Many women experience painful uterine cramps during menstruation. Pain results from ischemia
and muscle contractions. Spiral arteries in the secretory endometrium
constrict, resulting in ischemia to the secretory endometrium. This
allows the uterine lining to slough off.
The myometrium contracts spasmodically in order to push the menstrual fluid through the cervix and out of the vagina. The contractions are mediated by a release of prostaglandins. Dysmenorrhea is the medical term for painful periods.
Painful menstrual cramps that result from an excess of prostaglandin release are referred to as primary dysmenorrhea. Primary dysmenorrhea usually begins within a year or two of menarche, typically with the onset of ovulatory cycles.
Treatments that target the mechanism of pain include non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal contraceptives. NSAIDs inhibit prostaglandin production. With long-term treatment, hormonal birth control reduces the amount of uterine fluid/tissue expelled from the uterus.
Thus, resulting in shorter, less painful menstruation. These drugs are typically more effective than treatments that do not target the source of the pain (e.g. acetaminophen).
Risk factors for primary dysmenorrhea include: early age at menarche, long or heavy menstrual periods, smoking, and a family history of dysmenorrhea. Regular physical activity may limit the severity of uterine cramps.
For many women, primary dysmenorrhea gradually subsides in late second generation. Pregnancy has also been demonstrated to lessen the severity of dysmenorrhea, when menstruation resumes.
However, dysmenorrhea can continue until menopause. 5–15% of dysmenorrhea patients experience symptoms severe enough to interfere with daily activities.
Secondary dysmenorrhea is the diagnosis given when menstruation pain is a secondary cause to another disorder. Conditions causing secondary dysmenorrhea include endometriosis, uterine fibroids, and uterine adenomyosis.
Rarely, congenital malformations, intrauterine devices, certain cancers, and pelvic infections cause secondary dysmenorrhea.
Symptoms include pain spreading to hips, lower back and thighs, nausea and frequent diarrhea or constipation.
If the pain occurs between menstrual periods, lasts longer than the first few days of the period, or is not adequately relieved by the use of non-steroidal anti-inflammatory drugs (NSAIDs) or hormonal contraceptives, patients should be evaluated for secondary causes of dysmenorrhea.
When severe pelvic pain and bleeding suddenly occur or worsen during a cycle, the patient should be evaluated for ectopic pregnancy and spontaneous abortion.
This simple evaluation begins with a urinary pregnancy test and should be done as soon as unusual pain begins, because ectopic pregnancies can be life-threatening.
Menstrual cramps are pains in the belly and pelvic areas that are
experienced by a woman as a result of her menstrual period.
Menstrual cramps are not the same as the discomfort felt duringpremenstrual syndrome (PMS), although the symptoms of both disorders can sometimes be experienced as a continual process. Many women suffer from both PMS and menstrual cramps.
Menstrual cramps can range from mild to quite severe. Mild menstrual cramps may be barely noticeable and of short duration and are sometimes felt just as a sense of heaviness in the belly. Severe menstrual cramps can be so painful that they interfere with a woman's regular activities for several days.
There is a wide spectrum of differences in how women experience menstruation. There are several ways that someone's menstrual cycle can differ from the norm, any of which should be discussed with a doctor to identify the underlying cause:
There is a movement among gynecologists to discard the terms noted above, which although they are widely used, do not have precise definitions. Many now argue to describe menstruation in simple terminology, including:
All these bleeding abnormalities need medical attention; they may indicate hormone imbalances, uterine fibroids, or other problems. As pregnant women may bleed, a pregnancy test forms part of the evaluation of abnormal bleeding.
Vaginal pH is higher and less acidic than normal, the cervix is lower in its position, the cervical opening is more dilated, and the uterine endometrial lining is absent, thus allowing organisms direct access to the blood stream through the numerous blood vessels that nourish the uterus.
All these conditions increase the chance of infection and STI transmission during menstruation.
Sexual intercourse may also shorten the menstrual period. Some sources say that achieving orgasm helps the uterus contract and expel the lining.
However, it is more likely that because semen contains luteinizing hormone (LH) and follicle stimulating hormone (FSH), and the vagina easily absorbs these hormones, the woman's hormone balance is slightly offset and the follicular phase of the menstrual cycle begins earlier.
