Why do Periods Hurt? Cause of Cramps

A variety of painful symptoms may accompany menstrual periods. Sometimes symptoms can occur shortly before your period actually starts. They typically taper off during the first few days of your period.

Prostaglandins

Cramps are caused by the hormone-like lipids called prostaglandins that make your uterus contract to help get rid of its lining.

Prostaglandins are also involved in the inflammation and pain responses. They reside in the uterine lining and are also released from this lining.

Once released, they increase the force of the contractions during the first couple days of your period. The higher the level of prostaglandins, the more severe the cramping is.

Very high levels can also cause nausea and diarrhea. As the lining is shed, the levels of prostaglandins in your body is lowered. This is why cramps typically subside after the first couple of days of your period.

Underlying Medical Conditions

Other Causes

At-home treatments can be helpful in relieving painful menstrual periods. Types of things to try at home include:

• Doing regular physcial exercise
• Eating light, nutritious food
• Massaging your abdomen
• Taking a warm bath
• Practicing relaxation techniques or yoga
• Taking anti-inflammatory medications such as ibuprofen several days before you expect your period
• Using a heating pad on your pelvic area or back
• Taking vitamins and supplements such as:
  • Vitamin B-6
  • Calcium
  • Vitamin B-1
  • Magnesium
  • Omega-3 fatty acids
  • Reducing your intake of salt, alcohol, caffeine, and sugar to prevent bloating
    
  • Vitamin E
  • Raising your legs or lying with your knees bent

If menstrual pain is interfering with your ability to perform basic tasks each month, it may be time to talk to your gynecologist.

Talk to your doctor about your symptoms and if you experience any of the following:

• At least three painful menstrual periods
• Continuing pain after IUD placement
• Passing blood clots
• Cramping accompanied by diarrhea and nausea
• Pevic pain when not menstruating

Sudden cramping or pelvic pain could be signs of infection. An untreated infection can cause scar tissue that damages the pelvic organs and may lead to infertility.

If you have symptoms of an infection, seek prompt medical attention:

• Fever
• Severe pelvic pain
• Sudden pain, especially if you may be pregnant
• foul-smelling vaginal discharge

When trying to find out what the underlying cause of painful menstruation is, your doctor will likely take your medical history and perform a physical exam. This will include a pelvic exam to check for any abnormalities in your reproductive system and to look for signs of infection.

If your doctor thinks an underlying disorder is causing your symptoms, they may perform imaging tests. These can include:

• An ultrasound
• A CT scan
• An MRI

Depending on the results of your imaging tests, your doctor may order a laparoscopy. This is a test in which a doctor makes small incisions in the abdomen into which they insert a fiber-optic tube with a camera at the end to see inside your abdominal cavity.

If at-home treatment doesn’t relieve your menstrual pain, medical treatment options exist.

Treatment will depend on the severity and underlying cause of your pain. If PID or sexually transmitted infections (STIs) are causing your pain, your doctor will prescribe antibiotics to clear the infection.

Your doctor may also prescribe medications that include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). You can find these drugs over the counter or get prescription-strength NSAIDs from your doctor.
  • Other pain relievers. This includes over-the-counter options like acetaminophen (Tylenol) or stronger prescription pain medications.
• Antidepressants: Antidepressants are sometimes prescribed to help lessen some of the mood swings associated with PMS.

Your doctor may also suggest that you try hormonal birth control. Hormonal birth control is available as a pill, patch, vaginal ring, injection, implant, or IUD. Hormones prevent ovulation, which can control your menstrual cramps.

Surgery can treat endometriosis or uterine fibroids. This is an option if other treatments haven’t been successful. The surgery removes any endometriosis implants, uterine fibroids, or cysts.

In rare cases, a hysterectomy (the surgical removal of the uterus) is an option if other treatments haven’t worked and pain is severe. If you have a hysterectomy you will no longer be able to have children. This option is usually only used if someone isn’t planning on having children or is at the end of their childbearing years.