All About Menstrual Cramps (Dysmenorrhea)

Many women experience pain or discomfort at the time of their periods. Menstrual cramps are dull, throbbing or cramping pains in the lower abdomen. More than 50 percent of women experience menstrual cramps just before and during their menstrual periods. It is the most common of all gynaecological complaints. For most, the pain or unease is not so severe that it interferes with their daily lives or requires any special attention. For others, it can be severe enough to interfere with everyday activities for a few days every month. The medical term for excessively painful periods is dysmenorrhea.

There are two general types of dysmenorrhea. Secondary dysmenorrhea is diagnosed when symptoms are attributable to an underlying disease, disorder, or structural abnormality either within or outside the uterus. Primary dysmenorrhea is diagnosed when none of these is detected. It occurs most often in girls in their teens or in their twenties.

What causes menstrual pains?

Primary dysmenorrhea is caused by the normal production of prostaglandins. During menstrual periods, uterus contracts to help expel its lining. Uterine contractions are caused by prostaglandins, hormone-like substances involved in pain and inflammation. Higher levels of prostaglandins are associated with more severe menstrual cramps. Many experts believe that strong uterine contractions cause the blood supply to the uterus to temporarily shutdown, depriving the uterine muscle of oxygen and setting up the cycle of menstrual contractions and pain.

The most common cause of secondary dysmenorrhea is endometriosis (a painful condition in which the type of tissue that lines the uterus becomes implanted outside uterus, most commonly on fallopian tubes, ovaries or the tissue lining the pelvis). Other causes include leiomyoma, adenomyosis, ovarian cysts, and pelvic congestions.

What are the symptoms?

Symptoms of dysmenorrhea include dull, throbbing or cramping pain in the lower abdomen. Pain that radiates to the lower back and thighs. Some woman also experience nausea, vomiting, loose stools, bloating, diarrhea, dizziness and fatigue.

If you've started menstruating within the past few years and are experiencing cramps, chances are your menstrual pain is not a cause for concern. However, if menstrual cramps disrupt your life for more than a few days a month or if you're older and just started experiencing severe menstrual cramps, see your doctor.

What is the treatment?

The following steps can help relieve the symptoms of dysmenorrhea and bring relief for your painful stomach cramps and heavy periods:

• Take a warm bath or apply a heating pad to the lower abdomen (below your belly button).
• Do light circular massage with your fingertips around your lower abdomen.
• Follow a diet rich in complex carbohydrates such as whole grains, fruits, and vegetables, but low in salt, sugar, alcohol, and caffeine.
• Drink warm beverages.
• Eat light but frequent meals.
• Keep your legs elevated while lying down, or lie on your side with your knees bent.
• Try over-the-counter anti-inflammatory medicine, such as ibuprofen.
• Practice relaxation techniques such as meditation or yoga.

If these self-care measures do not work, your doctor may prescribe medications such as:

• Antidepressants
• Antibiotics
• Oral contraceptive pills (hormonal birth control pills)
• Stronger anti-inflammatory medicines.

If your menstrual cramps are caused by an underlying disorder, such as endometriosis or fibroids, the surgical removal of the abnormal tissue may help reduce your symptoms.

When should you call the doctor?

Call your doctor if:

• Self-care measures don't relieve your pain after 3 months.
• You experience a fever, nausea, or vomiting with your pain.
• You experience pelvic pain that is not associated with menstruation.
• Your pain is severe or sudden.
• Your pain occurs at times other than menstruation, begins more than 5 days before your period, or continues after your period is over.

Remember, menstruation is no longer a curse. The best thing to do is to stay in good physical health which is to be obtained with healthy lifestyle, daily exercises, plenty of sleep and rest.