Below:
 • What are menstrual cramps?
 • Are there different types of menstrual cramps?
 • What are the symptoms?
 • What causes menstrual cramps and pain?
 • What are my treatment options?
 • When should I see a doctor about menstrual pain?
 • Are there lifestyle changes I can make to lessen cramps caused by primary dysmenorrhoea?
 • What kinds of things are likely to make my cramps worse?
 • Are there any alternative treatments?

Note: This article has been localised for an Irish audience.

For decades, the medical establishment thought of menstrual cramps as an ailment that was minor at best. Doctors tended to deal with it by either dismissing the pain as a psychological problem or prescribing painkillers or tranquilisers. Today, researchers have come a long way toward a fuller understanding of menstrual cramps and the pain they cause for some 30 to 60 percent of women each month.

Most women who have cramps are experiencing what's known as dysmenorrhoea. Most often this condition is classified as primary dysmenorrhoea, meaning that it isn't caused by a physical abnormality of the reproductive organs. This type of dysmenorrhoea usually takes the form of sharp, spasmodic pains in your lower abdomen at the beginning of your period, or a day or two earlier, and it lasts two to three days. The condition is most common among young women in their teens and twenties; it usually moderates with age and may disappear if you give birth. According to some estimates, as many as 10 percent of young women have such severe cramps of this type that they're unable to maintain their normal schedules one or two days per month. In some women, the cramping is so painful that they can't walk, and a few have compared it to the contractions of childbirth.

Another kind of menstrual pain that's common in primary dysmenorrhoea feels more like a dull ache in the lower back and pelvis. It's more likely to affect older women and can sometimes get worse with age and multiple pregnancies. Another type of menstrual cramps is a much less common disorder known as secondary dysmenorrhoea, also marked by pelvic and lower-back pain. Unlike that of primary dysmenorrhoea, however, the pain is a symptom of another disease or condition that may require treatment -- perhaps endometriosis, pelvic inflammatory disease, uterine fibroids, and adenomyosis (in when uterine tissue grows into the wall of the uterus).

If you have primary dysmenorrhoea, you'll feel either sharp cramps or dull pelvic pain. You may also have backaches, headaches, pain in the inner thighs, diarrhoea or constipation, nausea and vomiting, dizziness, bloating, weight gain, and breast tenderness. Many of these symptoms are attributed to PMS (premenstrual syndrome), but stem from the same source as the dysmenorrhoea.

The symptoms of secondary dysmenorrhoea include pelvic and back pain, spotting between periods, pain during or after sex, a pus-like vaginal discharge, fever or chills, frequent urination, and changes in bowel movement.

The cramps of primary dysmenorrhoea are caused when your uterus contracts to push out the menstrual blood. Hormonal changes occurring naturally throughout your cycle can add to the pain; it's thought that imbalances between the hormones progesterone and oestrogen worsen menstrual cramping. And when there's an overabundance of the hormone-like chemicals called prostaglandins, the uterus goes into spasms and racking cramps can result. (Some studies have shown that a woman with cramps has an unusually high level of the hormone prostaglandin F2 alpha in her menstrual blood.)

The use of an intrauterine device, or IUD, for birth control can markedly increase menstrual cramping.

Cramps associated with primary dysmenorrhoea can often be eased with non-prescription pain-relievers and anti-inflammatory drugs like ibuprofen, aspirin, and naproxen (naproxen is a prescription only drug in Ireland). If your cycle is regular, you may be able to avoid cramps by taking these medicines one day before your period is due to arrive. Having a warm bath or lying down with a heating pad or hot-water bottle on your lower abdomen may also help. Exercise, believe it or not, can make you feel better; if you're up to it, a walk around the block or a few sit-ups will stimulate your muscles to release "feel-good" endorphins.

On the other hand, if your symptoms make it hard for you to work or even sit up straight, your doctor may prescribe a stronger drug or put you on birth control or oestrogen pills, which decrease your body's production of prostaglandin. Depending on what disorder is causing it, secondary dysmenorrhoea is treated with drugs and possibly surgery.

Call your GP for an appointment:

•if your pain is severe or lasts longer than two to three days.

•If your cramps don't seem like normal menstrual cramps or are occurring at the wrong time of the month.

•If you feel pain during or after sexual intercourse.

•If you have an abnormal vaginal discharge.

•If something just seems wrong.

Don't be shy about asking your doctor questions during your gynaecological examination.

Regular aerobic exercise (like walking or swimming for 20 minutes three times a week) has been shown to decrease menstrual pain in some women. And, according to a recent study, daily calcium supplements appear to lessen symptoms of PMS, including cramping.

Some gynaecologists think that smoking, stress, lack of sleep, poor posture, caffeine (found in coffee and most soft drinks), and a diet high in fat and salt are all culprits.

Yes. Although few scientific studies have been done in this area, many women have reported benefits from acupressure, acupuncture, and various herbal remedies, which are believed to help lessen menstrual cramps as well as the symptoms of PMS. The ancient Chinese arts of acupuncture and acupressure are based on the belief that stimulating specific points on the body with hair-thin needles or a practitioner's hand pressure may "unblock the flow of energy within the body" and relieve pain.

As regards herbs, black cobosh and evening primrose oil are both thought to safely relieve menstrual cramps.

Some experts recommend that women decrease their intake of eggs, red meat, and dairy products or switch to organic dairy foods, on the theory that milk containing added hormones and antibiotics may stimulate female hormones in ways we don't yet understand. Some other recommendations:

•Get plenty of essential fatty acids, which are found in canned sardines, salmon, flaxseed oil, and ground flaxseed, among other things.

•Take extra magnesium and a multivitamin-and-mineral supplement.

•Take extra vitamin E during your menstrual cycles.

•Try to eliminate trans-fatty acids from your diet (these are found in foods like commercially prepared pastries, which contain margarine, solid vegetable shortening, and other partially hydrogenated oils).

•Cut down on stress.

•Try yoga or massage.

This article has been revised by Vhihealthe for its audience and may contain, among other things, information or medical practices that are unique to Ireland. Neither Consumer Health Interactive nor the original author make any warranty as to the accuracy of the article as revised, and assume no responsibility for modified content.

First published April 3, 2002
Copyright © 2002 Consumer Health Interactive

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