Key points to remember:
- Menstrual cramps are likely caused by an excess of prostaglandins, which are released from the uterine lining during menstruation and can cause pain.
- To alleviate menstrual cramps, you can use a heat compress and take an anti-inflammatory medication like ibuprofen.
- To prevent cramps, you may want to try taking a magnesium supplement, as it may help reduce pain over time and reduce the need for pain medication.
Period cramps, also known as uterine cramps, are pains that occur in the abdomen, back, or thighs around the time of your period. They may also occur during ovulation. Most people first experience menstrual cramps a few months to a year after getting their first period. At first, they may be irregular, but as ovulation becomes more frequent, they may occur in most or all cycles. Menstrual cramps typically start just before or at the beginning of bleeding and last for one to three days. They can range from barely noticeable to severe and may come and go randomly or get better as time goes on. Severe menstrual cramps may be caused by medical conditions such as endometriosis or adenomyosis, and it is important to advocate for yourself and communicate your pain levels to a healthcare provider. Keeping track of your pain with an app can be helpful in understanding and managing your menstrual cramps.
What do we experience period cramps?
Menstrual cramps, also known as primary dysmenorrhea, are caused by an excess of prostaglandins, hormone-like compounds that are released from the uterine lining during menstruation. These compounds help the uterus contract and relax to shed the endometrium, but in excess, they can cause pain by causing strong contractions, reducing blood flow, and decreasing the supply of oxygen to the uterus, leading to inflammation. People who have heavy or long periods, started menstruating at an early age, or have irregular periods are more likely to experience painful periods. Other factors that may contribute to painful periods include smoking, being thin, being younger than 30, having a pelvic infection, and being sterilized. Research has also shown that people with undiagnosed sexually transmitted infections may be more likely to experience certain premenstrual symptoms, including cramps.
How to relieve period cramps
If you experience heavy, irregular, or extremely painful periods, it may be important to find and treat the underlying cause of these irregularities for your overall health. There are several approaches that can help relieve cramps by reducing inflammation, limiting prostaglandin production, blocking pain, increasing uterine blood flow, or treating an underlying condition like endometriosis. These approaches include taking medication, using heat therapy, trying transcutaneous nerve stimulation, making dietary changes, taking supplements, practicing stress relief techniques, quitting smoking, exercising, having sex, and engaging in self-care. Hormonal birth control can also help by preventing the build-up and shedding of the endometrium.
Medication for period cramps
Anti-inflammatory painkillers, such as non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, are an effective way to relieve period pain. These drugs inhibit prostaglandin production and inflammation, and are also used to reduce heavy bleeding. Other types of over-the-counter painkillers may provide some pain relief, but are generally less effective for treating menstrual cramps. Some people may also use hormonal contraceptives, such as the pill or the hormonal IUD, to relieve and prevent menstrual cramps by blocking ovulation and preventing the growth and shedding of the uterine lining, which reduces or eliminates the build-up of prostaglandins and muscle contractions that cause cramps.
Using heat for period cramps
Using heat to relieve pain, such as from menstrual cramps, is a simple and effective method that has been shown to be as effective as over-the-counter pain medications like NSAIDs and aspirin. A heated patch, pad, or water bottle can be used to provide continuous low-level heat therapy to help alleviate cramp pain. Your grandmother's hot water bottle is a good option to try, as it is a low-cost and side-effect-free way to manage cramp pain.
Transcutaneous nerve stimulation and period cramps
Transcutaneous nerve stimulation (TENS) is a treatment option for managing menstrual cramps that involves using a small machine to deliver a low-voltage electrical current to the skin. This can help increase the pain threshold and stimulate the release of endorphins, which are natural pain-relieving substances produced by the body. TENS can be used alone or in combination with other methods, such as heat therapy or medication, to help alleviate cramp pain. TENS is an approved treatment for menstrual cramps.
Diet for period cramps
There is limited, but promising, research on the relationship between inflammation and menstrual cramps, and the potential for certain diets to help prevent cramps. For example, one study of 33 women found that those who followed a low-fat vegetarian diet had less menstrual pain compared to those who took a placebo supplement. Another survey of 127 students found that those who consumed 3-4 servings of dairy per day had less menstrual pain compared to those who consumed no dairy, possibly due to the intake of calcium and vitamin D. However, a trial on vitamin D found that very high doses were needed to make a difference, which may not be considered safe by all practitioners. Magnesium deficiency, which is associated with anxiety and stress, has also been linked to more intense menstrual cramps. Currently, there are no formal clinical recommendations for a cramp-prevention diet.
Supplements for period cramps
There is limited evidence to support the use of supplements to treat menstrual cramps, but some people may find relief through experimentation. It is important to speak with a healthcare provider or a nutritionally-trained practitioner before taking any supplements, as they can have side effects and interact with other nutrients in the body. The top-evidenced supplements for menstrual cramps include ginger, magnesium, zinc, and vitamin B1. Ginger may be as effective as over-the-counter painkillers in reducing pain. Magnesium may help reduce menstrual pain and limit the need for pain medication, although it can cause loose stools. Zinc may also be effective in reducing the duration and severity of cramps, but more research is needed. Vitamin B1 has been shown to be effective in reducing period pain. Other supplements that have been studied for their potential role in easing cramps include vitamin E, vitamin B6, high doses of vitamin D, agnus castus, and fish oil. The results of these studies have been mixed.
Stress and period cramps
Stress reduction techniques may be effective at reducing the severity of menstrual cramps in some individuals. Early studies have shown that individuals who experience high levels of stress are more prone to experiencing painful periods. Stress during the first phase of the menstrual cycle (called the follicular phase) may be more likely to cause painful periods than stress during the second phase (called the luteal phase) after ovulation.
Smoking and period cramps
Smokers are more likely to experience severe menstrual cramps, and this risk increases the longer a person smokes. Secondhand smoke has also been linked to an increased risk of painful periods.
Exercise and period cramps
Exercise may be helpful in reducing the severity of menstrual cramps, possibly by increasing blood flow to the abdomen. A review of 11 studies found that various types of exercise, such as aerobic exercise, stretching, and yoga, are likely to reduce the intensity of menstrual pain and may also shorten its duration. Exercise can also help reduce stress, which can contribute to pain. If you are practicing yoga, you may find it helpful to focus on poses that stretch and stimulate the abdomen, such as cobra, cat, and fish poses.
Sex and period cramps
Many people find it comforting to talk about their menstrual cramps with a parent, friend, or healthcare provider. Other strategies people use to cope with cramps include staying in bed, watching television, and engaging in other distractions like eating special foods, drinking certain beverages, and exercising. Having a trusted friend or partner give you an abdominal or back massage using an oil with a pleasant scent (such as lavender) may also be helpful, even if it is just a nice gesture.
What is considered a “normal” period cramp?
If your menstrual cramps are severe enough that they are not relieved by over-the-counter pain medication, and if they interfere with your ability to work, study, or perform daily activities, it is important to speak with a healthcare provider. You should also see your healthcare provider if your cramps are suddenly or unusually severe or if they last for more than a few days. Severe menstrual cramps or chronic pelvic pain may be a symptom of a health condition such as endometriosis or adenomyosis. The pain experienced by people with endometriosis is different from typical menstrual cramps. It can be difficult to advocate for yourself when it comes to pain, but it is important to do so in order to get the treatment you need.