body by placing needles in the skin.

Acupressure stimulates the body without needles by putting pressure on certain points of the body. These practices can help you relax, release muscle tension and improve blood flow throughout your body.

13. Start hormonal birth control

Birth control can stop period pain if cramps are caused by a hormone imbalance. Balancing your levels of estrogen and progesterone helps thin the uterine lining so it sheds more easily.

Hormonal birth control also regulates the length and frequency of your period. Some forms of birth control can completely alleviate period cramps by stopping your period altogether.

Talk to your OB-GYN about birth control options, including the pill, birth control shot, or hormonal IUD. Then, you’ll be able to choose the type of birth control that works best for you.

Diagnosis of Menstrual Pain

Your doctor will review your medical history and perform a physical exam, including a pelvic exam. During the pelvic exam, your doctor will check for abnormalities in your reproductive organs and look for signs of infection.

If your doctor suspects that a disorder is causing your menstrual cramps, he or she may recommend other tests, such as:

  • Ultrasound. This test uses sound waves to create an image of your uterus, cervix, fallopian tubes, and ovaries.
  • Other imaging tests. A CT scan or MRI scan provides more detail than ultrasound and can help your doctor diagnose underlying conditions. CT combines X-ray images taken from many angles to produce cross-sectional images of bones, organs, and other soft tissues inside your body.MRI uses radio waves and a powerful magnetic field to produce detailed images of internal structures. Both tests are non-invasive and painless.
  • Laparoscopy. Although not usually necessary to diagnosis menstrual cramps, laparoscopy can help detect an underlying condition, such as endometriosis, adhesions, fibroids, ovarian cysts, and ectopic pregnancy. During this outpatient surgery, your doctor views your abdominal cavity and reproductive organs by making tiny incisions in your abdomen and inserting a fiber-optic tube with a small camera lens.

Treatment

To ease your menstrual cramps, your doctor might recommend:

  • Pain relievers. Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), at regular doses starting the day before you expect your period to begin, can help control the pain of cramps. Prescription nonsteroidal anti-inflammatory drugs also are available. Start taking the pain reliever at the beginning of your period, or as soon as you feel symptoms, and continue taking the medicine as directed for two to three days, or until your symptoms are gone.
  • Hormonal birth control. Oral birth control pills contain hormones that prevent ovulation and reduce the severity of menstrual cramps. These hormones can also be delivered in several other forms: an injection, a skin patch, an implant placed under the skin of your arm, a flexible ring that you insert into your vagina, or an intrauterine device (IUD).
  • Surgery. If your menstrual cramps are caused by a disorder such as endometriosis or fibroids, surgery to correct the problem might help your symptoms. Surgical removal of the uterus also might be an option if other approaches fail to ease your symptoms and if you’re not planning to have children.

When to See a Doctor

You should contact your doctor if you have severe pain and very heavy bleeding. See a doctor if:

  • The pain consistently prevents you from doing day-to-day activities
  • The pain worsens, or bleeding gets heavier, over time
  • You’re over 25 and severe cramps are a new development
  • OTC medication doesn’t work

For severe cases, the best way to get treatment is for a doctor to diagnose the cause of your menstrual pain.

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