Overview

You may have painful menstrual cramps (dysmenorrhea) from time to time. Menstrual cramps can occur during or just before your period. The pain from these cramps can range from mild to severe. It can involve the lower belly, back, or thighs. You may also have headaches, nausea, dizziness, fainting, diarrhea, or constipation with your cramps.

During the menstrual cycle, the lining of the uterus produces a hormone called prostaglandin. This hormone causes the uterus to contract, often with pain. If you have severe cramps, you may be producing higher-than-normal amounts of prostaglandin. Or you may be more sensitive to its effects.

Primary dysmenorrhea is a term used to describe painful menstrual cramping that isn't caused by a medical problem. It often starts during the teen years, when periods first start. But the pain often improves as you get older.

Secondary dysmenorrhea is a term used to describe painful menstrual cramping that's caused by a physical problem other than menstruation. Problems that can cause this type of cramping include:

• A condition in which cells that look and act like the cells of the lining of the uterus (endometrium) are found in other parts of the belly cavity (endometriosis) or grow into the muscular tissue of the uterine wall (adenomyosis). Pain usually occurs 1 to 2 days before menstrual bleeding starts. It continues through the period.
• Growths in the pelvis that aren't cancer (benign growths). This includes ovarian cysts, cervical or uterine polyps, and fibroids.
• Pelvic infections. They can cause worse pain and cramping in your belly during your period.
• Using an intrauterine device (IUD). An IUD may cause worse cramping during your period for the first few months you use it. If menstrual cramps persist or get worse, talk to your doctor.
• Structural problems that were present at birth (congenital). This includes narrowing of the lower part of the uterus that opens into the vagina (cervix).

Menstrual-type cramps may occur after a medical procedure. Examples are cautery, cryotherapy, conization, radiation, endometrial biopsy, and IUD insertion.

Self-Care

It's common to have painful cramps from your period now and then. But you can usually ease cramps with home treatment. Here are some things you can try.

• Apply heat to your belly.

  Use a heating pad (set on low) or a hot water bottle on your belly, or take a warm bath. You might find that heat relieves the pain as well as medicine does.

  Don't go to sleep with a heating pad on your skin. Put a thin cloth between the heating pad and your skin.

• Relieve pressure on your back.

  Lie down and put a pillow under your knees. Or lie on your side, and bring your knees up to your chest.

• Get regular exercise.

  It helps blood flow and may reduce cramping.

Using medicines for pain

It's common to have painful cramps from your period now and then. The good news is that you can usually ease cramps with over-the-counter (OTC) medicine.

Here are some medicines you can try and ways to help get the most benefit out of the medicine you use.

• Take over-the-counter medicines to reduce pain.
  • Try nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve).
  • Try acetaminophen (such as Tylenol) if NSAIDs don't relieve the pain.

  Be safe with medicines. Read and follow all instructions on the label. If you are trying to become pregnant, talk to your doctor before you use any medicine.

• Stay ahead of the pain.

  Pain medicine works better if you take it before the pain gets bad.

  • Start taking the recommended dose of the pain medicine as soon as you start to feel cramping, or on the day before your period starts.
  • Keep taking the medicine for as long as you have cramps.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

• New cramps in someone who could be pregnant.
• Pain that gets worse.
• Menstrual cramps that last longer than a period.
• New fever.
• Symptoms occur more often or are more severe.

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