1st Revision: Lara Paulus Menstruation, or periods, is a biological process in the lives of genetically female individuals. It lays the foundation for pregnancy and is regulated by certain hormones. The menstrual cycle typically lasts around 28-40 days and consists of four phases, with the bleeding phase lasting for 3-7 days.
Many women experience period cramps or premenstrual syndrome (PMS) symptoms, which can be due to minor hormonal issues, but at times may signal more serious health conditions. Let's check the reasons why some women experience these cramps and how they can alleviate period pain.
What are menstrual cramps?
Menstrual cramps, or dysmenorrhea, can be painful for some women. Menstrual pain occurs in the lower abdomen area during their periods. Some women feel minor menstrual cramps and go on with their life as usual. While others experience such severe cramps that they need to adjust their lives around their periods.
Causes of menstrual cramps
Menstrual cramps occur due to various reasons. These are classified into two groups:
Primary dysmenorrhea
Primary dysmenorrhea, a common menstrual disorder, occurs when there is no underlying medical condition causing the pain. Pain occurs before or during periods, due to the release of chemicals known as prostaglandins. During periods, the uterine lining sheds because of the regular contraction of uterine muscles. For some women, these contractions are not problematic, while others experience severe contractions. It has been found that higher levels of prostaglandins create severe menstrual cramps.
Secondary dysmenorrhea
Secondary dysmenorrhea, which refers to menstrual pain caused by an underlying medical condition, can be attributed to various conditions such as endometriosis, pelvic inflammatory disease (PID), uterine fibroids, or adenomyosis. These conditions can all contribute to the experience of menstrual cramps.
Menstrual cramps can also occur due to the presence of birth control devices such as the intrauterine device (IUD). This pain is typically felt in thefirst few months after insertion. The IUD is fitted in the uterus to prevent pregnancy, but there may be other associated symptoms such as irregular periods, pain during sex, or bleeding between periods. If you notice any of these changes after getting an IUD, it is better to consult your GP.1
Signs and symptoms of menstrual cramps
Primary dysmenorrhea signs and symptoms may include:1
- Abdominal pain
- Backache
- Pain in thighs
- Nausea
- Vomiting
- Diarrhea
Secondary dysmenorrhea signs and symptoms may include:
- Pain and swelling (mainly in women diagnosed with endometriosis)
- Women experiencing pain, in combination with abnormal bleeding (especially women diagnosed with adenomyosis)
- abdominal pain and pain during sexual intercourse
- Heavy and irregular periods
- Abnormal vaginal discharge
Treatment for menstrual cramps
Menstrual cramps can be caused by various factors, and there are numerous ways in which we can get rid of them. Some treatment options include:
Diet
A higher concentration of estrogen may cause cramps. A diet rich in fibre and fat can help ease menstrual cramps to some extent. Fibre helps in removing excess estrogen from the body. Fibre-rich foods such as broccoli, whole grains, strawberry, banana, chia seed, flax seed or brown rice can be helpful. Protein-rich foods such as fish or eggs are also good for the body.
Exercise
Everyone knows the benefits of exercise, but it also reliefs menstrual cramps. Exercise regulates hormones which relieve severe menstrual cramps. It has been found that exercise not only reduces cramps but also alleviates the symptoms of PMS.2
Hydration
Adequate hydration is the key to a healthy body. It is a good idea to drink water or fluids such as hot chocolate, green tea, raspberry tea, chamomile tea, lemon juice or ginger tea. Water or fluids help in eliminating toxins or excessive hormones from the body. This results in reduction of cramps, bloating and mood swings.³
Pain killers
Nonsteroidal anti-inflammatory drugs (NSAID) such as ibuprofen or aspirin, which are easily available in pharmacy stores, can help relieve menstrual cramps. They reduce the amount of prostaglandins, thus reducing the cramps. These can be taken for1-2 days. People diagnosed with asthma, children under 16, and people with stomach, kidney or liver problems, should not take NSAIDs. If NSAIDs are not effective, it is better to consult a GP.
Hot water bottle
You can use a heat pad or hot water bottle to ease cramps. Heat pads have an adhesive layer to be put on the tummy (not directly on the skin). They require some rubbing to activate them and can be used for up to 8 hours. These are very useful during travel. Hot water bottles require hot water, so they are not a feasible option while traveling, but they do provide good relief. Nowadays, electric hot water bottles are available. They are also a good option if you have difficulties walking to the kitchen for hot water. It is a good pain relief option for women who don't like painkillers.
