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Categories > Pelvic Pain and Disorders > Causes and cures

How to tame menstrual cramps
The chemistry of cramps
Over-the-counter relief

When cramps are more than just a pain
When cramps are more than just a pain

Occasionally, painful periods signal a more serious problem, such as pelvic inflammatory disease, endometriosis, fibroids or ovarian cysts. Fortunately, all of these conditions are relatively easy to identify if you know the symptoms. Here’s what to look for:

  • fever
  • vomiting
  • foul-smelling discharge
  • painful intercourse
  • pain that’s sharp and severe rather than a dull ache
  • pain that starts more than a day or two before your period and continues to the end or beyond
  • pain that’s centered on either side of the pelvis instead of above your pubic bone
  • pain that doesn’t respond to antiprostaglandin drugs or oral contraceptives

If you experience any of these symptoms, schedule an appointment with your physician.

Additional sources of relief
Additional sources of relief

Besides taking ibuprofen or a similar pain reliever, you may find that the following measures bring added relief from menstrual cramps:

  • Lie on your back with a pillow placed under your knees.
  • Lay a hot water bottle or heating pad across your belly.
  • Massage your belly lightly.
  • Perform mild exercises like stretching, walking or biking.

Many women experience some discomfort during menstruation. For most, the pain is mild and tolerable. For some, however, it’s severe and disabling. In fact, some women with dysmenorrhea (the medical term for painful menstruation, pronounced “dis-men-uh-ree-uh”) have such severe pain that their daily routines would come to a screeching halt each month if they didn’t take medication.

The chemistry of cramps

Researchers aren’t completely sure what causes painful periods, but most believe that hormone-like substances called prostaglandins are the culprit. Prostaglandins, produced by cells in the lining of the uterus and in many other parts of the body, stimulate the uterus to contract. Prostaglandin production peaks just before menstruation, making the uterus contract more strongly than at any other time of the cycle. These contractions may be so mild that they aren’t even noticed, or they may be so intense that the blood supply to the uterus is temporarily cut off. The result? Pain. Many experts believe that women who suffer from dysmenorrhea produce excessive amounts of prostaglandins, although no one knows why.

Fortunately, over-the-counter relief is available. The same ibuprofen that can work wonders for a garden-variety headache can put an end to painful periods, too, by blocking the production of prostaglandins. An added bonus: Ibuprofen usually prevents other unpleasant prostaglandin-related symptoms—such as nausea, diarrhea and general achiness—from cropping up.

Over-the-counter relief

Take ibuprofen at the first sign that your period is about to begin. That first sign could be breast tenderness, bloating or lower back pain. However, if you think you might be pregnant, talk to your doctor before taking ibuprofen or any other pain reliever.

If you don’t get satisfactory relief after two or three cycles of ibuprofen treatment, try another over-the-counter antiprostaglandin—naproxen sodium—for a few cycles. If you’re still plagued by cramps, schedule an appointment for a pelvic exam. Sometimes unusually stubborn menstrual cramps are caused by an underlying illness.

If no hidden cause is uncovered, you may be prescribed a more powerful antiprostaglandin, such as toprofen or meclofenamate, or an oral contraceptive. Birth-control pills help to lower prostaglandin levels by preventing ovulation and thinning the lining of the uterus.

Fortunately, most women with painful periods find relief with one of the above-mentioned strategies. So, if you’re plagued by pain each month, don’t suffer in silence.