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Your guide to menstrual cramps

Dysmenorrhoea is the medical term for the painful cramps that may occur immediately before or during the menstrual period. There are two types of dysmenorrhoea: primary dysmenorrhoea and secondary dysmenorrhoea.

Primary dysmenorrhoea is another name for common menstrual cramps. Cramps usually begin one to two years after a woman starts getting her period. Pain usually is felt in the lower abdomen or back and can be mild to severe. Common menstrual cramps often start shortly before or at the onset of the period and last for one to three days. They usually become less painful as a woman ages and may stop entirely after the woman has a baby.

Secondary dysmenorrhoea is pain caused by a disorder in the woman's reproductive organs. Pain from secondary dysmenorrhoea usually begins earlier in the menstrual cycle and lasts longer than common menstrual cramps.

What are the symptoms of menstrual cramps?

The symptoms of menstrual cramps include:

  • Aching pain in the abdomen (pain can be severe at times)
  • Feeling of pressure in the abdomen
  • Pain in the hips, lower back, and inner thighs

When cramps are severe, symptoms may include:

What causes common 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 a pain reliever, such as paracetamol or ibuprofen. (Note: for best relief, these medicines should be taken 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
  • Reduce or avoid foods that contain caffeine
  • 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 part of your weekly routine.

If these steps do not relieve pain, your doctor can prescribe medication for you, including:

  • Ibuprofen (higher dose than is available over-the-counter) or other prescription pain relievers. Oral contraceptives (women taking these have less menstrual pain).

What causes menstrual cramps from reproductive problems?

When a woman has a disease in her reproductive organs, cramping can be a problem. This type of cramping is called secondary dysmenorrhoea. Conditions that can cause secondary dysmenorrhoea 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
  • Tumours (also called 'fibroids'), or growths on the inner wall of the uterus
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