Menstrual cramps are also called dysmenorrhea or painful periods. Most women experience them at some time during their life. They can range from very mild to severe. They may also differ from month to month or year to year. The pain felt during menstrual cramps may be accompained by backache, fatigue, vomiting, diarrhea and headaches. It can be made worse by premenstrual bloating (water retention).
There are two types of dysmenorrhea – primary and secondary. The primary form usually occurs in females who have just begun to menstruate. It may disappear or become less severe after a woman reaches her mid-twenties or gives birth. (Childbirth stretches the uterus.) The cause of menstrual cramps is thought to be related to hormone-like substances called prostaglandins. These are chemicals that occur naturally in the body. Certain prostaglandins cause muscles in the uterus to go into spasms.
Dysmenorrhea occurs much less often in women who do not ovulate. For this reason, oral contraceptives reduce painful periods in 70-80% of women who take them. When the pill is stopped, women usually get the same level of pain they had before they took it.
Seconcary dysmenorrhea refers to menstrual cramps that are due to other disorders of the reproductive system such as fibroids, endometriosis, ovarian cysts and rarely, cancer. Having an intrauterine device (IUD), especially if you’ve never been pregnant, can also cause menstrual cramps, except with the Progestasert IUD. It releases a small amount of progesterone into the uterus which helps with cramps and lightens menstrual flow.
Self-Care Tips
To relieve menstrual cramps:
- Take over-the-counter ibuprofen or naproxen sodium around the clock as directed to relieve pain and inhibit the release of prostaglandins. Acetaminophen will help with pain, but not with prostaglandins. Most over-the-counter menstrual discomfort products contain acetaminophen. Read labels. [Note: Do not give aspirin or any medication containing salcylates to anyone 19 years of age or younger, unless directed by a physician, due to its association with Reye’s Syndrome, a potentially fatal condition.]
- Drink a hot cup of regular tea, chamomile or mint tea.
- Hold a heating pad or hot-water bottle on your abdomen or lower back.
- Take a warm bath.
- Gently massage your abdomen.
- Do mild exercises like stretching, yoga, walking or biking. Exercise may improve blood flow and reduce pelvic pain.
- Whenever possible, lie on your back, supporting your knees with a pillow.
- Unless you have reasons to avoid alcohol, have a glass of wine or other alcoholic beverage. Alcohol slows down uterine contractions.
- Get plenty of rest and avoid stressful situations as your period approaches.
- For birth control, consider using the pill because it blocks the production of prostaglandins or the Progestasert IUD because its use lessens menstrual cramps.
If you still feel pain after using self-care tips, call your doctor.
Questions to Ask
Have your menstrual periods been especially painful since having an intrauterine contraceptive device (IUD) inserted? |  |
 | |
Do you have any signs of infection such as fever and foul smelling vaginal discharge or do you have black stools or blood in the stools? | |
| |
For women who are still capable of bearing children: Do you have a heavier than usual blood flow or is your period late by one or more weeks? |  |
| |
Is the pain extreme or have you had pain-free periods for years, but are now having severe cramps? | |
| |
Does cramping continue even after your period is over? | |
| |
 |
Healthy Self: The Guide to Self-Care and Wise Consumerism
© American Institute for Preventive Medicine