What Causes PMS Cramps?

Updated: Nov 18, 2020

Written by: Dr. Sarah Rex, Medicine & Surgery

Periods are natural. But who doesn't hate all those loo runs to change pads on a heavy flow day? Or, not to mention, the perpetual fear that you've bled through your favorite jeans again?

Moreover, the crippling pain experienced by roughly 90% of menstruators gets too much at times.

Premenstrual syndrome affects most women to some degree during their reproductive years, so the good news is that we are all in this together.

Symptoms generally appear 5-10 days before your period and improve with it starts or soon after. PMS is a reality and not just "all in your head," as you've probably been told.

Thankfully this has been proven by multiple kinds of research so there's one thing less to prove as a woman. The exact cause has, however not been found. Researchers believe that it's related to a change in both sex hormone and serotonin levels at the beginning of the menstrual cycle.

The list of potential signs and symptoms for premenstrual syndrome ranges from emotional and behavioral to physical ones. However, one of the most hated ones is cramping.

Cramping pain in your lower abdomen starts 1 to 3 days before your period, peaks 24 hours after the onset of your period, and subsides in 2 to 3 days. It can be a continuous dull ache or more intense throbbing pain. This pain can also radiate to your lower back and thighs. And some women might also have associated nausea, loose stools, headache, and dizziness.

Menstrual cramps are physically caused by contractions (tightening) in the uterus (a muscular organ) by a hormone-like substance called prostaglandin.

The uterus is where a baby grows, and it contracts throughout a woman's menstrual cycle to expel its lining. During menstruation, the uterus contracts strongly as triggered by the prostaglandins (involved in pain and inflammation). More severe cramps are associated with higher levels of prostaglandins.

When the uterus contracts too strongly, it can press against surrounding blood vessels, thereby cutting off the supply of oxygen to the muscle tissue of the uterus. Pain results when the amount of oxygen to the muscle is briefly lost.

Menstrual cramps have also been linked to multiple risk factors including age less than 30 years, puberty < 11 years of age, heavy periods (menorrhagia), irregular menstrual bleeding (metrorrhagia), a family history of menstrual cramps (dysmenorrhea), and smoking.

PMS cramping is not always regular. Several medical problems can worsen symptoms. These include the following:

  • Endometriosis: This is when endometrial-like tissue, also known as implants, grows outside of the uterus resulting in chronic inflammation, scar tissue, and adhesions.
  • Uterine Fibroids: These are benign growths in the wall of the uterus that can cause pain.
  • Adenomyosis: The tissue that lines your uterus begins to extend into the muscular walls of the uterus.
  • Pelvic Inflammatory Disease: This is an infection of the female reproductive organs usually caused by sexually transmitted bacteria.
  • Cervical Stenosis: In some women, the opening of the cervix is too small that it hinders the flow of menstrual blood, causing a sharp increase of pressure within the uterus.

But, hey, it's okay, just BREATHE.

Menstrual cramps are not associated with any complications. They usually become less painful with age and may entirely stop after you have your first baby.

Periods can be an absolute pain in the ass but they're the kind that is relieved by pain killers. Moreover, it is always a good idea to consult your doctor regarding this. Happy Bleeding!!


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