Menstrual cramps are caused by muscle contractions of the smooth muscle in the uterus. The uterus responds to hormonal changes during the menstrual cycle. Chemicals called prostaglandins that cause uterine contractions are produced in response to these hormones. When pain occurs during menstruation in general, it is known as dysmenorrhea. Menstrual cramps are the most common form of dysmenorrhea, called primary dysmenorrhea. Secondary dysmenorrhea is menstrual pain caused from other conditions, such as endometriosis or fibroid tumors in the uterus. This menstrual pain may last longer than that associated with uncomplicated menstrual cramps, but it is still cyclical and related to the menstrual cycle in nature.
Menstrual cramps typically can start up to two days before the onset of menstruation, or during the first day of a woman’s period. Menstrual cramps can be severe in some women, or occur along with complications such as nausea, fatigue, vomiting and diarrhea. The pain of menstrual cramps may be felt in the lower abdomen, lower back and sometimes the inner thighs. Menstrual cramps are more severe and common in younger women who have not given birth. Many women who have given birth report that their menstrual cramps go away after giving birth.
Remedies for menstrual cramps include taking over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen and using heating pads or taking a hot bath. Smoking, alcohol consumption and excess caffeine consumption can make cramping worse. Exercise has been shown to reduce the severity of menstrual cramps.
If menstrual cramps are severe, it is probably worth going to see a doctor. The doctor can check for other conditions that may be causing your cramping to be more severe, such as endometriosis, pelvic inflammatory disease or uterine fibroid tumors. These conditions may require additional treatments, but menstrual pain typically decreases once these underlying conditions have been treated. If these secondary conditions are ruled out, a doctor may prescribe oral contraceptives. The birth control pill can reduce pain from cramping and other associated problems in some women. Other forms of birth control based on hormones, such as the dermal implant or vaginal ring, can also help reduce menstrual cramping. Non-hormonal birth control methods do not have this same effect, and some types of birth control, such as the intrauterine device (IUD), may increase cramping and menstrual bleeding in some women.