Understanding & Managing Menstrual Cramps

Menstrual cramps, also known as dysmenorrhea, i.e. the severe lower abdominal pain, right before or at the onset of menstruation, sometimes felt in the back or the thighs, and which may or may not be associated with diarrhoea, vomiting, headaches and fatigue,  is a common experience for many women and significantly impacts day to day  living and well-being. While the mechanism of menstrual cramps are not fully understood, the little we know and understand of it  could be essential for empowering women to manage their menstrual health effectively and seek appropriate support. 

In this article, we will explore some physiology behind menstrual cramps – factors that contribute to their occurrence and exacerbation, various coping mechanisms and relief strategies, and when to seek professional help.

During menstruation, the uterus contracts to shed its lining. These contractions are triggered by an increase in the production of  prostaglandins, hormones that cause the muscles and blood vessels of the uterus to contract. The more prostaglandins, the stronger the contractions and the more likely we'll experience cramps. Hormonal imbalances, uterine abnormalities, and conditions like endometriosis can also contribute to the intensity of cramps.

Various factors contribute to the occurrence and severity of menstrual cramps. Genetics and family history may play a role in determining susceptibility to more severe cramps. Young age (<30), early menarche (starting your period before age twelve), heavy menstrual flow and past sexual assault also increase your chances of dysmenorrhea.  Hormonal imbalances, such as excessive prostaglandin production or dysregulation of oestrogen and progesterone, also contribute to the intensity of cramps. Uterine abnormalities, such as fibroids or polyps, and conditions like endometriosis and adenomyosis worsen the inflammation and pain perception during menstruation.

As we age, our menstrual cycle and cramp patterns can change. Adolescents often experience more irregular cycles and intense cramps, improving over time. On the other hand, perimenopause and menopause bring new challenges and changes to our periods. While some individuals may experience mild discomfort that does not significantly interfere with their routine, others may face more intense pain that hinders work, relationships, and mental well-being.

Coping Strategies for Relief

When it comes to managing menstrual cramps, there are several strategies you can try. Over-the-counter pain relievers such as ibuprofen (Advil) and acetaminophen (Tylenol) can help alleviate discomfort. Applying heat to your lower abdomen through a warm compress, hot water bottle, or heating pad can also provide relief. Engaging in relaxation techniques such as yoga or meditation, exercise, and other self-care practices can help ease cramps too.

Diet during menstruation can also be important in relieving symptoms. A low fat, vegetable-rich diet has proved beneficial in some women. Certain teas and herbs such as rose tea, red raspberry tea, and ginger tea,  have also been said to make a difference. Some supplements such as Vitamin B1, Omega 3-fatty acids, and Magnesium, have shown some decrease in symptoms. 

If your cramps are severe, significantly impact your daily life, or if you suspect an underlying condition, it's a good idea to consult a healthcare professional. They can provide tailored advice and recommend appropriate treatments to help manage your symptoms.

Each person's experience with menstrual cramps is unique. What matters most is finding what works best for you. By understanding the causes, exploring coping strategies, and seeking support when needed, we can navigate our menstrual cycles with greater comfort and confidence.

Take care of yourself and embrace open conversations about menstrual health. You're not alone in this journey!

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References

• Barcikowska Z, Rajkowska-Labon E, Grzybowska ME, Hansdorfer-Korzon R, Zorena K. Inflammatory Markers in Dysmenorrhea and Therapeutic Options. International Journal of Environmental Research and Public Health. 2020; 17(4):1191. https://doi.org/10.3390/ijerph17041191
• Coco AS. Primary dysmenorrhea. Am Fam Physician. 1999 Aug;60(2):489-96. PMID: 10465224.
• Ferries-Rowe, Elizabeth MD, MA; Corey, Elizabeth MD, MPH; Archer, Johanna S. VMD, MD. Primary Dysmenorrhea: Diagnosis and Therapy. Obstetrics & Gynecology 136(5):p 1047-1058, November 2020. | DOI: 10.1097/AOG.0000000000004096