Menstrual Cramps

The term menstrual cramps is synonymously used for the term Dysmenorrhea, a condition that  causes different kind of pains which include Sharp, Dull, Throbbing, Nauseating, Burning or Shooting pain and it may coexist with Menstruation or can precede it for several days. This condition can also be related to heavy blood loss called Menorrhagia. The menstrual cramps are actually due to the uterine contractions that may vary in the frequency, strength and duration.


Main symptoms of Dysmenorrhea are as follows.

  • Pain concentrated in Lower Abdomen

  • Pain in Umbilical region

  • Pain going through Thigh and lower Back

  • Nausea

  • Vomiting

  • Diarrhea

  • Headaches

  • Fatigue

  • Dizziness

These symptoms only last until Menstruation ends. The symptoms of dysmenorrhea normally occur due to the hormonal changes occurring with Ovulation. Birth control pills prevent these symptoms as these pills stop Ovulation.


There are two types of Dysmenorrhea which are as follows.

  • Primary Dysmenorrhea:-

Primary Dysmenorrhea is diagnosed when no disease, disorder or abnormality occurs within or outside the Uterus. Due to destruction of Endometrial Cells, Prostaglandins are released during Menstruation. These Prostaglandins and other inflammatory agents cause the Uterus to contract. These substances are said to be the main cause for Primary Dysmenorrhea.

Contraction of Uterine Muscles results in constriction of blood supply to tissues of Endometrium causing them to break down and die. These Uterine contractions squeeze these dead endometrial tissues through Cervix and out of the body by Vagina. These contractions are responsible for the Pain or Cramps during Menstruation.

  • Secondary Dysmenorrhea:-

Symptoms of disease, disorder or structural abnormality within or outside Uterus lead to the diagnosis of Secondary Dysmenorrhea. Causes for Secondary Dysmenorrhea are as follows.

  • Endometriosis

  • Leiomyoma

  • Adenomyosis

  • Ovarian Cyst

  • Pelvic Congestion


Diagnosis is made by medical history of symptoms, menstrual cycles and Pelvic exam. From these results additional tests are taken i.e.

  • Pap test

  • Certain Lab tests

  • Gynecologic Ultrasonography

  • Laparoscopy


Treatment for Dysmenorrhea is carried out by the following drugs.

  • For relieving the pain of Primary Dysmenorrhea Non Steroidal Anti-Inflammatory drugs (NSAIDs) are effective. However, NSAIDs can lead to side effects like nausea, Dyspepsia, Peptic Ulcer, and constipation.

  • Patients that are unable to take common NSAIDs  are recommended COX-2 Inhibitor.

  • Hormonal Contraceptives (Birth Control) can also prove helpful in relieving the symptoms of Primary Dysmenorrhea. Some of the effective Hormonal Contraceptives are Norplant and Depo-provera.

  • Use of Transdermal Nitroglycerin Patch is also effective in the treatment.

  • Alternative medications are as follows.

    • Acupressure

    • Spine Manipulation

    • Chinese Herbal Medicine

    • Thiamine supplements diet

    • Vitamin E supplements or diet

    • Dietary Supplements like Omega-3 Fatty Acids and Vitamin B6.