Menstrual cramps

Description

Menstrual cramps (dysmenorrhea) are throbbing or cramping in the lower abdomen. Many women have menstrual cramps before and during their menstrual periods.

For some women, the discomfort is merely annoying. For others, menstrual cramps can be severe enough to interfere with everyday activities for a few days of each month.

Conditions such as endometriosis or uterine fibroids can cause menstrual cramps. The treatment of the cause is the key to reducing the pain. Menstrual cramps that aren't caused by another condition tend to decrease with age, and often improve after giving birth.

Symptoms

The symptoms of menstrual cramps include:

  • Throbbing or cramping pain in the lower part of your abdomen, which may be severe
  • The pain starts from 1 to 3 days before your period, peaks 24 hours after the onset of menstruation and disappears in 2 to 3 days
  • Dull, continuous pain
  • Pain that radiates to the lower back and thighs

Some women also have:

  • Nausea
  • Loose stools
  • Headache
  • Dizziness

When to see a doctor

Consult your health care provider if:

  • Menstrual cramps can disrupt your life each month
  • Your symptoms progressively worsen
  • You only began to have severe menstrual cramps after 25 years of age

Causes

During your menstrual period, your uterus contracts to expel its lining. Hormone-like substances (prostaglandins) involved in pain and inflammation trigger the muscle contractions of the uterus. Higher levels of prostaglandins are associated with more severe menstrual cramps.

Menstrual cramps can be caused by:

  • The Endometriosis. Tissue that acts similar to the lining of the uterus grows outside the uterus, usually in the fallopian tubes, ovaries or the tissue lining the pelvis.
  • Uterine fibroids. These noncancerous growths in the wall of the uterus can cause pain.
  • Adenomyosis. The tissue that lines the uterus begins to grow in the muscular walls of the uterus.
  • The pelvic inflammatory disease. This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.
  • Cervical Stenosis. In some women, the opening of the cervix is small enough to prevent the menstrual flow, causing a painful increase of the pressure inside the uterus.

Risk factors

You could be at risk of menstrual cramps if:

  • You are younger than the age of 30 years
  • Starts puberty early, at the age of 11 years or younger
  • You will bleed profusely during periods (menorrhagia)
  • You have irregular menstrual bleeding (metrorrhagia)
  • You have a family history of menstrual cramps (dysmenorrhea)
  • Smoke

Complications

Menstrual cramps are not caused by other medical complications, but they can interfere with school, work and social activities.

Certain conditions associated with menstrual cramps can have complications, however. For example, endometriosis can cause fertility problems. Pelvic inflammatory disease can scar your fallopian tubes, which increases the risk of a fertilized egg is implanted outside the uterus (ectopic pregnancy).

Menstrual cramps

Diagnosis

Your doctor will review your medical history and perform a physical exam, including a pelvic exam. During the pelvic exam, the provider of checking for anything unusual with the reproductive organs and looks for signs of infection.

Your doctor may also recommend certain lab tests, including:

  • Ultrasound. This test uses sound waves to create an image of your uterus, cervix, fallopian tubes, and ovaries.
  • Other imaging tests.A computed tomography (CT) or Magnetic resonance imaging (MRI) provides more detail than an ultrasound and can help your doctor diagnose underlying conditions.CTcombines X-ray images taken from many angles to produce cross-sectional images of the bones, organs, and other soft tissues inside your body. MRIuses radio waves and a powerful magnetic field to produce detailed images of the internal structures. Both tests are non-invasive and painless.
  • The laparoscopy. Although it is not usually necessary for the diagnosis of menstrual cramps, laparoscopy can help to detect an underlying condition, such as endometriosis, adhesions, fibroids, ovarian cysts and ectopic pregnancy. During this outpatient surgery, your doctor, view your abdominal cavity and reproductive organs, making small incisions in the abdomen and inserting a fiber-optic tube with a small camera lens.

Other imaging tests. A computed tomography (CT) or Magnetic resonance imaging (MRI) provides more detail than an ultrasound and can help your doctor diagnose underlying conditions. CT combines X-ray images taken from many angles to produce cross-sectional images of the bones, organs, and other soft tissues inside your body.

MRI uses radio waves and a powerful magnetic field to produce detailed images of the internal structures. Both tests are non-invasive and painless.

