Menstrual cramps – causes and treatments

People who have periods will have experienced period cramps or pain at some point, reports vary from 80-96 out of every 100 women and girls state they have had period pains. For some that might be mild cramps with little discomfort, while others might experience severe period pain that gets in the way of… well, everything from school to work and mre. Menstrual cramps can happen to anyone with a period and can come monthly, both in the few days before and then during your period. The good news is that menstrual cramps often become less painful as you age (yay for getting older!), So, sit back, grab a hot water bottle, and keep reading.

What are menstrual cramps?

The medical name for period or menstrual cramps is dysmenorrhea. Periods can be painful because the muscles of the uterus tighten and contract to help shed the lining during menstruation. These contractions are triggered by chemicals called prostaglandins, which also increase inflammation and make the nerves more sensitive to pain. Higher levels of prostaglandins usually mean stronger, more painful cramps. Reduced blood flow to the uterus during these contractions can add to the discomfort, causing the familiar cramping, aching, or throbbing pain many people experience during their period. Menstrual cramps can be mild or severe with the most common symptoms being pain or pressure felt in the lower abdomen, lower back, or even spread down your thighs. Some people experiencing severe cramps have symptoms of nausea, loose stool, headaches and dizziness.

Secondary period pain is caused by an underlying condition rather than the normal uterine contractions that lead to primary cramps. Common causes include endometriosis, where tissue similar to the uterine lining grows outside the uterus and becomes inflamed during the menstrual cycle; adenomyosis, in which this tissue grows into the muscle of the uterus itself; and fibroids, which are non-cancerous growths that can make periods heavier and more painful. Pelvic inflammatory disease, usually caused by an infection, can also lead to ongoing pelvic pain that worsens with menstruation. Other causes include ovarian cysts, cervical stenosis, and the use of certain intrauterine devices.

And, if you’ve ever found yourself wondering if tampons make menstrual cramps worse, Dr Melisa Holmes, OB-GYN, has your answer. “No, they don’t... tampons have nothing to do with prostaglandin synthesis or the way they’re used in the body”. Thank goodness for that!

Cramp duration - when to expect menstrual cramps

Primary dysmenorrhea, or menstrual cramps, usually begins within the first one to two years after a person’s first period and may lessen or disappear after childbirth for some people. Cramps typically occur each month, often starting one to two days before or at the onset of bleeding. The pain can last anywhere from several hours to up to three days and may vary in intensity throughout the menstrual period.

How to reduce period cramps and other treatment options

Don’t let this cramp your style though – there are several home remedies which may help alleviate the symptoms of menstrual cramps and get you feeling like yourself again. So, if you are looking to relieve period cramps fast or make the reduce period pain, use these tips to ease your painful periods:

• Lie down with a heating pad on your stomach, lower back, or lower abdomen to take the edge off the pain
• You can also place a hot water bottle on your lower back or lower abdomen to alleviate your period pain
• Take a warm bath to reduce the pain of menstrual cramps and increase blood flow
• Speak to a pharmacist about over the counter painkillers such as paracetamol or ibuprofen. Ibuprofen is one of the medications called NSAIDs (non steroidal anti inflammatory drugs) which reduce the prostaglandins which are involved in period pain.You can take these even if you get ‘pre period’ cramps, which start in the day or so before your period. Additionally taking these before the pain gets too severe can be helpful.
• Give yourself a little massage where it hurts
• Exercise. You probably have zero interest in moving while in pain but exercising before and during your period can really help.
• Have sex! You heard us – having sex on your period may help with period cramps. Learn more about period sex here.

When should you see a doctor about period pains?

If you are not managing your period pains with the simple measures described above, then it is time to see your doctor.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen or mefenamic acid can be used. These work by reducing prostaglandins, the chemicals that trigger uterine contractions and pain. If your periods are also heavy, then medications such as tranexamic acid can be useful.

Hormonal treatments are another effective option for managing period pain. Combined hormonal contraception, such as the pill, patch, or vaginal ring, can reduce or even eliminate menstrual cramps by preventing ovulation and thinning the uterine lining. Hormonal coils such as the Mirena, progestogen-only methods may also help, particularly for people with heavy bleeding alongside pain.

For persistent or worsening pain, a doctor may investigate underlying causes of secondary dysmenorrhea, such as endometriosis, adenomyosis, fibroids, or pelvic inflammatory disease. Diagnosis may involve pelvic examinations, ultrasound, or laparoscopy. Targeted treatment for these conditions can include medication, hormonal therapy, or surgery depending on severity and patient preference.

Want more ways to alleviate menstrual cramps and feel better during your period? Check out these period hacks.