Cramps

Cramps (Dysmenorrhea)

Dysmenorrhea means painful cramps during your period. Cramps are very common and can occur at any age, but severe cramps tend to occur more often in the late teens and early twenties. This type of abdominal pain usually starts when your period begins and peaks during the first day or two, when flow is heaviest. Some women also experience nausea, diarrhea or vomiting, fatigue, fever, headache, lower back pain and/or lightheadedness. In about 10% of women, cramps are so painful that they interfere with normal activities and prevent a woman from going to work or school.

Cause
Dysmenorrhea results from the release of chemicals called prostaglandins from the uterine lining cells. These chemicals cause contractions of the muscle wall of the uterus, which are felt as menstrual cramps. Women with severe dysmenorrhea tend to produce higher levels of prostaglandins.

Treatment Options
Since a number of conditions can cause severe pelvic pain, it is a good idea to have a pelvic examination by your doctor to rule out other possible causes. Once you know there is no abnormality, your can treat your cramps with an over-the-counter non-steroidal anti-inflammatory drug (NSAIDS) such as Advil, Aleve, Motrin or other brand of ibuprofen. NSAIDS work by blocking the formation of prostaglandins in the uterine lining cells; therefore, they work best if you take them just before your period or at the very onset of bleeding.

Birth control pills can help prevent painful periods because they tend to make the uterine lining cells thinner. This not only causes periods to be lighter and shorter, but also less painful since there are fewer cells to release prostaglandins.

Surgery is not recommended as a treatment for dysmenorrhea except in rare cases where pain is severe and unmitigated by other treatments. In such cases, your doctor may discuss the option of presacral neurectomy with you.

References

American College of Obstetricians and Gynecologists. Gynecological Problems: Dysmenorrhea. 2006. www.acog.org/publications/patient_education.pdf/bp086.cfm.
American Society for Reproductive Medicine. Pelvic Pain: A Guide for Patients. Patient Information Series 1997. www.asrm.org/patients/patientbooklets/pelvicpain.pdf.