For some women, menstrual cramps can be the bane of monthly cycles, but treatment can put a stop to painful cramps.
Menstrual cramps — also known as dysmenorrhea — are painful, cramping, or throbbing sensations that occur before and during a menstrual period.
The severity can range from mild to
Menstrual cramps may be accompanied by nausea, vomiting, and diarrhea.
"More than half of women who menstruate have some cramping for one or two days each month, and 15 percent have severe menstrual cramps," says Carol Livoti, MD, a gynecologist in New York City and
But there are ways to help make the misery of menstrual cramps go away.
Menstrual cramps are contractions — tightening and relaxing of the uterine muscle — that enable the shedding of the bloody uterine lining.
When the uterine lining breaks down and sheds itself each month, hormonelike substances called prostaglandins are released and can cause pain and inflammation.
These substances can increase the contractions' intensity, especially if prostaglandin levels are particularly high.
"Women with high levels of prostaglandins tend to have more severe menstrual cramping," says Dr. Livoti.
As the uterine lining is shed, contractions push the old tissue through the cervix and out of the body via the vagina.
If a woman's cervical canal is narrow, the pain can be particularly intense when clots or pieces of tissue pass through a narrowed cervix.
Menstrual cramps often start shortly before the menstrual period, peak 24 hours later, and get much better after a day or two.
However, some women have mild cramping throughout their entire menstrual period.
Severe menstrual cramps are most common in teenagers, often beginning one to two years after a young girl starts having periods.
Menstrual cramps usually improve and become less bothersome as a woman gets older.
Women who have given birth are also less likely to be plagued by painful periods, perhaps because childbirth enlarges the cervix.
Although most women have at least a little monthly discomfort, some have pain so severe that it interferes with daily life.
Severe menstrual cramps caused by uterine contractions and prostaglandins released by the onset of menstrual bleeding are described as primary dysmenorrhea.
When severe cramping is caused by a disease or physical problem, it's known as secondary dysmenorrhea.
Conditions that can cause secondary dysmenorrhea
Over-the-counter and prescription medication can help ease the pain of menstrual cramping.
At the other extreme, pelvic surgery may be
The following treatments are options for menstrual cramping:
Over-the-counter medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil or Motrin (ibuprofen) and Aleve (naproxen) often work well to alleviate menstrual cramping because they inhibit prostaglandin formation.
The trick is to start taking these pain relievers at the very first sign of pain or even before the pain begins.
"If your menstrual cycle is regular, start taking ibuprofen a day or two before your period is scheduled to start," recommends Livoti.
Prescription medications. If over-the-counter NSAIDs don't do the trick, doctors can prescribe stronger anti-inflammatories to ease the pain.
Narcotic pain relievers like acetaminophen plus hydrocodone (Vicodin, Norco) are an alternative for women with unbearable menstrual cramping.
Contraceptives: Hormonal contraceptives such as birth control pills, patches, and vaginal rings can lessen the discomfort of severe menstrual cramps by halting ovulation.
"If you don't ovulate, it's less likely that you'll have cramping," says Livoti.
Hormonal contraceptives may also stop or slow the growth of fibroids and endometriosis.
Surgery. If fibroids or endometriosis are the reason for your pain, you may consider a surgical procedure such as a laparoscopy surgery or uterine artery embolization to remove the unwanted growths.
A hysterectomy, in which the entire uterus is removed, can be a last resort treatment for cramps for women who no longer want children.
Some women find that certain lifestyle changes and natural remedies can help:
Exercise: For mild cramps, get physical.
Aerobic workouts, such as walking, jogging, cycling, and swimming, cause the release of brain chemicals called endorphins that help reduce pain.
Heat: Taking a warm bath or applying a hot water bottle or heating pad to your lower abdomen can often soothe cramping that isn't severe.
"This works well for aching types of menstrual cramps," says Dr. Livoti.
Massage: Try doing some circular light massages around your abdomen, recommends Dr. Livoti. Or ask someone to massage that area of your body.
Calcium: Research suggests that calcium supplements may help ease the discomfort of menstrual cramps and the emotional symptoms of premenstrual syndrome.
"Calcium has been associated with
Aromatherapy: In one small study, topically applied aromatherapy with rose, lavender, or sage oils significantly relieved menstrual cramp discomfort.
In the study, the oils were rubbed onto the lower-abdomen area.
Acupuncture: Two study reviews have suggested that acupuncture may also help ease the pain of menstrual cramps.
In addition, a clinical trial found that patients with severe menstrual pain who received 15 acupuncture treatments over three months had less cramping during their periods than women who didn't have acupuncture.
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