• Dr Stella E. Okereke-Nwokeji


Having menstrual cramps is one of the most common, annoying parts of your period. They can strike right before or during that time of the month. Many women get them routinely.

You’ll feel these cramps in your lower belly or back. They can range from mild to severe. They usually happen for the first time a year or two after a girl first gets her period. With age, they usually become less painful and may stop entirely after you have your first baby.

Your doctor may call your cramps “dysmenorrhea.”


Chances are, you know all too well how it feels. You may have:

  • Aching pain in your belly (sometimes severe)

  • Feeling of pressure in your belly

  • Pain in the hips, lower back, and inner thighs

When cramps are severe, symptoms may include:

  • Upset stomach, sometimes with vomiting

  • Loose stool

What Causes

Menstrual cramps happen because of contractions in the uterus, or womb, which is a muscle. If it contracts too strongly during your menstrual cycle, it can press against nearby blood vessels. This briefly cuts off the supply of oxygen to the uterus. It’s this lack of oxygen causes your pain and cramping.

What You Can Do

If you have mild menstrual cramps, take aspirin or another pain reliever, such as acetaminophenibuprofen, or naproxen. For best relief, you must take these medications as soon as bleeding or cramping starts.

Heat can also help. Place a heating pad or hot water bottle on your lower back or tummy. Taking a warm bath may also provide some relief.

You should also:

  • Rest when needed.

  • Avoid foods that contain caffeine and salt.

  • Not use tobacco or drink alcohol.

  • Massage your lower back and abdomen.

Women who exercise regularly often have less menstrual pain. To help prevent cramps, make exercise a part of your weekly routine.

If these steps do not relieve pain, tell your doctor, in case you need medicines such as:

  • Ibuprofen (higher dose than is available over the counter) or other prescription pain relievers

  • Oral contraceptives (Women taking birth control pills have less menstrual pain.)

Secondary Dysmenorrhea

Primary dysmenorrhea means that your cramps are due to your cycle. Secondary dysmenorrhea is the term your doctor may use if you have a problem in your reproductive organs that causes your cramps. Several conditions can cause it:

  • Endometriosis is a condition in which the tissue lining the uterus (the endometrium) is found outside of the uterus.

  • Pelvic inflammatory disease (PID) is an infection caused by bacteria that starts in the uterus and can spread to other reproductive organs.

  • Stenosis (narrowing) of the cervix , which is the lower part of the uterus, can be caused by scarring, as well as a lack of estrogen after menopause.

  • The inner wall of the uterus may have fibroids (growths)

If you have severe or unusual menstrual cramps, or cramping that lasts for more than 2 or 3 days, tell your doctor. Menstrual cramps, whatever the cause, can be treated, so it's important to get checked.

Your doctor will ask you about your symptoms and menstrual cycles. You’ll get a pelvic exam, in which your doctor will use a tool called a speculum to see into your vagina and cervix. She may take a small sample of vaginal fluid for testing, and use her fingers to check your uterus and ovaries for anything that doesn’t feel normal.

If it turns out that your cramps aren’t due to your period, you might need other tests to find the right treatment.