Similarly, levonorgestrel-releasing intrauterine devices and oral birth control pills alter the default hormone-release cycle, although by different mechanisms such as maintaining a high progestin level throughout a woman's cycle.
The time from LMP until ovulation is, on average, 14.6 days, but with substantial variation both between people and between cycles in any single person, with an overall 95% prediction interval of 8.2 to 20.5 days.
During pregnancy and for some time after childbirth, menstruation is normally suspended; this state is known as amenorrhoea, i.e. absence of the menstrual cycle. If menstruation has not resumed, fertility is low during lactation.
The average length of postpartum amenorrhoea is longer when certain breastfeeding practices are followed; this may be done intentionally as birth control.
The myometrium contracts spasmodically in order to push the menstrual fluid through the cervix and out of the vagina. The contractions are mediated by a release of prostaglandins. Dysmenorrhea is the medical term for painful periods.
Painful menstrual cramps that result from an excess of prostaglandin release are referred to as primary dysmenorrhea. Primary dysmenorrhea usually begins within a year or two of menarche, typically with the onset of ovulatory cycles.
Treatments that target the mechanism of pain include non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal contraceptives. NSAIDs inhibit prostaglandin production. With long-term treatment, hormonal birth control reduces the amount of uterine fluid/tissue expelled from the uterus.
Thus, resulting in shorter, less painful menstruation. These drugs are typically more effective than treatments that do not target the source of the pain (e.g. acetaminophen).
Risk factors for primary dysmenorrhea include: early age at menarche, long or heavy menstrual periods, smoking, and a family history of dysmenorrhea. Regular physical activity may limit the severity of uterine cramps.
For many women, primary dysmenorrhea gradually subsides in late second generation. Pregnancy has also been demonstrated to lessen the severity of dysmenorrhea, when menstruation resumes.
However, dysmenorrhea can continue until menopause. 5–15% of dysmenorrhea patients experience symptoms severe enough to interfere with daily activities.
Secondary dysmenorrhea is the diagnosis given when menstruation pain is a secondary cause to another disorder. Conditions causing secondary dysmenorrhea include endometriosis, uterine fibroids, and uterine adenomyosis.
Rarely, congenital malformations, intrauterine devices, certain cancers, and pelvic infections cause secondary dysmenorrhea.
Symptoms include pain spreading to hips, lower back and thighs, nausea and frequent diarrhea or constipation.
If the pain occurs between menstrual periods, lasts longer than the first few days of the period, or is not adequately relieved by the use of non-steroidal anti-inflammatory drugs (NSAIDs) or hormonal contraceptives, patients should be evaluated for secondary causes of dysmenorrhea.
When severe pelvic pain and bleeding suddenly occur or worsen during a cycle, the patient should be evaluated for ectopic pregnancy and spontaneous abortion.
This simple evaluation begins with a urinary pregnancy test and should be done as soon as unusual pain begins, because ectopic pregnancies can be life-threatening.
Menstrual cramps facts
- 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 seven of these women.
- Medically, menstrual cramps are called dysmenorrhea.
- Primary dysmenorrhea is common menstrual cramps 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.
What are menstrual cramps?
Menstrual cramps are not the same as the discomfort felt duringpremenstrual syndrome (PMS), although the symptoms of both disorders can sometimes be experienced as a continual process. Many women suffer from both PMS and menstrual cramps.
Menstrual cramps can range from mild to quite severe. Mild menstrual cramps may be barely noticeable and of short duration and are sometimes felt just as a sense of heaviness in the belly. Severe menstrual cramps can be so painful that they interfere with a woman's regular activities for several days.
There is a wide spectrum of differences in how women experience menstruation. There are several ways that someone's menstrual cycle can differ from the norm, any of which should be discussed with a doctor to identify the underlying cause:
There is a movement among gynecologists to discard the terms noted above, which although they are widely used, do not have precise definitions. Many now argue to describe menstruation in simple terminology, including:
- Cycle regularity (irregular, regular, or absent)
- Frequency of menstruation (frequent, normal, or infrequent)
- Duration of menstrual flow (prolonged, normal, or shortened)
- Volume of menstrual flow (heavy, normal, or light)
All these bleeding abnormalities need medical attention; they may indicate hormone imbalances, uterine fibroids, or other problems. As pregnant women may bleed, a pregnancy test forms part of the evaluation of abnormal bleeding.
