Even though they are essentially the same thing—a muscle contracting suddenly and painfully against your will—there are some important differences between an ordinary muscle cramp and menstrual cramps. Duration, for one thing: sure, a muscle cramp can last for up to 15 minutes, but as anyone who's experienced a seemingly continuous day-long menstrual cramp can attest, that's nothing. And for another: menstrual cramps are in your uterus, which can make it feel as if the pain is radiating from the very core of your being. Besides that, it's more or less socially acceptable to suddenly fall down in the middle of a crowded hallway because of a wrenching pain in your calf; on the other hand, a woman who doubles over midstride, clutching at her abdomen and groaning in pain, just tends to make everyone feel awkward.
So we suffer discreetly. And there are a lot of us who suffer. Experts estimate that more than half of all women regularly experience some degree of period cramping (known medically as dysmenorrhea), with up to 15% of those women reporting menstrual cramps severe enough to disrupt their normal activities. While some women have secondary dysmenorrhea, in which they develop cramps in adulthood as a symptom of a medical condition such as endometriosis, most start getting them six months to a year after their first menstrual period. This is called primary dysmenorrhea, and it's an unfortunate but natural side effect of the uterine muscle contractions that help push menstrual fluid out of the body. The good news is that many women (myself included) find that period cramps begin to subside as they get older. It's also common for women to have no menstrual cramps at all after giving birth. I know that may not be terribly comforting if you're young and not on the verge of motherhood, so what follows are some ways to ease menstrual cramps in the meantime.
How to Relieve Menstrual Cramps
Nonsteroidal anti-inflammatory drugs, or NSAIDs, are the most effective medications for treating painful menstrual cramps. Period cramps are related to an increase in hormone-like substances called prostaglandins. These cause the muscle contractions necessary for expelling menstrual fluid from the uterus, but are also associated with inflammation and pain. In other words, more prostaglandins equals more severe menstrual cramps. Enter NSAIDs: a whole class of drugs devoted to reducing prostaglandin levels in the body. Your doctor may offer a prescription-strength NSAID if you have very bad menstrual cramps, but for most women, an over-the-counter NSAID such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Midol) is strong enough.
Applied heat can provide menstrual pain relief. Much of the pain of menstrual cramps is due to strong muscle contractions; some experts even think that the muscles can tighten with enough force to restrict their own blood supply, resulting in pain similar to angina in the heart. Since warmth helps to relax tight muscles, many women find that applying heat to the lower abdomen can relieve cramps. Hot compresses and electric heating pads are well-suited to this purpose. Soaking in a hot bath can also help, and has the added advantage of warming the lower back and inner thighs, which are often affected during painful periods.
Exercise can help alleviate menstrual cramps pain. Unless you're in too much pain to get up and move around during your period, aerobic exercise such as walking, running, or swimming can ease your cramps by increasing circulation and gently stretching your abdominal muscles. Exercise also stimulates the production of endorphins, which act as the body's natural painkillers. Regular aerobic exercise between periods is associated with reduced menstrual pain, too, and some research suggests that if your body is exposed to regular bursts of endorphins, it actually slows down its production of pain-causing prostaglandins.
Reducing stress can reduce the pain of menstrual cramps. It's hardly news that psychological stress takes a toll on the body, but you may be surprised to learn that high stress levels are associated with more severe menstrual cramps. The link between the two makes sense, though, because the body produces extra prostaglandins in response to stress. And as we know, prostaglandins equal pain. Stress reduction means different things to different people, but getting enough rest and limiting your commitments are pretty standard ways to get started. Beyond those, yoga, massage, and meditation have made their way into the mainstream for a reason: they really do help a lot of people relax.
Stretching the abdominal muscles can help ease period cramps. It's tough to come by any kind of expert consensus regarding the best way to stretch away your cramps, but many doctors and yoga instructors agree that the most effective stretches are relatively gentle and also involve the muscles surrounding the abdomen, like the pelvis and lower back and sides. My personal favorite stretch for menstrual cramps is a beginner's yoga pose called the sphinx. Lie on your belly with your ankles about hips' distance apart and press the tops of your feet to the floor. Position your elbows directly below your shoulders with your forearms and palms flat on the floor, straight in front of you, and don't hunch your shoulders. You know, like the Sphinx.
How Your Doctor Can Help with Menstrual Cramps
Usually, menstrual cramps are an issue that's just between a woman and her uterus; some of the self-care techniques on this page have been alleviating cramps for centuries. But sometimes, involving a doctor is the only way to get relief from menstrual cramps.
For example, if your cramps are so severe that they keep you from your normal activities for a day or more every month, a doctor might prescribe some form of hormonal birth control—usually a pill or an intrauterine device (IUD) that releases hormones—to decrease the amount of menstrual tissue that builds up in your uterus each month. If you're currently using a copper IUD for contraception, it could be aggravating your cramps, and your doctor can help you decide whether to have it removed.
If you've been getting your period for years and are just now starting to experience cramps, you may have secondary dysmenorrhea caused by an underlying condition such as endometriosis, uterine fibroids, or pelvic inflammatory disease. A doctor can diagnose the cause of your cramps and recommend a treatment. Surgery is sometimes necessary to correct the most common causes of secondary dysmenorrhea.
If you've been sexually active and you're experiencing cramps without bleeding, your doctor can determine whether you're pregnant or experiencing complications of pregnancy.