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 period pains – primary and secondary dysmenorrhea:
- Primary Dysmenorrheais the most common type and is characterized by pain in the lower abdomen and the lower backbeginning a day or two before the period and lasting up to 4 days. This type of dysmenorrhea has no underlying problem that is causing the pain.
- Secondary Dysmenorrhea is however, 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 50 per cent women complain of menstrual cramps, out of which about 15 per cent 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 can cause menstrual cramps.
Women with delayed sleep phase syndrome are more likely to report irregular menstrual cycles, premenstrual symptoms as well as menstrual cramps, according to researchers.
Other Medical Conditions Capable of Causing Menstrual Cramps
- 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) – asexually transmitted infection caused by a bacterium
- Cervical stenosis – the opening of the cervix is small and limits menstrual flow.
Symptoms of Menstrual Cramps
- Dull, throbbing, cramping pain in the lower abdomen
- Pain in the lower back and thighs
- Bloating in the belly area
- Light headedness – feeling faint.
Diagnosis and Treatment
The following imaging techniques help identify cases of endometriosis, adhesions, fibroids, ovarian cysts, and ectopic pregnancy.
- Computerized tomography (CT) scan
- Magnetic resonance imaging (MRI)
Over-the-counter medication is available to treat most cases of menstrual cramps. Often called anti-prostaglandins, 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).
Sometimes, physicians will prescribe hormonal birth control pills. These medicines will prevent ovulation and reduce the severity of menstrual cramps. 97 per cent of physicians in a poll agreed that continuous oral contraceptive therapy to suppress menstruation is medically safe and acceptable.
Chinese herbal medicines have been found to help women with menstrual cramps, as well.
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 by:
- 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
Researchers at Imperial College London also found chamomile tea to help relieve menstrual pains.