Menstrual Cramps (Period Pain) – Causes and Treatment

Menstrual Cramps or Dysmenorrhea is the pain experienced during the periods by women. Most females experience pain in lower abdomen in every cycle, while others might not feel any sort of pain at all. Slight pain and discomfort during menstruation is normal but excessive, debilitating pain can indicate something serious and should be seriously adressed.

Location of pain

Pain is experienced in the pelvis, lower abdomen, lower back, and even legs.

Character of pain

Pain is aching and gripping, ranging from mild to moderate in intensity. If pain is severe, you should see a doctor for this, as it might indicate an underlying condition.

Duration of pain

Most females experience pain in the first 3 days and it goes away in the preceding days of their menstruation. Some females also experience similar pain around the time of ovulation and are known as ovulation pain. Most females have noted that their periods become less painful after the birth of the first baby.


Menstrual cramps are experienced in the form of aching pain along with a feeling of fullness and pressure and the abdomen. Some other associated symptoms, females can experience along with the pain are:

  • An upset stomach
  • Nausea and vomiting
  • Diarrhea or sometimes constipation
  • Headaches particularly migraine
  • Dizziness
  • Heavy and irregular bleeding
  • Passing of blood clots with menstrual blood


During menstruation, the uterus sheds its lining, and uterine muscles contract for the expulsion of this layer. These contractions are responsible for the pain and discomfort during the period. Menstrual cramps or Dysmenorrhea can be primary as well as secondary. Causes of both are listed as under

Primary dysmenorrhea:

This is primarily due to high prostaglandin levels that are associated with severe menstrual cramps due to uterine contractions caused by these.

Secondary dysmenorrhea:

Severe Menstrual Cramps which affect your day to day life can be caused by:

  • Endometriosis, in which endometrial tissue that lies outside the uterus, bleeds as well and causes inflammation in the peritoneum or abdomen.
  • Uterine fibroids, these growths in the uterine walls can be painful when contractions occur.
  • Pelvic inflammatory disease is an infection of reproductive organs and causes widespread inflammation which is the cause of painful menstruation.
  • Stenosis of the cervix: Some females have a smaller opening of the cervix, that does not allow proper flow of menstrual blood from the uterus, to the vagina. This leads to the pooling of blood in the uterus and thus the feeling of increased pressure. If the blood remains in the uterus for long, this can also cause infection and sepsis.
  • Adenomyosis, in which the endometrial lining grows into the muscular wall of the uterus. This results in inflammation, pressure, and pain along with longer and heavier menstruation.

Risk factors

Some women are more at risk of having menstrual cramps than others:

  • Age younger than 30
  • Early menarche
  • Heavy bleeding (menorrhagia)
  • Irregular menstrual cycle as in PCOS
  • Family history
  • Smokers
  • Obese


Primary dysmenorrhea can be evaluated and diagnosed by taking a detailed history of the patient’s symptoms. However, secondary dysmenorrhea requires some diagnostic tools to reach the exact cause:

  • Pelvic examination to look for any mass.
  • Pelvic ultrasound for structural abnormalities, ovarian cysts, and some others.
  • Blood tests to rule out anemia or a clotting disorder in case of menorrhagia associated with menstrual cramps.
  • Laparoscopy to visualize the structures and look for conditions such as endometriosis, fibroids, ectopic pregnancy, etc.
  • Other imaging tests like CT scan or MRI for detailed images of internal structures.


Menstrual cramps can be relieved by medical treatments:

  • Over the counter painkillers such as ibuprofen or naproxen can help with pain
  • Nonsteroidal anti-inflammatory drugs can decrease inflammation.
  • Birth control pills can also be employed to prevent ovulation and reduce the severity of menstrual cramps.
  • Antidepressants are also given for mood swings associated with PMS.
  • Transcutaneous nerve stimulation (TENS) is another useful method that includes adhesive patches containing electrodes on the skin. They deliver electric current to stimulate nerves which in return release endorphins, which are natural painkillers.
  • Surgical methods are used to correct underlying disorders like fibroids, endometriosis, adenomyosis, and others.

Home remedies

  • Use a heating pad to relieve inflammation and pain.
  • Take hot baths for inflammation.
  • Reduce stress.
  • Exercise regularly.
  • Some alternative treatments like acupuncture or acupressure are also effective.
  • Turmeric for Menstrual Cramps has been used for ages and is known for its anti-inflammatory properties.
  • Hot oil massages in the abdominal area provide great relief.
  • Some essential oils include Geranium, Rosemary, and Myrrh.
  • Tea and other hot drinks also relieve the pain and inflammation.
  • Quit smoking.
  • Make some dietary changes.
  • Some doctors also recommend taking supplementation to boost immunity such as magnesium, calcium, Omega 3 fatty acids, vitamin B6, vitamin E.
  • Reduce your salt, sugar, alcohol, and caffeine intake.

Comfort food for menstrual cramps

  • Dark chocolate
  • Milk and honey
  • Herbal Teas
  • Peanut butter
  • Dark greens and general green leafy vegetable

When to consult a doctor?

Mild to moderate menstrual cramps are normal but severe pain can be a symptom of an underlying health condition and should be addressed immediately. If you experience any of these symptoms along with your Menstrual Cramps you should see a doctor as soon as possible:

  • Pain that is affecting your day to day life
  • Heavy bleeding and passing of blood clots.
  • Dizziness and syncope.
  • Fever or vomiting.
  • Pain lasting more than a few days.
  • Pain in Pelvis even when you are not on your period.
  • Abnormal vaginal discharge.


Do Menstrual cramps get worse with age?

No, most women have reported little or no pain during their periods, with increasing age.

What is the best method for menstrual cramps relief?

Your doctor might suggest you take and over a counter painkiller, which helps with pain.

Can I have menstrual cramps before my period?

Yes, the majority of cramps happen with the onset of menstruation but in premenstrual syndrome, changing hormone levels in the body can cause you to have cramps before your period.