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Menstrual cramps

Stomach cramps are the most common menstrual-related symptom. Everyone will experience a different severity of pain, sometimes also related to back. Pain and upper leg pain.

Particularly painful periods are termed dysmenorrhea. Primary dysmenorrhea is when you have always had painful periods and can be associated with nausea, vomiting, GI disturbance and fatigue.

Secondary dysmenorrhoea is when you start having painful periods after several years of having no pain and the pain can last after your period finishes.

What phase of your menstrual cycle do you experience menstrual cramps?

Menstrual cramps are usually experienced at the end of the luteal phase, a day period your period starts and/or at the start of the early follicular phase for the first 1-2 days of a period.

Late Luteal Phase
Early Follicular Phase

Causes of menstrual cramps

The cause of menstrual cramps is still uncertain, linked to several factors including lack of blood flow and oxygen delivered to the uterus caused by increased intrauterine pressure and vessel constriction, behavioural or psychological factors and increased production and release of prostaglandins. 

Note: Prostaglandins are a hormone like substance that affect several bodily functions including inflammation, pain and uterine contractions. The uterine contractions help release the uterine lining from your uterus and result in a period. Prostaglandins are hormone-like because they coordinate different functions in your body and tell your body what to do and when to do it. Prostaglandins are different from hormones because your endocrine system glands don’t release them into your bloodstream, instead, your tissues make prostaglandins at the site of the action, damage or infection. Prostaglandins play a very important role in the body, are natural and necessary. However, sometimes your body can have excessive amounts as is the case with painful or heavy periods.

Prostaglandins cause uterine contractions, the higher the level of prostaglandins the more severe the menstrual cramps can be. These contractions are caused by constriction of small endometrial (layer of tissue that lines the uterus) blood vessels which cause tissue ischemia (lack of blood) and result in pain. Levels rise shortly before and during the start of a period which has suggested the increase in prostaglandins may be related to a decline in progesterone and/or estradiol.

How to manage menstrual cramps

Eat at least 5 portions of fruit and vegetables each day and increase omega 3 intake (oily fish, flaxseeds, rapeseed oil) the week before your period. Certain foods can make pains worse due to prostaglandins and inflammatory response. Foods to avoid have been suggested as caffeine and sugar. Focussing on anti-inflammatory foods (e.g. fruit and veg) can help reduce inflammation in the body, try avoiding pro-inflammatory foods (e.g. crisps, cake, ready meals).

Yoga and light exercise can feel difficult when in pain but certain poses may help relieve symptoms – there are videos online for yoga specifically to reduce menstrual cramps

Heat applied to the area – heated wheat bags, hot water bottles or a hot bath. 

Ibuprofen and paracetamol (if no underlying medical conditions) can help with pain management (follow pack instructions) – taking ibuprofen the day before your period starts can help reduce inflammation and prevent menstrual cramps.

Ginger products (ginger tea, ginger biscuits, adding crushed or dried ginger to foods) can reduce nausea.

Peppermint tea may help with stomach cramps

High frequency TENS machines can be helpful (can buy online or at chemists)

If your pain is affecting your life or continues past your period, then you should discuss with your GP. Keep a log of the amount of pain you are in and how long it lasts to discuss further with them.

Secondary dysmenorrhea requires further investigation and discussion with a doctor.

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