Menstrual cramps are an uncomfortable yet completely normal part of a woman’s cycle. However, just as no two women are exactly alike, neither are their menstrual cramps. Some women experience barely noticeable cramps just before their period starts, while for others, the pain can last for days and be so intense that it makes getting out of bed a challenge. The symptoms of menstrual cramps can vary, but often include throbbing pain in your lower abdomen and/or lower back. Some women also report nausea, diarrhea, headaches, and dizziness. Understanding menstrual cramps is essential for women’s health, as every woman experiences them uniquely.
Phases of the menstrual cycle
The natural rise and fall of hormones trigger the four phases of a standard 28-day menstrual cycle, causing your reproductive organs to respond accordingly. This intricate process is fundamental to female reproductive health, involving a coordinated sequence of hormonal signals and physical changes. Each phase has its own distinct characteristics and roles, contributing to the overall cycle that prepares the body for potential pregnancy.
- Menses Phase: The menses phase begins on the first day of your period, when the lining of your uterus sheds if you are not pregnant. Most women bleed for 3-5 days, although bleeding for up to seven days is usually not a cause for concern.
- Follicular Phase: This phase also begins the day you get your period, overlapping with the menses phase and ending with ovulation. During the follicular phase, your estrogen levels rise, causing the lining of your uterus to thicken and grow. At the same time, another hormone (follicle-stimulating hormone or FSH) causes follicles in your ovaries to grow. Between the 10th and 14th day of your menstrual cycle, one of these developing follicles will form a fully mature egg.
- Ovulation Phase: Around the 14th day of your menstrual cycle, a sudden increase in yet another hormone (luteinizing hormone or LH) prompts your ovary to release the egg – a process known as ovulation.
- Luteal Phase: During the luteal phase, which lasts from the 15th to 28th day of your menstrual cycle, the egg leaves your ovary and begins to travel through the fallopian tubes to your uterus. At the same time, your progesterone level rises to prepare the lining of your uterus for pregnancy. If the egg is fertilized and successfully attaches to your uterine wall, you become pregnant. But if pregnancy does not occur, your estrogen and progesterone levels drop, and the menses phase begins again.
Hormonal changes
Like the menstrual cycle, hormonal changes also play a major role in menstrual cramps. During the menses phase, your uterus produces hormone-like chemicals called prostaglandins that cause your uterine muscles to contract and relax. These contractions are designed to help expel the lining of your uterus – but if the muscles contract too forcefully, cramps are often the result. Women who have high levels of prostaglandins may feel cramps as early as a day or two before the menses phase begins, and their cramps may also be more severe.
Cramps that occur before your period are often associated with premenstrual syndrome (or PMS), which may include the following physical and emotional symptoms:
- Breast swelling and tenderness
- Bloating
- Weight gain
- Joint pain
- Headache
- Diarrhea or constipation
- Irritability
- Mood swings
- Crying spells
- Anxiety or depression
- Sleeping issues
Hormonal changes are likely responsible for PMS symptoms, but researchers do not know why some women are more affected than others. You may also experience twinging or cramps during the ovulation phase, as your ovary releases an egg. Ovulation cramps typically occur in your lower abdomen or pelvic region. Most women have two ovaries, one on the left side and one on the right side of the uterus. These ovaries take turns, each releasing an egg every other month. Some women report feeling ovulation cramps on whichever side releases the egg that month. Menstrual cramps cause pain in your lower abdomen and/or lower back.
Managing Cramps
Whether your menstrual cramps are mildly uncomfortable or cause severe pain, there are several remedies you can try to alleviate them:
- Pain relievers – Take over-the-counter pain relievers such as ibuprofen (Advil) or naproxen sodium (Aleve) as early as the day before you expect your period to start. Continue taking them for 2-3 days or until your cramps subside. Prescription nonsteroidal anti-inflammatory drugs are also available.
- Heat therapy – Soak in a hot bath or use a heating pad on your lower abdomen or lower back.
- Dietary changes – Take supplements or eat foods rich in vitamin E, omega-3, vitamin B-1, vitamin B-6, and magnesium.
- Rest and relaxation – Get plenty of sleep and practice relaxation techniques like meditation or yoga.
- Exercise – Physical activity, even sex, can help ease menstrual cramps.
- Hormonal birth control – Some forms of birth control contain hormones that prevent ovulation and reduce the severity of menstrual cramps. Your options may include a pill, patch, shot, vaginal ring, or intrauterine device (IUD).
When to seek medical care
Contact your TopLine MD Alliance affiliated provider right away if:
- Your symptoms suddenly worsen
- You get severe cramps for the first time after age 25
- A fever accompanies your cramps
- The pain of menstrual cramps is disrupting your life every month
TopLine MD Alliance affiliated healthcare providers, diagnostic centers, and imaging centers provide high-quality care and exceptional service while ensuring that you are always satisfied with your care. Affiliated women’s health specialists cover gynecology, obstetrics, maternal fetal medicine, reproductive endocrinology and infertility, reconstruction, and urogynecology. To learn more, find a TopLine MD affiliated provider today.