Menstrual cramps refer to pain in abdominal and pelvic areas of a woman during the menstrual period. The pain can either be mild or can even become quite severe.
Menstrual cramps are pains a woman experiences in the abdominal (belly) and pelvic areas during her menstrual period. It can be mild to quite severe in intensity. Menstrual pain is not the same as the discomfort felt during premenstrual syndrome (PMS), in the lower abdomen and pelvis. Many women can have both PMS and menstrual cramps. Mild menstrual cramps may not be even noticed and are usually of short duration, at times felt just as a sense of heaviness in the lower abdomen. Severe menstrual cramps can disturb a woman's regular activities for several days.
During the menstrual cycle, the uterus contracts when the uterine lining is shed. The lining of the uterus produces a hormone prostaglandin, that causes many of the symptoms associated with menstrual discomfort. If more prostaglandin is produced by a woman she experiences more severe cramps. Prostaglandins may also cause vomiting, diarrhea, and headaches that accompany painful periods.
The pain in menstrual cramps starts in the lower abdomen and pelvis. The pain or the discomfort can extend to the lower back or legs. The pain can be a severe or simply a dull ache, and it can be periodic or continous. Menstrual pain generally starts just before the periods, becomes most severe within 24 hours of onset, and then subsides slowly after a day or two.
Some women especially if the pain is severe can have headache, nausea, or even vomiting.
During menstrual pain some women can have constipation or diarrhea, because the prostaglandins which cause smooth of the uterus to contract are found in intestinal tract also. Some women may have an urge to urinate more frequently.
Test and Diagnosis
The diagnosis of menstrual pain is a clinical diagnosis which is usually made by the woman herself and reflects her individual perception of pain. After some menstrual periods a woman becomes well aware of her typical symptoms. Your doctor will take a detailed medical history regarding menstrual pain and other associated symptoms. The doctor may do a pelvic exam to check for any problems if your symptoms are severe.
Blood test: Your doctor may ask for blood tests and culture if there are concerns about a possible infection. To confirm the diagnosis additional tests like ultrasound, laparoscopy, hysteroscopy may be ordered.
Ultrasound examination may be advised if your doctor discovers any abnormal masses during the pelvic exam. Other imaging tests, such as computed tomogaphy scan, magnetic resonance imaging (MRI) show the internal structures.
Laparoscopy, is a minor surgical procedure by which the doctor can look directly into the pelvic cavity with a fiber-optic scope.
Hysteroscopy may be done if it is needed, by inserting a hysteroscope (lighted instrument) through the vagina, to see the cervix and inside the uterus.
Every woman discovers a treatment that works for her. The most common treatment in the past was to lie down at the first sign of pain.
Non-drug therapy include not only adequate rest and sleep but regular exercise (especially walking) as well. Abdominal massage, yoga, or a heating pad applied to the abdominal area may relieve the pain and congestion.
Medications: OTC medications for mild cramps are aspirin or acetaminophen. These are generally effective for control of mild pain.
Oral contraceptive pills: If the menstrual pain is severe and not controlled with NSAIDs your doctor may prescribe oral contraceptive pills (OCP) containing low dose estrogen and progestin in a regular or extended cycle. The OCP prevent ovulation (the monthly release of an egg) and reduce the production of prostaglandins which, thereby decreases the severity of pain and causes a light menstrual flow.
Nonsteroidal antiinflammatory drugs : Nonsteroidal antiinflammatory drugs (NSAIDs) are considered as the drug of choice for treating moderate menstrual. The NSAIDs usually prescribed for menstrual cramps include ibuprofen, diclofenac, and naproxen sodium. The NSAIDs effectively lower the production of prostaglandin and lessen its effect. It is important to start the medicine before your pain becomes difficult to control. You should start the medicine 1-2 days before your period is due to begin and continue taking it 1-2 days after the menstrual period starts. The NSAIDs have best effect in controlling pain if the medicine is taken on a scheduled basis and not waiting for the pain to begin.
Surgery: If your menstrual pain is severe and is associated with abnormally heavy uterine bleeding, your doctor may advice endometrial ablation, a procedure in which the lining of the uterus is burned away or vaporized using a heat-generating device. An operation known as a D & C (dilation and curettage) to remove some of the lining of the uterus is also helpful in some women to reduce severe menstrual cramps.
If you have menstrual cramps you may take paracetamol or ibuprofen to relieve the pain. NSAIDs like ibuprofen, diclofenac have adverse effects on the stomach and kidney. Hence if you have a history of kidney problems or stomach problems (such as ulcers or reflux), consult your doctor before taking these medicines.
Other strategies that may help to relieve menstrual cramps are
Application of heat to lower abdomen with hot water bottles, heating pads, or hot baths, relaxes tense muscles and can relieve pain.
Herbal teas, like chamomile, mint, raspberry, and blackberry, can relieve pain and relax tense muscles and anxious moods.
Regular workouts can reduce the severity of cramps.
Massage of back and lower abdomen can also reduce the severity of menstrual pain.
Menstrual pain can be effectively treated with nutritional support, mind-body techniques (such as meditation), acupuncture, chiropractic, and exercises (such as yoga and tai chi).
Some herbal remedies that may provide relief from symptoms include Chaste tree (Vitex agnus castus), Black cohosh (Actaea racemosa), Evening primrose oil (Oenothera biennis), Cat's claw (Uncaria tomentosa), Bromelain (Ananus comosus), Turmeric (Curcuma longa).
Homeopathic remedies can also effectively provide relief from menstrual pain. Some of the homeopathic remedies effective in menstrual pain include Belladonna, Chamomilla, Cimicifuga, Colocynthis, Lachesis, Magnesia phos, Nux vomica, Pulsatilla.
Some measures which can prevent painful menstrual cramps are
Maintain a healthy weight.
Avoid smoking and do not drink excessively.
Do regular exercises
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