We call the pains related to periods (before and during) as dysmenorrhea or menstrual cramps. 50% women report having cramps, 15% have severe cramps and about 90% adolescent girls have cramps. Cramps are of two types – Primary and secondary.

In primary, pain is usually felt in lower abdomen and back, may radiate to legs. It is usually mild. Painful periods indicate ovulatory cycles. It may start shortly before or at the onset of periods and may last for 2-3 days. Pain becomes less after women has her first baby.

In secondary, pain is caused by any disorder of the reproductive organs. This pain is usually more severe in intensity and longer in duration than the common cramps.

Symptoms of menstrual cramps :

Pain in abdomen

• Pressure sensation
• Pain in back, thighs
• Stomach upset
• Nausea, vomiting
• Diarrhoea
• Headache
• Dizziness
• Constipation
• Bloated abdomen

Reason for menstrual cramps:

Each month lining of uterus builds up in preparation of pregnancy and if no pregnancy occurs, the lining sheds due to hormonal interplay.

• Contraction of Uterus
• Blood vessels are momentarily pressed by the muscles and blood supply is occluded causing ischemic pain in uterus due to the vasoconstriction
• Hormones called as prostaglandins cause pain
• Passage of thick clot or tissue causes pain

Prevention of menstrual cramps :

• Exercise
• Reduce stress
• Eat fruits and vegetables
• Quit smoking
• Relaxation
• Yoga
• Meditation
• Acupuncture

Treatment of menstrual cramps :

• Hot fomentation- Place a heating pad or hot water bottle on lower abdomen and back. Take a warm bath
• Mild pain killers – Take medication as soon as bleeding or cramps start, don’t wait for pain to worsen
• Physical exercise- Routine exercise helps as natural pain killers called endorphins are secreted during exercise. Physical fitness is helpful in many other ways also
• Oral contraceptive pills help
• Healthy diet

If pain is severe and associated with other symptoms visit your doctor for reassurance and detection of any other problem. You will have to give history, undergo examination and some tests. Medical problems which can lead to severe cramps are:

•  Endometriosis
• Fibroid uterus
• Pelvic infection
• Adenomyosis
• Cervical stenosis
• Retroverted uterus