• Menstrual cramps are periodic abdominal and pelvic pains experienced by women.
• More than half of all menstruating women have cramps.
• The cramps are severe in at least one in four of these women.
• Medically, menstrual cramps are called dysmenorrhea.
• Primary dysmenorrhea is a common menstrual cramp without an identifiable cause.
• Secondary dysmenorrhea results from an underlying abnormality that usually involves the woman’s reproductive system.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat cramps.
• Physical exercise can help alleviate menstrual cramps.
• Menstrual cramps tend to improve with age.
1. Menstrual cramps usually begin before the onset of menstrual period, peak within 24 hours after the start of the bleeding, and subside again after a day or two.
2. Menstrual cramps are pains that begin in the lower abdomen and pelvis. The discomfort can extend to the lower back or legs.
3. Menstrual cramps can be quite painful or merely a dull ache.
4. The pain can be periodic or continuous.
5. Pain may be felt in the inner thighs or hips.
Menstrual cramps may be accompanied by a headache and or nausea, which can lead, although infrequently, to vomiting. Either constipation or diarrhea can also accompany menstrual cramps because the prostaglandins, which cause smooth muscles to contract, also affect the intestinal tract. Some women experience an urge to urinate more frequently.
• An unusually narrow cervical canal tends to increase menstrual cramps.
• Another anatomical factor that may contribute to menstrual cramps is a retroverted uterus (the uterus tilts backward instead of forwarding).
• Lack of exercise is now recognized to contribute to painful menstrual cramps because exercise releases endorphins that relieve pain.
• It has long been thought that psychological factors also play a role. For example, it is widely accepted that emotional stress can increase the discomfort of menstrual cramps.
• Adenomyosis and endometriosis can increase the severity of menstrual cramps
• Having uterine fibroids can worsen menstrual cramping
Every woman needs to find a treatment that works for her. There are several possible remedies for menstrual cramps.
Current recommendations include not only adequate rest and sleep but also regular exercise (especially walking). Some women find that abdominal massage, yoga, or orgasmic sexual activity may bring relief. A heating pad applied to the abdominal area may relieve the pain and congestion.
Several nonprescription (over-the-counter) agents can help control the pain as well as prevent the menstrual cramps altogether. For mild cramps, aspirin, acetaminophen (Tylenol), or acetaminophen plus a diuretic (Diurex MPR, FEM-1, Midol, Pamprin, Premsyn, and others) may be sufficient. However, aspirin has a limited effect in curbing the production of prostaglandin, and it is only useful for less painful cramps.
The main agents for treating moderate menstrual cramps are nonsteroidal anti-inflammatory drugs (NSAIDs), which lower the production of prostaglandin and lessen its effect. The NSAIDs that do not require a prescription are:
• ibuprofen (Advil, Midol IB, Motrin, Nuprin, and others);
• naproxen sodium (Aleve, Anaprox); and
• ketoprofen (Actron, Orudis KT).
A woman should start taking one of these medications before her pain becomes difficult to control. This might mean starting medication 1 to 2 days before her anticipated period is due, and then continuing taking the drug for the first one to two days of her period. The best results are obtained by choosing one of the NSAIDs on a scheduled basis and not waiting for the pain to begin.
Prescription NSAIDs available for the treatment of menstrual cramps include mefenamic acid (Ponstel) and meclofenamate (Meclomen).
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