Menstrual Cramps Overview

Menstrual cramps are painful sensations that affect many women before and during a menstrual period.

They’re some of the most common, annoying parts of your period. They can strike right before or during that time of the month. Many women get them routinely.

Cramps can range from mild to severe. They usually happen for the first time a year or two after a girl first gets their period. With age, they usually become less painful and may stop entirely after you have your first baby.

The pain, also known as dysmenorrhea or period pain, ranges from dull and bothersome to severe and extreme. Menstrual cramps tend to begin after ovulation, when the ovaries release an egg that travels down the fallopian tube.

Pain can affect the lower abdomen and lower back. In about 10% of women who menstruate, the discomfort is severe enough to affect their daily life for 1–3 days each month.

Aching and pain that only occurs with menstruation is known as primary dysmenorrhea. Secondary dysmenorrhea is period pain that stems from a medical problem, such as endometriosis, uterine fibroids, or pelvic inflammatory disease.

Signs and Symptoms of Menstrual Cramps

Menstrual cramps usually refer to a dull, throbbing, cramping pain in the lower abdomen, just above the pelvic bone.

Other symptoms may include the following:

  • Firstly, aching pain in your belly (sometimes severe)
  • Secondly, bloating
  • Thirdly, constipation
  • Next. diarrhea and loose stools
  • In addition, dizziness
  • For example, feeling of pressure in your belly
  • Likewise, fainting
  • Also, headaches
  • Moreover, nausea
  • Furthermore, pain in the hips, lower back and inner thighs 
  • Lastly, sweating
  • Finally, vomiting

Causes of Menstrual Cramps

Menstruation usually happens approximately every 28 days between puberty and menopause, except during pregnancy. During menstruation, the muscles of the womb contract and relax in an irregular way. This motion helps the womb expel unwanted tissue and blood.

Everyone experiences these contractions, but some women do not notice them. For others, however, the discomfort can be severe. Some individuals may also experience nausea, vomiting, and other symptoms.

The hormone-like substances that trigger this process are called prostaglandins. Prostaglandins form in the lining of the uterus.

Menstrual cramps happen because of contractions in the uterus, or womb, which is a muscle. If it contracts too strongly during your menstrual cycle, it can press against nearby blood vessels. This briefly cuts off oxygen to the uterus. It’s this lack of oxygen that causes the pain and cramping.

Cramps can also develop because of the following conditions:

  • Adenomyosis, when your uterine lining grows into nearby muscle 
  • Cervical stenosis, or a narrowing of the lower part of your uterus, caused by scarring, as well as a lack of estrogen after menopause
  • Endometriosis, a condition in which the tissue lining the uterus (the endometrium) grows outside of the uterus
  • Fibroids in the uterus
  •  Pelvic inflammatory disease (PID), an infection caused by bacteria that starts in the uterus and can spread to other reproductive organs

Causes of Menstrual Cramps

Menstruation usually happens approximately every 28 days between puberty and menopause, except during pregnancy. During menstruation, the muscles of the womb contract and relax in an irregular way. This motion helps the womb expel unwanted tissue and blood. 

Everyone experiences these contractions, but some people do not notice them. For others, however, the discomfort can be severe. Some individuals may also experience nausea, vomiting, and other symptoms.

The hormone-like substances that trigger this process are called prostaglandins. Prostaglandins form in the lining of the uterus.

Risk Factors of Menstrual Cramps

Factors that appear to reduce the risk of menstrual cramps include

  • Having given birth more often
  • Older age
  • The use of birth control pills

An individual is more likely to have severe cramps if they are:

  • A family history of menstrual cramps
  • Experiencing stress
  • Have irregular menstrual bleeding (metrorrhagia)
  • Individuals aged under 30 years, especially before the age of 20 years
  • People with a family history of menstrual cramps 
  • Started puberty early, at or before age 11
  • Women who have heavy periods (menorrhagia)


Other factors that may increase the likelihood include:

Conditions That Can Worsen Menstrual Cramps

Several underlying medical conditions can also cause or worsen menstrual cramps.

These include the following:

  • Adenomyosis
  • Endometriosis
  • Pelvic inflammatory disease
  • Some forms of birth control
  • Uterine fibroids

If these cause severe symptoms, a person may need surgery.

Treatment of Menstrual Cramps

Over-the-counter pain relievers are often effective in easing menstrual cramps. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin or another pain reliever, such as acetaminophen, or naproxen can often relieve the pain.

Some drug companies have created some products specifically for menstrual cramps. These combine NSAIDs and anti-prostaglandins, and they can reduce cramping in the uterus, lighten the flow of blood, and relieve discomfort.

In some cases, a doctor may prescribe hormonal birth control pills to prevent ovulation and reduce the severity of menstrual cramps. These pills work by thinning the lining of the uterus, where the prostaglandins form, which can reduce cramping and bleeding.

Other types of hormonal birth control, including some intrauterine devices (IUDs), vaginal rings, patches, and injections can all help decrease cramping.

If the cramps are due to an underlying medical condition, such as endometriosis or fibroids, a doctor may recommend surgery to remove the unwanted tissue.

Prevention of Menstrual Cramps

Women can also try certain lifestyle measures to reduce cramping. These include the following:

  • Exercising regularly
  • Trying to reduce stress, for example, practicing meditation, mindfulness, or yoga
  • Quitting smoking, if a smoker, or avoiding secondhand smoke

Yoga or acupuncture may help, but more research is necessary to confirm their benefits.

Home Remedies

Some natural remedies that may provide relief are:

  • Applying a heat pad to the lower abdomen
  • Engaging in physical exercise, such as jogging or yoga
  • Having a massage
  • Practicing relaxation and mindfulness techniques
  • Taking a warm bath or shower
  • Using transcutaneous electrical nerve stimulation (TENS)

Herbal Remedies

Various herbal teas and other herbal remedies may help manage symptoms, although research has not yet proven that they can help.

Chamomile Tea

A 2019 review concluded that chamomile tea has antispasmodic, anti-Inflammatory sedative, and anti-anxiety properties that may make it useful in treating premenstrual syndrome (PMS), including cramps.

Chinese Herbal Medicines

A review from 2008 concluded that treatment with Chinese herbal medicines might help reduce menstrual cramps. The herbs varied but included Chinese angelica root, Szechuan lovage root, and red and white peony roots.

However, the authors noted that the evidence was low quality and that there was not enough information about adverse effects.

Pine Bark

A 2014 study found that people who took Pycnogenol, the registered trademark brand name for French maritime pine bark extract, for 3 months alongside birth control pills had less pain and fewer days of bleeding compared with those who used only birth control pills.

Fennel

At least one small study has found that fennel extract may help reduce menstrual pain. Other research found that it did not reduce pain but that the severity of bleeding was less when people took fennel drops for up to two menstrual cycles.

Aromatherapy

Lavender and other essential oils may help reduce menstrual discomfort. In one research study, half of the participants smelled a cloth scented with lavender for the first 3 days of their period over two menstrual cycles. These individuals experienced less severe pain than those who used a placebo.

The authors of a 2018 review concluded that lavender and rose oils might have moderate benefits.

Ginger

A 2016 review suggests that oral ginger may help reduce menstrual pain.

There is not enough evidence to prove that any of these remedies work, but they are unlikely to be harmful if a person uses them under supervision.

The Food and Drug Administration (FDA) do not regulate herbs and supplements for quality or purity. Therefore, it is best to check with a doctor before using any herbs or supplements, as they can sometimes have adverse effects.

Biospecimens

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