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Menstrual Cramps

Menstrual cramps, or primary dysmenorrhea, are pains in the abdomen that are felt during menstruation. Most women experience menstrual cramps at some time in their life with the pain ranging from mildly uncomfortable to severe and debilitating. Menstrual cramps are most prevalent in young women and if there is no underlying condition (secondary dysmenorrhea) they tend to lessen as you age.

What Causes the Cramps?

Menstruation is the shedding of the lining of the uterus. Each month, this lining builds up in preparation for possible pregnancy. If, after ovulation, the egg has not been fertilized, this lining is no longer needed so estrogen and progesterone hormone levels decrease and the lining begins to break down releasing compounds called prostaglandins. Prostaglandins cause the muscles of the uterus to contract which restricts blood supply to the lining causing the tissue to further break down, and die. These contractions then force the dead tissue out through the cervix. The cramping feeling is caused by these contractions.

Why Does It Hurt So Much?

Prostaglandin levels appear to be higher in women that experience uncomfortable to severe menstrual cramping. Many women compare the pain to that which is felt during labor. The pain can be intensified when there are blood clots or pieces of tissue being passed through the cervix, especially if the passage is narrow. As well, primary dysmenorrhia can be aggravated by factors such as a retroverted or backward-tilting uterus, lack of exercise, and emotional distress.

How Do I Know They Are Menstrual Cramps?

Menstrual cramps usually begin shortly before your period makes its appearance, start to peak after about 24 hours of the commencing of the pain and then slowly decrease over the next day or so. The pain is felt primarily in the lower abdomen and pelvic region and can expand into the legs and lower back. It may be felt as a constant dull ache, or intermittently as the uterine muscle contracts and releases. Some women also experience headache, nausea, and constipation or diarrhea.

When Should I Seek Help for the Pain?

When you are in your teens or early twenties, it is more common than not that you will experience menstrual cramps. If the pain is so severe that it interferes with your daily life, you should see your healthcare provider to investigate the possibility of an underlying condition and to discuss the management of your pain. Primary dysmenorrhia tends to lessen as you age so if you are in your late twenties and beyond and are experiencing uncomfortable cramping and pain during menstruation for the first time, or you are finding that your cramps are getting worse, you should seek medical attention as there may be a secondary health issue developing.

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