Treatment

To relieve menstrual cramps, your doctor might recommend:

  • Pain relievers.Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), at regular doses starting the day before the start of the period to start with can help control the pain of the cramps. The prescription of nonsteroidal anti-inflammatory drugs are also available. You start to take the medication to relieve the pain in the beginning of your period, or as soon as you feel symptoms, and to continue taking the medication as directed for two or three days, or until symptoms have disappeared.
  • Hormonal birth Control. Oral birth control pills contain hormones that prevent ovulation and reduce the severity of menstrual cramps. These hormones can also be delivered in various other forms: injection, patch, implant is placed under the skin of your arm, a flexible ring that is inserted in the vagina, or an intrauterine device (IUD).
  • Surgery. If your menstrual cramps are caused by a disorder such as endometriosis or fibroids, surgery to correct the problem may help your symptoms. Surgical removal of the uterus may also be an option if other approaches fail to relieve your symptoms and if you're not planning to have children.

Pain relievers. Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), at regular doses starting the day before the start of the period to start with can help control the pain of the cramps. The prescription of nonsteroidal anti-inflammatory drugs are also available.

You start to take the medication to relieve the pain in the beginning of your period, or as soon as you feel symptoms, and to continue taking the medication as directed for two or three days, or until symptoms have disappeared.

Self-care

In addition to getting enough sleep and rest, the things that you might want to try include:

  • Exercise regularly. Physical activity, including sex, it helps to relieve menstrual cramps for some women.
  • The use of heat. Soaking in a hot bath or using a heating pad, hot water or heat in the form of a patch in the lower part of your abdomen, it could relieve menstrual cramps.
  • Try dietary supplements. A number of studies have indicated that vitamin E, omega-3 fatty acids, vitamin B-1 (thiamine), vitamin B-6 and magnesium supplements can reduce menstrual cramps.
  • Reduce stress. Psychological stress can increase the risk of menstrual cramps and their severity.

Alternative medicine

The majority of alternative therapies for the treatment of menstrual cramps has not been sufficiently studied by experts to recommend one of them. However, some alternative treatments can help, including:

  • Acupuncture. Acupuncture involves the insertion of extremely thin needles through the skin at strategic points on your body. Some studies have found that acupuncture helps to relieve menstrual cramps.
  • Transcutaneous electrical nerve stimulation (TENS).A transcutaneous electrical nerve stimulation (TENS) device is connected to the skin with sticky patches with electrodes on them. The electrodes offer a varied level of electrical current to stimulate the nerves. TENSmight of work by the increase in the threshold for pain signals and stimulating the release of your body's natural painkillers (endorphins). In the studies,TENSwas more effective than a placebo in relieving menstrual cramp pain.
  • Herbal medicine. Some herbal products, such as pycnogenol, the fennel, or the combination of the products, you could provide some relief from menstrual cramps.
  • The acupressure. Like acupuncture, acupressure also involves stimulating certain points on the body, but with a gentle pressure on the skin instead of needles. Although the research on acupressure and menstrual cramps is limited, it seems that acupressure may be more effective than a placebo in the relief of menstrual cramps.

Transcutaneous electrical nerve stimulation (TENS). A transcutaneous electrical nerve stimulation (TENS) device is connected to the skin with sticky patches with electrodes on them. The electrodes offer a varied level of electrical current to stimulate the nerves.

TENS could work by raising the threshold for pain signals and stimulating the release of your body's natural painkillers (endorphins). In the studies, TENS was more effective than a placebo in relieving menstrual cramp pain.

Preparing for your appointment

If you have annoying menstrual cramps, make an appointment with your family doctor or a doctor who specializes in the female reproductive system (gynecologist). Here's some information to help you prepare for your appointment.

What you can do

Tracking your menstrual cycle, when they start and the severity of the cramps. Also, make a list of:

  • The medical problems that you have had and recent of the main stress factors in your life
  • All medications, vitamins or supplements that you take
  • Questions to ask your doctor

For menstrual cramps, the basic questions are:

  • What is the most likely cause of my symptoms?
  • Are my symptoms can change over time?
  • Do I need any tests done?
  • What treatments or home remedies can help?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Do not hesitate to ask other questions that occur to you.

What to expect from your doctor

Your doctor may ask you questions, such as:

  • How old were you when you started menstruating?
  • How far you are your menstrual periods, and how long do they typically last?
  • How heavy is heavy menstrual bleeding? Have you ever bleeding between periods?
  • Where do your cramping pain?
  • Do you have other symptoms with your cramps, such as nausea, vomiting, diarrhea, back pain, dizziness, or headaches?
  • Did your symptoms cause you to limit your activities, stay home from work or school, or to avoid exercise?
  • If you're sexually active, it is intercourse painful?
  • What treatments have been tried so far, if any? Nothing has helped?
  • Do women in your family has a history of similar symptoms?

What you can do in the meantime

When you have cramps, try taking a warm bath or applying a heating pad, hot water or heat patch on its abdomen. Over-the-counter pain relievers, such as ibuprofen, can also help.

The symptoms and the treatment of Menstrual cramps