What to Do About Menstrual Cramps

Many women suffer from menstrual cramps, which can range from mild to incapacitating. Cramps and pain can come from various conditions. Most are normal aspects of the menstrual cycle, but some may require medical treatment.

What causes menstrual cramps

• Menstrual cramps can range from a feeling of pressure to a dull ache in the abdomen. For some women, these can be accompanied by vomiting, diarrhea, nausea and other general aches and pains throughout the body. Often, pains begin in the lower abdomen and pelvis and may extend to legs and lower back. Cramps are common during menstruation, as the uterus contracts in order to discard the lining that has built up over the previous month. These contractions are controlled by prostaglandins, a natural substance made by the body. Once the uterine lining is discarded, the cycle, which is controlled by hormones directed via the pituitary gland, starts all over again for the next month.

Types of cramping

• Most menstrual cramping is a normal part of the menstrual cycle. Sometimes, cramping ceases after having a child, although not always. Cramps can also change in intensity at different times in a woman's life. The intensity is a function of the level of prostaglandins, which varies for each woman.
  Cramps may also be caused by diseases in the uterus, fallopian tubes or ovaries. Sometimes, these cramps last longer than usual and can cause more severe pain. Pelvic pain and/or pain during sexual intercourse may occur during other times of the monthly cycle. This kind of cramping and pain can be a result of more serious conditions, including uterine fibroids, endometriosis or pelvic inflmmatory disease. If this happens, women should see their gynecologist immediately for diagnosis and treatment. Treatments exist for each of these conditions.

Treatments for cramps

• There are many ways to relieve cramps, including exercise, walking and using a heating pad . Additionally, medications such as nonsteroidal anti-inflammatory drugs like ibuprofen can reduce cramps and discomfort. Some women may need to take higher doses of these medications and should consult with their doctor because this class of medications can cause stomach problems if taken in high doses over time. Usually, it is advisable to start the medication a couple of days before bleeding is expected to start. Sometimes, if a women experiences very heavy bleeding and/or medications are not effective, an endometrial ablation can help. This procedure burns away the lining of the uterus using a heat-generating device. It is a clinical procedure, does not require hospitalization and is done with a short-term anesthetic.

Treatments for more serious conditions

• More extreme pain and discomfort is often caused by benign uterine tumors (fibroids) and/or endometriosis. Fibroids are not uncommon, are fed by estrogen and can often shrink and disappear as women approach menopause. Many women have fibroids but experience no symptoms. When fibroids do cause pain or other discomfort, they can be treated with hormones or medications. In some cases, they may need to be removed surgically.
  A recent new treatment for fibroids is the use of ultrasound. According to a May 30, 2007, article in the Washington Post, lead study author Dr. Fiona M. Fennessy, assistant professor of radiology at Harvard Medical School and staff radiologist at Brigham and Women's Hospital, said, "This treatment immediately stops blood flow in the treated fibroid tissue, which results in a significant, sustained decrease in symptoms for up to 12 months."
  Endometriosis is a condition in which tissue normally found only in the uterine wall grows in other parts of the pelvis. It can cause considerable pain over several days. It can be treated both with medications and, if necessary, through surgery. Since endometriosis can affect fertility, it is important to see a doctor so that it can be diagnosed and treated early on.