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The Cause of Period Cramps and How To Remedy Them

Written by: Tabitha Britt

Fact-Checked by: Dr. Inna Santkovsky, Obstetrics & Gynecology Specialist


Being on your period is the perfect excuse to couch surf, apply a clay face mask, and fire up the heating pad (all the while chowing down on something that’s both sweet and salty). But sometimes, our periods can feel somewhat uncomfortable making it nearly impossible to actually enjoy the little bit of “me” time we allow ourselves to have during this time of the month.


Having a period isn’t great. Sure, it’s cool that our bodies are capable of creating a habitable environment for a living being each month, only to shed the uterine lining and do it all over again. But, honestly, we could probably do without the sweet and salty cravings, acne, irritability, and cramping.


Unfortunately, a lot of women experience mild cramping six months to one year into their first period. From there, the cramping comes and goes with each cycle (around ovulation time, before and during menses).


“Period cramps are typically caused by uterine contractions,” says Dori Gelfman, Community Manager and RN at Fruitful Fertility. “The uterus lining thickens throughout your cycle, creating a fluffy space for an embryo to implant. If the embryo does not implant, the uterus will contract to shed the thickened lining, which causes a period.”


This “cramping” is normally felt in the abdomen, back, or thigh area and can last anywhere from one to three days. While some women may not feel anything at all, others may experience painful cramping each month.


“Cramping can also be caused when ovulation occurs,” Gelfman adds. “When an egg is released you can sometimes feel a pain or a twinge on one side of your abdomen. Some people also experience low back pain with periods, especially if they have a tilted or retroverted uterus. The location of the uterus can determine where you feel the discomfort and if the uterus is tilted towards your back, that is where you may feel pain.”


Mild cramping is considered “normal,” especially if it has been two-to-three years after your first cycle. If you’re experiencing menstrual cramps that are severe enough to interfere with your daily life, however, it’s important to consult your OB-GYN as you may have a chronic inflammatory condition such as endometriosis or adenomyosis.


As a young woman (or even someone who’s in their 20s), you may feel awkward reaching out to your doctor to talk about your period. Even so, when it comes to cramping, it’s important to stand up for yourself and to advocate for your health. To help you out, we’ve created a quick and easy-to-read guide that explains the causes of menstrual cramps and how to manage the pain.


What causes period cramps?


Period pain, clinically known as “dysmenorrhea,” is categorized into two groups: Primary dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea refers to menstrual cramps that are caused by the period itself whereas secondary dysmenorrhea is period pain that’s caused by a health condition, such as endometriosis.


Although there’s still a bit of research to be done, menstrual cramps are thought to be caused by an excess of prostaglandins, or hormone-like substances, that are released from the uterine lining as it prepares to be shed.


Prostaglandins help the uterus contract and relax, this way the endometrium can remove itself and flow out of the body. The production of prostaglandins is also associated with inflammation—the culprit of many health conditions. According to the Mayo Clinic, high levels of prostaglandins can cause severe cramping.


Menstrual cramps (secondary dysmenorrhea) may also be caused by:

  • Endometriosis

  • Adenomyosis

  • Uterine fibroids

  • Pelvic inflammatory disease

  • Cervical stenosis

Risk Factors of Dysmenorrhea


Believe it or not, there are quite a few risk factors associated with menstrual cramping, including:

  • Age

  • Earlier age at menarche (first period)

  • Smoking

  • A high body mass index (BMI)

  • Longer, heavier menstrual flow (menorrhagia)

  • Irregular bleeding (metrorrhagia)

  • A family history of dysmenorrhea

  • Depression

  • Stress

How can I relieve my period cramps?


Painful periods, irregular or extraordinarily heavy bleeding could be a sign of a serious health condition. If you’re experiencing severe pain, you should contact your OB-GYN. If your periods are on the “normal” side, however, you may be able to alleviate the pain at home.


“Heating pads, ibuprofen, and sipping warm liquids can help alleviate the pain to some degree, but if the pain is significant and accompanied by very heavy bleeding, you may want to discuss your symptoms with an OB-GYN,” says Gelfman.


To help ease your pain, here are a few at-home remedies you can try.


Over The Counter Medication


OTC medications and anti-inflammatory painkillers are an effective way to get period-related pain relief quickly. NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen will help limit the production of prostaglandins and reduce inflammation.


Popular OTC medications for period pain relief include:

  • Pamprin

  • Midol

  • Advil

  • Motrin

  • Aleve

  • Naprosyn

Note: You should not take NSAIDs if you have bleeding problems, liver disease, ulcers, or other stomach problems.


Anti-Inflammatory Diet


Throughout history, people have been experimenting with the theory of food as medicine. When it comes to dysmenorrhea, an anti-inflammatory diet may reduce or alleviate period pain. While the concrete data may be limited, it’s promising.


Foods that fight inflammation include:

  • Nuts

  • Green leafy vegetables (kale, collards, and spinach)

  • Fatty fish (salmon, tuna, and sardines)

  • Fruit (strawberries, cherries, blueberries, and oranges)

  • Olive oil

Transcutaneous Nerve Stimulation


Within the past few years, transcutaneous nerve stimulation (TENS) has grown in popularity. TENS is a non-invasive way to tackle period pain head-on. TENS works by sending electrical pulses through the skin via a small, portable device to ignite the body's natural pain killers. Livia and Ovira are examples of TENS devices.

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