Menstruation and sexual activity
Sexual intercourse during menstruation does not cause damage in and of itself, but the woman's body is more vulnerable during this time.Vaginal pH is higher and less acidic than normal, the cervix is lower in its position, the cervical opening is more dilated, and the uterine endometrial lining is absent, thus allowing organisms direct access to the blood stream through the numerous blood vessels that nourish the uterus.
All these conditions increase the chance of infection and STI transmission during menstruation.
Sexual intercourse may also shorten the menstrual period. Some sources say that achieving orgasm helps the uterus contract and expel the lining.
However, it is more likely that because semen contains luteinizing hormone (LH) and follicle stimulating hormone (FSH), and the vagina easily absorbs these hormones, the woman's hormone balance is slightly offset and the follicular phase of the menstrual cycle begins earlier.
Similarly, levonorgestrel-releasing intrauterine devices and oral birth control pills alter the default hormone-release cycle, although by different mechanisms such as maintaining a high progestin level throughout a woman's cycle.
Menstruation and pregnancy
Menstruation is the most visible phase of the menstrual cycle, and corresponds closely with the hormonal cycle, and is therefore used as the limit between cycles; Menstrual cycles are counted from the first day of menstrual bleeding, a point in time commonly termed last menstrual period (LMP).The time from LMP until ovulation is, on average, 14.6 days, but with substantial variation both between people and between cycles in any single person, with an overall 95% prediction interval of 8.2 to 20.5 days.
During pregnancy and for some time after childbirth, menstruation is normally suspended; this state is known as amenorrhoea, i.e. absence of the menstrual cycle. If menstruation has not resumed, fertility is low during lactation.
The average length of postpartum amenorrhoea is longer when certain breastfeeding practices are followed; this may be done intentionally as birth control.
Causes Of Menstrual Cramps?
Menstrual cramps are caused by contractions in the uterus,
which is a muscle. The uterus, the hollow, pear-shaped organ where a
baby grows, contracts throughout a woman's menstrual cycle.
If the
uterus contracts too strongly, it can press against nearby blood
vessels, cutting off the supply of oxygen to the muscle tissue of the
uterus. Pain results when part of a muscle briefly loses its supply of
oxygen.
How Can I Relieve Mild Menstrual Cramps?
To relieve mild menstrual cramps:
- Take aspirin or another pain reliever, such as Tylenol (acetaminophen), Motrin (ibuprofen) or Aleve (naproxen). (Note: For best relief, you must take these medications as soon as bleeding or cramping starts.)
- Place a heating pad or hot water bottle on your lower back or abdomen. Taking a warm bath may also provide some relief.
To relieve menstrual cramps, you should also:
- Rest when needed.
- Avoid foods that contain caffeine and salt.
- Avoid smoking and drinking alcohol.
- Massage your lower back and abdomen.
Women
who exercise regularly often have less menstrual pain. To help prevent
cramps, make exercise a part of your weekly routine.
If these steps do not relieve pain, your health care provider can order medications for you, including:
- Ibuprofen (higher dose than is available over the counter) or other prescription pain relievers
- Oral contraceptives (Women taking birth control pills have less menstrual pain.)
How Do Problems With Reproductive Organs Cause Menstrual Cramps?
When
a woman has a disease in her reproductive organs, cramping can be a
problem. This type of cramping is called secondary dysmenorrhea.
Conditions that can cause secondary dysmenorrhea include:
- Endometriosis, a condition in which the tissue lining the uterus (the endometrium) is found outside of the uterus
- Pelvic inflammatory disease, an infection caused by bacteria that starts in the uterus and can spread to other reproductive organs
- Stenosis (narrowing) of the cervix, the lower part of the uterus (the hollow, pear-shaped organ where a baby grows), often caused by scarring
- Tumors (also called "fibroids"), or growths on the inner wall of the uterus
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