In the past, women who experienced menstrual cramps or dysmenorrhea often were told that “its’ all in your mind” or “that the pain is not really that bad”. However, today we know that the pain some women experience from menstrual cramps is very real and is caused by prostaglandins.
What are prostaglandins?
Prostaglandins are chemicals which are found in nearly every cell of the body. These chemicals act to regulate the tone of smooth muscles, the nonvoluntary muscles of the body (e.g.: blood vessels, uterus, and intestines). An excessive amount of prostaglandins causes contractions of the smooth muscles.
How do prostaglandins cause menstrual cramps?
The levels of prostaglandins in the body increase as menstruation approaches, with the highest levels at the onset of the menstrual period. Higher prostaglandin levels increase uterine contractions causing cramps and pain. In essence, the uterus squeezes so hard that it compresses the uterine blood vessels and cuts off the blood supply. In addition, some of the excess prostaglandins escape from the uterus into the bloodstream where they may affect other smooth muscles. Thus, prostaglandins are responsible for the headaches, dizziness, hot and cold flashes, diarrhea and nausea that can accompany painful periods.
Do all women have high prostaglandin levels?
Research has shown that women with severe menstrual cramps have considerably higher concentrations of prostaglandins in their menstrual fluid than women without cramps. Significant prostaglandin production occurs only during ovulatory (egg producing) menstrual cycles. This appears to explain why many young women’s cramps begin a year or so after their first periods – it takes tat long for their cycles to become ovulatory, and for significant prostaglandin production to begin.
How many women are affected by menstrual cramps?
At least 70% of women who have periods suffer from menstrual cramps. Severe pain may be an indication of another serious problem such as endometriosis, uterine fibroid tumors, or pelvic infection. Women with dysmenorrhea should have a pelvic exam to rule out other problems.
What can I do to relieve the pain caused by menstrual cramps?
Since an excess of prostaglandins in the lining of the uterus seems to be one of the major causes of dysmenorrhea, medication that reduces the amount of prostaglandins may be helpful in relieving the pain. For example, aspirin is a mild prostaglandin inhibitor and helps some women. However a more effective prostaglandin inhibitor is ibuprofen.
Are there any side effects associated with ibuprofen?
If you have had a severe allergic reaction to aspirin (e.g.: asthma, swelling, shock or hives), been told not to take aspirin, had an adverse reaction to ibuprofen such as Motrin or Advil, have a chronic medical condition, or take other medication consult your health care provider prior to taking an ibuprofen medication. Occasionally some people experience indigestion, heartburn, nausea, vomiting or diarrhea. Most of these gastrointestinal side effects can be prevented by taking the medication with milk or food.
What if ibuprofen medication does not alleviate my menstrual cramps?
If your menstrual cramps continue to persist after taking the recommended doses of ibuprofen, last longer than 2 or 3 days, do not seem like normal menstrual cramps or become worse, make an appointment to see your health care provider at Student Health.
Are there other methods that may help alleviate my menstrual cramps?
Since women experiencing a wide range of menstrual pain, there is a wide range of options available for dealing with dysmenorrhea.
Some options include
- HEAT/MASSAGE
- A warm bath or heating pad on the lower abdomen and/or lower back back may help promote blood flow to the muscles and relax spasms; back and abdominal massage often feels soothing.
- NUTRITION
- Although scientific evidence regarding the relationship between cramps and nutrition is inclusive, some women find monitoring their intake of sodium, sugar, or caffeine helpful. Other women drink more fluid, increase fiber intake, or eat food high in B vitamins.
- RELAXATION
- Rest, sleep and relaxation exercises can help reduce the pain and discomfort of menstrual cramps.