Period Cramps: How to Feel Better & When to Seek Help

Although many women experience menstrual cramping, for some women, cramps can be more than just an annoyance. For about 50% of women, cramps negatively impact their quality of life,and are the leading cause of recurrent absenteeism from work or school among reproductive age women in the United States. The scientific term for painful menstrual cramps is dysmenorrhea. To help you learn more about this condition and whether you may be experiencing it, we’ve put together answers to some of the most commonly asked questions about the topic. At Diana Health, we believe it’s valuable for you to be educated so that you can make informed decisions about your health care. 

What causes menstrual cramps?

Menstrual cramping before or during a period is thought to be caused when endometrial cells (the cells that line the inside of the uterus), are sloughed off during menstruation (the menstrual blood that comes from the uterus and out of the vagina). These endometrial cells release prostaglandins that can cause the uterus (which is actually a muscle) to contract. There also may be a transient decrease in blood supply during this time which may increase the pain. Although prostaglandins are natural chemicals, some women have more cramping pain than other women, when these prostaglandins are released. 

Is this all that can cause menstrual pain? 

The above description is for what is called primary dysmenorrhea, when there isn’t another underlying pelvic problem that is causing the pain. In addition to primary dysmenorrhea, painful menstruation may be due to other problems such as endometriosis (when cells that are usually supposed to be inside of the uterus are in places outside of the uterus and cause pain during menstruation) or ovarian cysts. 

What can I do to decrease painful menstruation, besides take an over-the-counter or prescription medication?

Nutrition: 

Some research has shown that women who consume more sugar, salty and sweet snacks, desserts, fruit juices, soft drinks, and processed meat and/or red meat may experience more primary dysmenorrhea. Eating high-quality foods that are high in fiber (such as vegetables, fruits, whole grains, beans, nuts, and seeds) may help decrease pain associated with menstrual cramping. Some small studies have even suggested that rose tea and green tea may be associated with less menstrual pain.  

Physical Activity: 

Although the evidence is limited, there is some research that suggests that aerobic activity may decrease the intensity of painful uterine cramping. There is other research that suggests that low intensity exercise including yoga and stretching, may be the most beneficial for women with primary dysmenorrhea. 

Stress Management:

Women who have high levels of psychological stress during the follicular phase of the menstrual cycle, seem to have higher levels of primary dysmenorrhea. As stress intensity increases, dysmenorrhea severity may increase too. There is some research suggesting that pain management training, relaxation, and/or aromatherapy may support decreasing primary dysmenorrhea symptoms. 

Sleep: 

Women who have more severe insomnia seem to have more severe primary dysmenorrhea. Also, women who have primary dysmenorrhea report worse sleep quality, lower alertness and daytime energy, and higher daytime sleepiness. It isn’t known whether the dysmenorrhea causes the sleep disruption or if the sleep disruption contributes to the increased pain. 

Heat Therapy: 

Local heat therapy using heated pads or patches has been found to decrease primary dysmenorrhea in some women. For some women, local heat may be as effective as over-the-counter pain medication. If using heat therapy, just make sure that it is not too hot or that a heated device is not placed directly on the skin, due to the risk of burns. 

Substance use: 

There seems to be a relationship between the number of cigarettes that someone has smoked and the relative risk of primary dysmenorrhea. If you smoke, painful menstruation is just one of many reasons to seek help for quitting. 

When should I see my healthcare team? 

If you are struggling with painful menstruation, we encourage you to speak with a healthcare provider, whether that’s Diana Health or your preferred provider. Painful menstruation is not just something that you have to accept!

Since there are causes of painful menstruation that can be caused by other pelvic problems (such as endometriosis or ovarian cysts), if your periods are becoming more painful, if you have a particularly painful period, or if they are negatively impacting your life, please reach out. There is help available. Your healthcare practitioner will learn more about your cramping and help determine if additional tests (such as a pelvic ultrasound), bloodwork, or other evaluation is indicated. They may suggest medication to help with your painful menstruation that is over-the-counter or prescription. Regardless, it is best to reach out to a healthcare provider so that they can help you navigate what is best for you and engage in shared decision making. Also, if you are experiencing nausea, vomiting, a fever, or heavy menstrual bleeding along with your pain, it is very important that you see a healthcare provider

Although there are healthy lifestyle suggestions listed above, they should not be considered replacing medical care or the advice of your healthcare practitioner. 

At Diana Health, we know that menstrual cramps can be a big deal and disruptive to your life. We are here to support you with education, shared decision making, and a comforting shoulder to lean on every step of the way. Book a visit with us today either in person or virtually.

For more information about menstrual health, visit our menstrual health blog.