Overview

Menstrual cramps (dysmenorrhea) are throbbing or cramping pains in the lower abdomen. Many women have menstrual cramps just before and during their menstrual periods.

For some women, the discomfort is merely annoying. For others, menstrual cramps can be severe enough to interfere with everyday activities for a few days every month.

Conditions such as endometriosis or uterine fibroids can cause menstrual cramps. Treating the cause is key to reducing the pain. Menstrual cramps that aren't caused by another condition tend to lessen with age and often improve after giving birth.

Symptoms

Symptoms of menstrual cramps include:

  • Throbbing or cramping pain in your lower abdomen that can be intense
  • Pain that starts 1 to 3 days before your period, peaks 24 hours after the onset of your period and subsides in 2 to 3 days
  • Dull, continuous ache
  • Pain that radiates to your lower back and thighs

Some women also have:

  • Nausea
  • Loose stools
  • Headache
  • Dizziness

When to see a doctor

If menstrual cramps disrupt your life every month, if your symptoms progressively worsen or if you just started having severe menstrual cramps after age 25, see your doctor.

Causes

During your menstrual period, your uterus contracts to help expel its lining. Hormonelike substances (prostaglandins) involved in pain and inflammation trigger the uterine muscle contractions. Higher levels of prostaglandins are associated with more-severe menstrual cramps.

Menstrual cramps can be caused by:

  • Endometriosis. The tissue that lines your uterus becomes implanted outside your uterus, most commonly on your fallopian tubes, ovaries or the tissue lining your pelvis.
  • Uterine fibroids. These noncancerous growths in the wall of the uterus can cause pain.
  • Adenomyosis. The tissue that lines your uterus begins to grow into the muscular walls of the uterus.
  • Pelvic inflammatory disease. This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.
  • Cervical stenosis. In some women, the opening of the cervix is small enough to impede menstrual flow, causing a painful increase of pressure within the uterus.

Risk factors

You might be at risk of menstrual cramps if:

  • You're younger than age 30
  • You started puberty early, at age 11 or younger
  • You bleed heavily during periods (menorrhagia)
  • You have irregular menstrual bleeding (metrorrhagia)
  • You have a family history of menstrual cramps (dysmenorrhea)
  • You smoke

Complications

Menstrual cramps don't cause other medical complications, but they can interfere with school, work and social activities.

Certain conditions associated with menstrual cramps can have complications, though. For example, endometriosis can cause fertility problems. Pelvic inflammatory disease can scar your fallopian tubes, increasing the risk of a fertilized egg implanting outside of your uterus (ectopic pregnancy).

April 14, 2018
References
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  2. Dysmenorrhea. Merck Manual Professional Version. http://www.merckmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/dysmenorrhea#v1062408. Accessed Dec. 26, 2017.
  3. Smith RP, et al. Treatment of primary dysmenorrhea in adult women. https://www.uptodate.com/contents/search. Accessed Dec. 26, 2017.
  4. Frequently asked questions. Gynecologic problems FAQ046. Dysmenorrhea: Painful periods. American College of Obstetricians and Gynecologists. https://www.acog.org/Patients/FAQs/Dysmenorrhea-Painful-Periods. Accessed Dec. 26, 2017.
  5. Harada T. Dysmenorrhea and endometriosis in young women. Yonago Acta Medica. 2013;56:81.
  6. Period pain: Overview. PubMedHealth. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072508/. Accessed Dec. 26, 2017.