Menstrual cramps (dysmenorrhea) are dull, throbbing or cramping pains in the lower abdomen. Many women experience menstrual cramps just before and during their menstrual periods. For some women, the discomfort is merely annoying. For others, it can be severe enough to interfere with everyday activities for a few days every month.
Menstrual cramps may be caused by identifiable problems, such as endometriosis or uterine fibroids. Treating the underlying cause is key to reducing the pain. Menstrual cramps that aren't caused by some underlying condition tend to lessen with age and often disappear once a woman has given birth.
Symptoms of menstrual cramps include:
Some women also experience:
When to see a doctor
During menstrual periods, your uterus contracts to help expel its lining. Hormone-like substances (prostaglandins) involved in pain and inflammation trigger the uterine muscle contractions. Higher levels of prostaglandins are associated with more severe menstrual cramps.
Many experts believe that severe contractions constrict the blood vessels feeding the uterus. The resulting pain can be compared to the angina that occurs when blocked coronary arteries starve portions of the heart of food and oxygen.
Menstrual cramps also may be caused by:
Risk factors associated with dysmenorrhea include:
Menstrual cramps have no medical complications in themselves, but they often interfere with school, work and social activities.
The diseases and conditions sometimes associated with menstrual cramps may have complications, though. For example, endometriosis can cause fertility problems, while pelvic inflammatory disease can scar your fallopian tubes, increasing the risk of a fertilized egg implanting in the tube (ectopic pregnancy) instead of in your uterus.
Preparing for your appointment
While you may initially see your family physician, he or she may refer you to a gynecologist. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions ahead of time will help you make the most of your time together. List your questions from most important to least important, in case time runs out. For menstrual cramps, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
What you can do in the meantime
Tests and diagnosis
Your doctor will review your medical history and perform a physical examination, including a pelvic exam. During the pelvic exam, your doctor will check for any abnormalities in your reproductive organs and look for signs of infection.
In some cases, if your doctor suspects that your menstrual cramps are being caused by an underlying disorder, he or she may order one or more of the following tests:
Treatments and drugs
Menstrual cramps are a treatable condition. Your doctor may recommend:
Lifestyle and home remedies
Soaking in a hot bath or using a heating pad on your lower abdomen appears to be just as effective as over-the-counter pain medication for relieving menstrual cramps.
Alternative therapeutic approaches to menstrual cramps include:
Last Updated: 2011-05-03
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