Treatment and drugs
Menstrual cramps are treatable. Your doctor may recommend the following:
Pain relievers: Your doctor may suggest taking over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), at regular doses starting the day before you expect your period to begin. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as mefenamic acid (Ponstel), also are available. If you can’t take NSAIDs, acetaminophen (Tylenol, others) may lessen your pain.
Start taking the pain reliever at the beginning of your period or as soon as you feel symptoms, and continue taking the medicine as directed for two to three days, or until your symptoms have gone away.
Hormonal birth control: Oral birth control pills contain hormones that prevent ovulation and reduce the severity of menstrual cramps. These hormones can also be delivered in several other forms: an injection, a patch you wear on your skin, an implant placed under the skin of your arm, a flexible ring that you insert into your vagina, or an intrauterine device (IUD).
Surgery: If your menstrual cramps are caused by an underlying disorder, such as endometriosis or fibroids, surgery to correct the problem may help reduce your symptoms. Surgical removal of the uterus also may be an option if you›re not planning to have children.
Tests and diagnosis
Your doctor will review your medical history and perform a physical examination, including a pelvic exam. During the pelvic exam, your doctor will check for any abnormalities in your reproductive organs and look for signs of infection.
If your doctor suspects that your menstrual cramps are being caused by an underlying disorder, he or she may recommend other tests, such as:
Ultrasound: This test uses sound waves to create an image of your uterus, cervix, fallopian tubes and ovaries.
Other imaging tests: A CT scan or magnetic resonance imaging (MRI) provides more detail than an ultrasound and can help your doctor diagnose underlying conditions. A CT scan combines X-ray images taken from many angles to produce cross-sectional images of bones, organs and other soft tissues inside your body.
MRI uses radio waves and a powerful magnetic field to produce detailed images of internal structures. Both tests are noninvasive and painless.
Laparoscopy: Laparoscopy usually isn›t necessary for the diagnosis of menstrual cramps, but it can help detect an underlying condition, such as endometriosis, adhesions, fibroids, ovarian cysts and ectopic pregnancy. During this outpatient surgery, your doctor views your abdominal cavity and reproductive organs by making tiny incisions in your abdomen and inserting a fiber-optic tube with a small camera lens.
Lifestyle and home remedies
Things you may want to try at home include:
Exercise: Studies have found that physical activity may ease the pain of menstrual cramps.
Heat: Soaking in a hot bath or using a heating pad, hot water bottle or heat patch on your lower abdomen may ease menstrual cramps. Applying heat may be just as effective as over-the-counter pain medication for relieving menstrual cramps.
Dietary supplements: A number of studies have indicated that Vitamin E, omega-3 fatty acids, Vitamin B-1 (thiamine), Vitamin B-6 and magnesium supplements may effectively reduce menstrual cramps.
Avoiding alcohol and tobacco: These substances can make menstrual cramps worse.
Reducing stress: Psychological stress may increase your risk of menstrual cramps and their severity.
You may be at greater risk of menstrual cramps if:
• You are younger than age 30;
• You started puberty early, at age 11 or younger;
• You have heavy bleeding during periods (menorrhagia);
• You have irregular menstrual bleeding (metrorrhagia);
• You have never given birth;
• You have a family history of dysmenorrhea;
• You are a smoker.
Menstrual cramps do not cause any other medical complications, but they can interfere with school, work and social activities. Certain conditions associated with menstrual cramps may have complications, though. For example, endometriosis can cause fertility problems. Pelvic inflammatory disease can scar your fallopian tubes, increasing the risk of a fertilised egg implanting outside of your uterus (ectopic pregnancy).