Menstrual Cramps

Menstrual cramps are painful cramps girls get in their lower abdomen before and during their monthly period.

Menstrual cramps can range from a mild throbbing to severe pain that interferes with daily activities.

In some cases, girls won’t begin having cramps until several years after their periods have started. As women age, menstrual cramps usually become less frequent and less painful. Many women stop having cramps after going through childbirth.

Patients can be seen by Texas Children's experts in Pediatric and Adolescent Gynecology.

Causes & Risk Factors

Menstrual cramps occur when the uterus – which is a muscle – repeatedly tightens and then relaxes to push menstrual blood out of the body. During these contractions, chemicals are released that increase the intensity and pain of the contractions

In some cases, menstrual cramps may be caused by underlying health conditions, including:

• Endometriosis – a condition in which tissue normally found in the lining of a woman’s uterus grows elsewhere in the body
• Uterine fibroids – noncancerous growths in the wall of the uterus
• Adenomyosis –a condition in which the tissue lining the uterus grows into the muscular walls of the uterus
• Pelvic inflammatory disease (PID) – an infection of the female reproductive organs usually caused by sexually transmitted bacteria
• Cervical stenosis –a condition in which the opening of the cervix is too small. The proper menstral flow is reduced, causing painful pressure within the uterus

Symptoms & Types

Menstrual cramps are sometimes referred to as dysmenorrhea, which means “difficult or painful periods.” There are two types of dysmenorrhea:

• Primary dysmenorrhea – common menstrual cramps that may start a few days before a monthly period and last several days.
• Secondary dysmenorrhea – menstrual cramps that are the result of an underlying medical condition

Symptoms of menstrual cramps include:

• Dull, throbbing or cramping pain in the lower belly
• Pain that spreads to the lower back and thighs
• Nausea
• Vomiting
• Diarrhea
• Bloating
• Sweating
• Dizziness

Diagnosis & Tests

Diagnosis starts with a thorough medical history and physical exam, including a pelvic exam.

If an underlying health condition is suspected as the cause of the menstrual cramps, additional testing may include:

• Imaging – such as ultrasound,CT (computerized tomography) scan, or MRI (magnetic resonance imaging) to create images of the internal organs
• Laparoscopy or hysteroscopy – minimally invasive procedures that use tiny scopes to view internal organs

Treatment & Care

Treatment depends on the individual and the severity of symptoms. Treatment strategies include:

• Medications – to relieve the pain, including over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, or prescription NSAIDs
• Hormonal birth control – to prevent ovulation and reduce the severity of menstrual cramps; available as injections, a patch, an implant under the skin, or a flexible ring inserted in the vagina
• Surgery – to address any underlying condition, such as endometriosis or fibroids
• Lifestyle and home remedies – such as a hot bath or heating pad
• Exercise
• Alternative approaches – including acupuncture or transcutaneous electrical nerve stimulation (TENS) that release endorphins, your body's natural painkillers