What are menstrual cramps?

Menstrual cramps are pain or discomfort in the lower belly just before or during your menstrual period. Dysmenorrhea is the medical term for menstrual cramps.

Pain may start several days before your period and last throughout your period.

Menstrual cramps are common during the late teens and early 20s. They often get better after age 25. They are less common if you have gone through childbirth.

Even though the cramps are painful, they will not hurt the uterus or your ability to have children.

What is the cause?

Menstrual cramps are caused by chemicals in the lining of your uterus called prostaglandins. These chemicals make the uterus squeeze (contract) to shed the lining that has built up during the menstrual cycle. Women who have painful periods may have higher levels of prostaglandins. Other causes of dysmenorrhea include:

• Endometriosis, which is tissue from the lining of the uterus growing outside the uterus
• Pelvic inflammatory disease (PID), which is an infection of the female organs (uterus, tubes, and ovaries)
• Tumors (called fibroids) or cysts in the uterus
• An IUD, which is is a plastic or metal birth control device put into your uterus by your healthcare provider

What are the symptoms?

Symptoms may include:

• Pain or discomfort in your lower belly
• A dull ache in your lower back
• Headache
• Nausea
• Diarrhea
• Discomfort in the inner part or front of the thighs

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you, including a pelvic exam. Tests may include:

• Blood tests
• An ultrasound, which uses sound waves to show pictures of your uterus and ovaries

How is it treated?

Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.

• Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
• Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.

If your symptoms are severe, you may need a prescription anti-inflammatory drug or pain medicine.

Birth control pills or other hormone medicines may be prescribed. Hormone medicine lessens cramping by decreasing prostaglandin production. If birth control pills relieve the pain, you may take them even if you don’t need them for birth control.

If menstrual cramps are caused by infection or a problem with an IUD, treating those problems may relieve the cramps

You may need surgery to treat problems that may be causing the pain, such as endometriosis or fibroids.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Put a heating pad set on low, or a covered hot water bottle, on your lower back or belly.
• Soak in a warm (not hot) tub.
• Gently massage your lower belly or lower back.

Ask your provider:

• How and when you will hear your test results
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

What can I do to help prevent menstrual cramps?

• Take care of your health. Try to get at least 7 to 9 hours of sleep each night. If you smoke, try to quit. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Learn ways to manage stress. Exercise according to your healthcare provider’s instructions. Exercise such as walking, swimming, or bicycling may improve blood flow and ease menstrual pain.
• If your periods are regular and predictable, you can try taking ibuprofen or naproxen 1 to 2 days before you think your period will start. Keep taking the medicine through the first 2 to 3 days of your period. This may help prevent cramps.
• Have checkups, including a pelvic exam and Pap test, as often as recommended by your healthcare provider so that problems can be found and treated early.