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Menstrual cramps

Menstrual cramps (dysmenorrhea) are throbbing or cramping pains in the lower abdomen. Many women experience 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.

Menstrual cramps may be caused by identifiable problems, such as endometriosis or uterine fibroids. Treating any underlying cause is key to reducing the pain. Menstrual cramps that aren't caused by an underlying condition tend to lessen with age and often improve once a woman has given birth.

Symptoms Causes Risk factors Complications

Symptoms of menstrual cramps include:

  • Throbbing or cramping pain in your lower abdomen that may be intense
  • Dull, constant ache
  • Pain that radiates to your lower back and thighs

Some women also experience:

  • Nausea
  • Loose stools
  • Headache
  • Dizziness

When to see a doctor

If you've started menstruating within the past few years and have menstrual cramps, chances are your menstrual pain isn't a cause for concern. However, if menstrual cramps disrupt your life every month, if your symptoms progressively worsen, or if you're older than 25 and just started having severe menstrual cramps, see your doctor.

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

Severe contractions may constrict the blood vessels feeding the uterus. The resulting pain can be compared to the chest pain that occurs when blocked blood vessels starve portions of the heart of food and oxygen.

Menstrual cramps may also be caused by:

  • Endometriosis. In this painful condition, 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 may be the cause of pain.
  • Adenomyosis. In this condition, the tissue that lines your uterus begins to grow into the muscular walls of the uterus.
  • Pelvic inflammatory disease (PID). This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.
  • Cervical stenosis. In some women, the opening of the cervix may be so small that it impedes menstrual flow, causing a painful increase of pressure within the uterus.

You may be at greater risk of menstrual cramps if:

  • You're younger than age 30
  • You started puberty early, at age 11 or younger
  • You have heavy bleeding during periods (menorrhagia)
  • You have irregular menstrual bleeding (metrorrhagia)
  • You've never given birth
  • You have a family history of dysmenorrhea
  • You're a smoker

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

Certain conditions associated with menstrual cramps may 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).

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