Yoga
Yoga is an ancient practice for physical as well as mental health. There are several yoga poses for different organs or medical conditions. Try contacting a certified yoga instructor, or watch videos and try to practice the poses regularly. Regular yoga can help ease cramps to some extent. Various yoga poses for menstrual cramps relief are.
- matsyasana (fish pose)
- janu sirsasana (one legged forward bend)
- dhanurasana (bow pose)
- bhujangasana (cobra pose)
- ustrasana (camel pose)
Rest
Rest means giving your body a break from a tedious schedule. Try to sleep for 7-8 hours and follow some relaxation techniques for relief from cramps. You can also try a light massage around your abdomen for some relief.
Warm bath
A warm bath or shower is a great way to ease cramps.
TENS machine
Transcutaneous electrical nerve stimulation (TENS) uses mild electric current to alleviate menstrual cramps. This device uses a battery and has leads attached to electrodes. The pads with electrodes are attached directly to the skin. The machine is switched on and it generates electrical impulses to that area. These impulses reduce pain. They also help in releasing endorphins which are considered natural painkillers. TENS is useful not only for menstrual cramp relief but also during labour, knee pain or arthritis. You can consult your GP before using it.
Hormonal birth control
Birth control is a good idea for menstrual pain relief. Birth control can be taken in the form of pills, patches, rings, injections or an IUD. These reduce the amount of prostaglandin or thin the uterus lining and reduce the painful cramps. Birth control can only be taken after consultation with a gynaecologist as there are some side effects attached to them.
Surgery
Some women have extreme discomfort during periods due to medical conditions such as endometriosis, uterine fibroids or adenomyosis. Doctors might opt for surgery depending on the condition of the patient. Surgery is performed only when other options are ineffective. Some women undergo a hysterectomy which means the removal of the uterus. A hysterectomy is the last resort as women won't be able to get pregnant after this.
Supplements
Some studies suggest Vitamin B or magnesium supplements can ease period pains.
Avoiding alcohol and tobacco
Alcohol and tobacco consumption are linked to bad health. Try reducing your alcohol and tobacco intake and slowly cutting them out of your life. This move might give you some comfort during your periods.
Who are more at risk of menstrual cramps
People with hormonal imbalance and high levels of prostaglandins experience severe menstrual cramps. To some extent, these can be controlled by making healthy lifestyle choices. But sometimes there are some medical causes which need medical attention.
How many hours do menstrual cramps last?
Period pains usually last for 2-3 days. They start when the period begins as prostaglandins are high at this time. As the period progresses, the level of prostaglandins reduces and thus, the pain disappears.
How painful are menstrual cramps
Menstrual cramps can vary in severity among women. For some, they are minor discomfort that can be relieved by resting or using home remedies. However, for others, more intense cramps may require medical intervention such as surgery or medication.
Summary
Menstruation is a vital biological process for maintaining a healthy reproductive system. A normal menstrual cycle should not have a significant impact on mental, physical, or sexual health. Minor discomfort can often be managed at home, but secondary dysmenorrhea requires medical attention. No one should have to suffer from severe menstrual cramps and those who do deserve compassion and care. If you are experiencing cramps, incorporating a healthy diet, regular exercise, and practising yoga poses can help manage primary dysmenorrhea. Remember, menstrual pain should not be endured needlessly, so seek medical assistance if necessary.
References
- Burbeck R, Willig C. The personal experience of dysmenorrhoea: An interpretative phenomenological analysis. J Health Psychol [Internet]. 2014 [cited 2023 May 5]; 19(10):1334–44.
- Daley A. The role of exercise in the treatment of menstrual disorders: the evidence. Br J Gen Pract [Internet]. 2009 [cited 2023 May 5]; 59(561):241–2.
- Torkan B, Mousavi M, Dehghani S, Hajipour L, Sadeghi N, Ziaei Rad M, et al. The role of water intake in the severity of pain and menstrual distress among females suffering from primary dysmenorrhea: a semi-experimental study. BMC Women’s Health [Internet]. 2021 [cited 2023 May 5]; 21(1):40.
