Menstrual Cramps

What Are Menstrual Cramps?

Menstrual cramps are throbbing, aching cramps you get in your lower belly just before and during your period. They’re some of the most common, annoying parts of your period. They can strike right before or during that time of the month. Many women get them routinely.

Cramps can range from mild to severe. They usually happen for the first time a year or two after a girl first gets their period. With age, they usually become less painful and may stop entirely after you have your first baby.

Your doctor may call your cramps dysmenorrhea.

Menstrual Cramp Symptoms

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You may have:

  • Aching pain in your belly (sometimes severe)
  • A feeling of pressure in your belly
  • Pain in your hips, lower back, and inner thighs

When cramps are severe, symptoms may include:

  • Upset stomach
  • Vomiting
  • Loose stools

When to Call Your Doctor

If you have severe or unusual menstrual cramps, or cramping that lasts more than 2 or 3 days, tell your doctor. Whatever the cause, cramps can be treated, so it's important to get checked.

Your doctor will ask about your symptoms and menstrual cycles. You’ll get a pelvic exam, in which your doctor will use a tool called a speculum to see into your vagina and cervix. They may take a small sample of vaginal fluid for testing and use their fingers to check your uterus and ovaries for anything that doesn’t feel normal.

If it turns out that your cramps aren’t due to your period, you might need other tests to find the right treatment.

Menstrual Cramp Causes and Risk Factors

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Menstrual cramps happen because of contractions in the uterus, or womb, which is a muscle. If it contracts too strongly during your menstrual cycle, it can press against nearby blood vessels. This briefly cuts off oxygen to the uterus. It’s this lack of oxygen that causes your pain and cramping.

You can also have cramps because of:

  • Endometriosis, a condition in which the tissue lining the uterus (the endometrium) grows outside of the uterus
  • Fibroids in your uterus
  • Adenomyosis, when your uterine lining grows into nearby muscle
  • Pelvic inflammatory disease (PID), an infection caused by bacteria that starts in the uterus and can spread to other reproductive organs
  • Cervical stenosis, or a narrowing of the lower part of your uterus, caused by scarring, as well as a lack of estrogen after menopause

Certain things put you at a higher risk of menstrual cramps. You’re more likely to have them if you:

  • Are under 30
  • Started puberty early, at or before age 11
  • Bleed heavily during periods (menorrhagia)
  • Have irregular menstrual bleeding (metrorrhagia)
  • Have a family history of menstrual cramps
  • Smoke

Menstrual Cramp Treatment

If you have mild menstrual cramps, take aspirin or another pain reliever, such as acetaminophen, ibuprofen, or naproxen. For best relief, take these medications as soon as bleeding or cramping starts.

Heat can also help. Place a heating pad or hot water bottle on your lower back or tummy. A warm bath may also provide some relief.

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Other lifestyle changes that may help:

  • Rest when you need it.
  • Avoid foods with caffeine and salt.
  • Avoid tobacco and alcohol.
  • Massage your lower back and abdomen.
  • Take dietary supplements.
  • Try to manage your stress.
  • Try acupuncture or acupressure.
  • Ask your doctor about herbal medicines.

Women who exercise regularly often have less menstrual pain. To help prevent cramps, make exercise a part of your weekly routine.

If these steps don’t do enough, tell your doctor. They may prescribe medicines such as:

  • Ibuprofen (a higher dose than is available over the counter) or other strong pain relievers
  • Oral contraceptives (Women who take birth control pills have less menstrual pain.)

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