Menstrual cramps or period cramps (also known by the medical term “dysmenorrhea”) are that nagging ache that creeps up on you before or during your period. They usually last for 1-3 days. For some menstruators, cramping is barely noticeable, but for others, it can be a real pain in the pelvis (or lower back, or vagina, or upper thighs!). Sometimes cramps can be so painful, they cause nausea, vomiting or even fainting. The good news is that they tend to get less severe with age or after childbirth, but until then, they often require some treatment to prevent them from preventing YOU from having your usual fun!
Remember that your uterus is like a hollow muscle with a nice fluffy lining on the inside (called the endometrium). When it comes time for that lining to freshen up (about once a month), something has to push the old lining out so a new lining can grow. And that’s where cramps come in.
Menstrual Cramps are caused by the muscular walls of the uterus working hard to squeeze out your endometrial lining which exits your vagina along with some extra blood and fluids as your period. Just like any muscle can cramp when it’s fatigued or working hard, your uterus can, too. But since your uterus is deep inside your body, you may feel the cramping as pain in any of your body parts that surround your uterus - lower belly, lower back, hips, vulva, or upper thighs.
5 ways to get relief
1.) Exercise. One of the best ways to prevent or lessen cramps is to exercise regularly. Science has shown that girls who exercise regularly have fewer cramps. But even if cramps have already kicked in, a brisk walk or slow jog can provide some relief (and exercise also boosts your mood, and mood boosting is always good around your period!).
2.) Nutrition. Improving your nutrition can help, too. Eating less animal protein (particularly red meats) and more complex carbohydrates and high fiber foods have been shown to improve menstrual pain. Before and during your period, eating foods rich in Vitamins B6, E, Magnesium, Zinc and Omega-3 fatty acids may help reduce muscle cramping. So, fill your plate with fruits & veggies (especially leafy-greens), nuts, berries, whole grains, sweet potatoes and other colorful choices, and stay away from foods high in sugars and animal fats.
3.) Heat. Heat increases circulation and causes muscles to relax. Plus, it just feels good! You can use a hot water bottle, an electric heating pad, a warm bath, or you can make your own natural heating pad by filling a (clean) sock with rice and heating it in a microwave for about 2 minutes (be careful not to heat it too long - it can get too hot and the rice can even burn!)
4.) Pain relievers. If exercise, nutrition, and heat aren’t doing it for you, you may need to use medication. Try an over the counter medication like ibuprofen or naproxen sodium (but always check with a parent or guardian before taking any medications). Some over-the-counter products that are labeled for menstrual cramps actually have caffeine and diuretics (something that makes you pee a lot to lose extra fluids). Neither caffeine nor diuretics do anything to help cramping and aren’t necessary.
If you know you get bad cramps and want to prevent them, it’s best to take these medications a day before you expect the cramps to show up or as soon as possible once they start. That means you need to track your periods on a calendar or app so you know when to expect your next one. Don’t wait for cramps to get horrible, but instead, take the medication at the first sign of cramping.
If you’re going to take a pain reliever, make sure to follow the directions on the bottle about the recommended dose. For Ibuprofen, we usually recommend 400-600 mg for the first dose, then 400 mg every 6-8 hours. For naproxen sodium it’s 440 mg tablets for the first dose, then one tablet every 12 hours (which lets you get through a whole school day before needing another dose). Make sure to take these medications with food, and don’t take ibuprofen and naproxen at the same time. We don’t usually recommend aspirin or acetaminophen for period cramps because they don’t seem to work as well, and they may increase bleeding.
5.) Prescription medications. Finally, if you’ve tried these things and your cramps are still keeping you from doing your usual activities or if they’re worsening over time, talk with your doctor or nurse practitioner. There are other treatments available ranging from prescription strength (non-addictive) pain medications to hormonal treatments such as birth control pills. Before starting to these, your provider will also consider conditions that can make menstrual cramps become more severe over time such as endometriosis, sexually transmitted infections, or fibroids. Although fibroids are rare in teens, endometriosis and STI are definitely considerations. Your healthcare provider will be able to offer testing and treatment options that are very successful but require knowing details about your menstrual cycle, your cramps, your general health, and your family medical history.
If simple treatments aren't doing enough to help you, it's definitely worth talking with your doctor. Once your provider knows more about you and your periods, she can talk with you about several simple and safe treatments that can stop or decrease period pain so that your period doesn’t stop you from doing all the great things you do! Sometimes, worsening cramps can also be a symptoms of an infection or condition called endometriosis. If your period is keeping you from doing your usual activities and none of the above treatments are helping, please talk with your healthcare provider.