What are menstrual cramps?
Menstruation is when you have your period. Menstrual cramps are pains in your lower belly that happen a few days before, during, or after your period.
Your pain may be crampy or sharp
The pain may reach from your lower belly to your lower back and down the backs of your legs
Getting enough sleep, exercising, and taking NSAIDs, such as ibuprofen, may help lessen your discomfort
There are 2 types of menstrual cramps:
Primary
Secondary
Primary menstrual cramps are the most common type. Such cramps:
Don’t have a specific cause
Usually start when you're a teenager
Often run in families
Usually become less severe as you get older or after having a baby
Secondary menstrual cramps:
Usually start when you're an adult
What causes menstrual cramps?
Primary menstrual cramps may be caused by:
High levels of prostaglandins
Prostaglandins are chemicals your body makes. They make your uterus contract, and your nerve endings more sensitive to pain.
Secondary menstrual cramps are most often caused by health problems that affect your uterus such as:
Endometriosis Endometriosis Endometrium is the tissue that lines the inside of your uterus (womb). That tissue grows every month during your menstrual cycle because it's getting ready to support a baby. If you don't become... read more : tissue (endometrium) that normally belongs inside your uterus grows outside your uterus
Adenomyosis Adenomyosis In adenomyosis, tissue from glands in the lining of the uterus (endometrium) grows into the muscular wall of the uterus. The uterus becomes enlarged, sometimes doubling or tripling in size.... read more : the tissue in the lining of your uterus grows into the wall of your uterus, causing it to get bigger and swell during your periods
What are the symptoms of menstrual cramps?
The main symptom is:
A crampy or sharp pain in your lower belly—the pain may come and go, or be a dull, constant ache
You may also have:
Headache
Feeling sick to your stomach or throwing up
Constipation
Diarrhea (frequent, loose watery stool)
You're more likely to have severe symptoms if:
Your menstrual periods started at an early age
You have long, heavy periods
You smoke
You have family members with severe menstrual cramps
When should I go to a doctor for menstrual cramps?
Menstrual cramps are unpleasant but not dangerous. However, more serious medical problems sometimes cause pain in the lower belly.
Go to a doctor today if you have lower belly pain and any of these:
Severe pain that began suddenly
Constant pain
Pain that gets much worse when you touch your belly or when you walk
Fever or chills
A thick, white or yellow discharge (fluid) from your vagina
Go to a doctor within a few days if you have menstrual cramps that are worse than usual or last longer than usual. If you don’t have any of the above, call your doctor when you can.
How can doctors tell if I have menstrual cramps?
Doctors will suspect menstrual cramps based on your symptoms and an exam. To make certain there's no other cause for your symptoms, they may do one or more tests:
Pregnancy test
Ultrasound of your lower belly to see your ovaries, uterus, and cervix
If your doctor thinks you may have pelvic inflammatory disease Pelvic Inflammatory Disease (PID) Pelvic inflammatory disease may affect the lining of the uterus, the fallopian tubes, and sometimes the ovaries. Pelvic inflammatory disease is usually caused by bacteria from the vagina. The... read more
, they’ll take a sample from your cervix with a cotton swab and test it for infections
Rarely, your doctor may need to do imaging tests, such as MRI, or use a viewing tube (hysteroscopy) to look inside your uterus.
How do doctors treat menstrual cramps?
If you have primary menstrual cramps, doctors will suggest ways to lessen your pain:
Get enough sleep
Exercise
Put a heating pad on your lower belly
Take NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen a day or 2 before your period starts and the first 2 days of your period
Sometimes, take nutritional supplements such as omega-3 fatty acids, flaxseed, magnesium, vitamin E, zinc, and vitamin B1
If you still have pain, doctors may:
Give you birth control pills—these pills keep your ovaries from releasing an egg
Give you other hormone treatments
Try nerve pain medicines such as gabapentin
If your pain is very severe even with treatment, doctors may:
Do surgery to cut the nerves that send pain signals from your uterus to your brain
If you have secondary menstrual cramps, doctors will treat the health problem that’s causing your pain.
