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Menstrual Cramps

Overview

Menstrual cramps are throbbing or sharp pain in the lower abdomen before or during the menstrual cycle. Some degree of pain during menses is normal, but too much pain that disrupts your daily activities needs to be addressed. In medical terms, menstrual cramps are known as dysmenorrhea. Different women experience different degrees of pain and cramps during their period cycle. If it affects your overall performance and efficiency, you may need medications or other remedies to ease the cramps. Generally, menstrual cramps tend to improve with age or after childbirth if they are not caused by an underlying condition. 

Causes

When your menstrual cycle begins, hormone-like substances known as prostaglandins are released to contract your uterus muscles and shed their inner lining. These contractions can be tolerable in some cases and may be painful in others. Higher levels of prostaglandins can cause more degrees of pain. Period pain or menstrual cramps can also result from certain underlying medical conditions. One of such conditions is endometriosis. In this condition, tissues from the uterine lining grow outside the uterus on other parts of the body. Premenstrual syndrome (PMS) can also cause menstrual cramps before your period cycle begins. Other medical conditions include fibroids in the uterus, adenomyosis, pelvic inflammatory disease (PID), and cervical stenosis.

Risk Factors And Epidemiology

The risk of menstrual cramps has been noticed to be associated with age. Women under the age of 30, particularly those younger than 20, are more likely to experience menstrual cramps. Girls who reach puberty earlier than normal (age 11 or younger) may also suffer from frequent menstrual cramps. Heavy or irregular bleeding during your period cycle is also considered as a potential risk factor. Family history of period pain can increase the likelihood of developing this issue. Smoking, irregular diet, obesity and depression has also been seen to be linked with painful periods.

 

The risk of menstrual cramps decreases with increasing age as your body prepares you to reach menopause. According to research, approximately 10 to 15% of females suffer from menstrual cramps each month that are painful enough for them to miss school or work. 

Signs And Symptoms

The predominant sign of menstrual cramps is throbbing pain that begins in your lower abdomen where your uterus is located. The pain may begin 1 to 3 days earlier than your expected period date and reaches its peak during the first 24 hours of bleeding. Eventually it subsides within 2 to 3 days in most cases. You may also experience it as a constant dull ache in the lower abdomen. In severe cases, this pain may also radiate to your thighs and lower back region. Some females also suffer from other symptoms such as nausea, headache, diarrhea, constipation, bloating, dizziness, sweating and weakness. 

Diagnosis

Menstrual cramps can be diagnosed on the basis of symptoms that are experienced every month. If they are mild, no further tests are required. In moderate to severe cases, it is important to diagnose the underlying cause. Your doctor will require your history and may perform a pelvic examination. If a medical condition is suspected, your doctor may perform suitable imaging tests, which may include an ultrasound of the lower abdomen, CT scan or MRI. These tests can help in visualizing your uterus, cervix, ovaries and fallopian tubes to check for any abnormality. In rare instances, a laparoscopy may be required to have a close view of your reproductive organs. 

Differential Diagnosis

Other conditions that may present with similar symptoms include endometriosis, obstruction of the reproductive tract, adnexal cysts, adnexal torsion, sexually transmitted diseases (STDs), chronic pelvic pain, pelvic inflammatory disease, ectopic pregnancy, urinary tract infections or irritable bowel syndrome. Differentiation can be done on the basis of history, symptoms and diagnostic tests. 

Treatment

Treatment depends on the severity of your condition. If you have mild to moderate pain, your symptoms may ease using over-the-counter painkillers. Several home remedies are recommended to lessen menstrual cramps, but only few of them are effective. Placing a heating pad on your lower abdomen may help with the pain. Balanced diet and regular exercise is also recommended on period-free days. Some studies suggest that dietary supplements can also help relieve symptoms of dysmenorrhea.

In moderate to severe cases, the treatment options may vary. Oral birth control pills are prescribed in certain cases as they prevent ovulation and can lessen period pain. If menstrual cramps are caused by a medical conditions such as endometriosis or uterine fibroids, surgical options can be considered. Complete removal of the uterus is also another option if no other treatment measures are effective enough.

 

Pain killers such as ibuprofen, naproxen, acetaminophen, etc., can help relieve menstrual cramps to a certain extent. Hormonal birth control in the form of oral pills, patches, implants, vaginal rings, or intrauterine devices (IUD) can be suggested to ease the symptoms. 

Prognosis

Menstrual cramps may persist in your teenage or 20s, but they can be managed with the help of medications and home remedies. If menstrual cramps occur irregularly outside of your expected period dates, it is better to consult a doctor as it may be a sign of a medical condition. 

Prevention

Maintain a balanced diet with all necessary vitamins, minerals, and fatty acids. Exercise regularly to stay physically fit and improve overall health. Yoga, meditation, and mindfulness exercises are also useful. Avoid smoking as it may contribute to the occurrence of menstrual cramps. 

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