Menstrual Cramps (Dysmenorrhea)
What are menstrual cramps?
Menstrual cramps cause pain in your the lower abdomen during
the first few days of your menstrual period. Sometimes the
pain radiates to lower back or both thighs. Some girls also
have nausea, vomiting, diarrhea, or dizziness along with
cramps.
What is the cause?
More than 50% of girls and women have cramps during their
menstrual periods. The cramps are caused by strong
contractions (and sometimes spasms) of the muscles in the
uterus as it expels menstrual blood.
Menstrual periods usually are not painful during the first 1
to 2 years after a girl has started having periods.
However, once ovulation (the release of an egg from the
ovary) begins, the level of progesterone in the bloodstream
increases and leads to stronger contractions and some
cramps.
How long do they last?
Cramps last 2 or 3 days and usually occur with each
menstrual period. There are several drugs that can lessen
the pain to a very mild level. The cramps often disappear
permanently after your first pregnancy and delivery,
probably because the opening of the uterus has stretched.
How can I take care of myself?
- Pain relief: Ibuprofen (Advil, Motrin, and Nuprin)
or naproxen (Aleve) are excellent drugs for menstrual
cramps. They not only decrease the pain but also
decrease contractions of the uterus. You do not need
a prescription to get ibuprofen in 200 mg tablets or
naproxen in 220-mg tablets.
For ibuprofen, you can take 2 tablets 3 times a day.
Take 3 tablets (600 mg) as the first dose. For
naproxen, you can take 1 tablet 3 times a day. Start
with 2 tablets (440 mg). Start taking the drug as
soon as there is any menstrual flow, or even the day
before, if possible. Don't wait until your menstrual
cramps begin. Ibuprofen or naproxen should make you
feel well enough not to miss anything important.
Never take both drugs together.
If you don't have these drugs, you can take acetaminophen
(Tylenol) until you can get ibuprofen or naproxen.
- Heat: A heating pad or warm washcloth applied to the
area of pain may be helpful. A 20-minute warm bath
twice a day may also reduce the pain.
- Aggravating factors: If you are tired or upset, the pain
will seem more severe. Try to avoid getting exhausted
or too little sleep during menstrual periods. If you
have troubles or worries, talk to someone about them.
- Full activity during menstrual cramps: Do not miss any
school, work, or social activities because of menstrual
cramps. If the pains are limiting your activities even
though you are using ibuprofen or naproxen, ask your
health care provider about stronger prescription
medicine.
- Common mistakes: A common mistake is to go to bed when
the cramps are bad. However, people who are busy
usually notice their pain less. There are absolutely no
restrictions on your activities. You can go to school,
take gym, swim, take a shower or bath, wash your hair,
go outside in bad weather, date, etc. during your
menstrual periods.
When should I call my health care provider?
Call IMMEDIATELY if:
- The pain becomes severe and is not relieved by
ibuprofen or naproxen.
- You develop an unexplained fever (over 100°F).
- You start feeling very sick.
Call during office hours if:
- Ibuprofen or naproxen do not give adequate pain
relief.
- The menstrual cramps cause you to miss school or other
important activities.
- You have other concerns or questions.
Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
Copyright © 2006 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.