Menstrual cramps that occur in the absence of a known abnormality or cause are medically referred to as primary dysmenorrhea.

• Non-drug treatments for menstrual cramps include adequate rest and sleep, regular exercise (especially walking), and smoking cessation.
• Menstrual cramps are not the same as the symptoms experienced due to premenstrual syndrome (PMS), although the symptoms of both disorders can sometimes be experienced together.
• Premenstrual syndrome (PMS) is a combination of emotional, physical, psychological, and mood disturbances that occur after a woman's ovulation; and usually end with the onset of her menstrual flow.
• For moderate menstrual cramps, the nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen [Advil, Motrin, Nuprin, etc.] or naproxen [Aleve, Anaprox, Naprosyn, Naprelan]) are often helpful. The NSAIDs are more effective than aspirin in inhibiting the production and action of the prostaglandins that cause menstrual cramps.

What are menstrual cramps?

Menstrual cramps are abdominal and pelvic pains experienced by a woman around the time of her menstrual period. Menstrual cramps usually start shortly before the menstrual period, peak within 24 hours after their onset, and subside after a day or two.

Menstrual cramps can range from mild to severe. Mild menstrual cramps may be barely noticeable and short-lived, sometimes felt just as a sense of light heaviness in the belly. Severe menstrual cramps can be so painful that they interfere with a woman's regular activities for several days. The discomfort can extend to the lower back or legs. Menstrual cramps are not the same as the symptoms experienced due to premenstrual syndrome (PMS), although the symptoms of both disorders can sometimes be experienced together. Many women suffer from both PMS and menstrual cramps.

Medical research of menstrual cramps has shown that they are often worse in women who began menstruating early and who have long menstrual periods with heavy menstrual flow. Smoking and a family history of severe menstrual cramps are also associated with painful menstrual cramps.

• Abdominal pain
• Lumbar pain
• Nausea
• Loose stools
• Headache
• Dizziness

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

Menstrual cramps can be caused by:

• Endometriosis. Tissue that acts similar to the lining of the uterus grows outside of the uterus, most commonly on fallopian tubes, ovaries or the tissue lining your pelvis.
• Uterine fibroids. These noncancerous growths in the wall of the uterus can cause pain.
• Adenomyosis. The tissue that lines your uterus begins to grow into the muscular walls of the uterus.
• Pelvic inflammatory disease. This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.
• Cervical stenosis. In some women, the opening of the cervix is small enough to impede menstrual flow, causing a painful increase of pressure within the uterus.

Treatment options vary and each woman needs to find a treatment that works for her. Non-drug measures that may help include adequate rest and sleep, regular exercise (especially walking), and smoking cessation. Some women find that abdominal massage, yoga, or orgasmic sexual activity can help. A heating pad applied to the abdominal area may also relieve the pain.

For mild menstrual cramps, over-the-counter (OTC) aspirin and acetaminophen (Tylenol), or acetaminophen plus a diuretic (such as Diurex MPR, Midol, Pamprin, Premesyn) may help. However, aspirin has a limited effect in curbing the production of prostaglandin and is only useful for mild cramps. For moderate menstrual cramps, the nonsteroidal anti-inflammatory drugs (NSAIDs) can be helpful. The NSAIDs are more effective than aspirin in inhibiting the production and action of the prostaglandins. NSAIDs that are available OTC are:

• ibuprofen (Advil, Midol IB, Motrin, Nuprin, and others);
• naproxen sodium (Aleve, Anaprox); and
• ketoprofen (Actron, Orudis KT).

For optimal control of menstrual cramps, a woman should start taking a NSAID before her pain becomes difficult to control. This might mean starting medication 1 to 2 days before her period is due to begin and continuing taking medication 1 to 2 days into her period. The best results are obtained by taking one of the NSAIDs on a regular schedule rather than on an as needed basis. Therefore, ibuprofen should be taken every 4-6 hours, ketoprofen every 4-8 hours, and naproxen every 8-12 hours for the first few days of the menstrual flow.

Prescription NSAIDs available for the treatment of menstrual cramps include mefenamic acid (Ponstel).

You might be at risk of menstrual cramps if:

• You're younger than age 30
• You started puberty early, at age 11 or younger
• You bleed heavily during periods (menorrhagia)
• You have irregular menstrual bleeding (metrorrhagia)
• You have a family history of menstrual cramps (dysmenorrhea)
• You smoke

To ease your menstrual cramps, your health care provider might recommend:

1. Pain medications: Over-the-counter pain relievers, such as ibuprofen (Advil,) or naproxen sodium (Aleve), at regular doses starting the day before you expect your period to begin can help control the pain of cramps. Prescription nonsteroidal anti-inflammatory drugs also are available.

2. Hormonal birth control: Oral birth control pills contain hormones that prevent ovulation and reduce the severity of menstrual cramps. These hormones can also be delivered in several other forms: an injection, a skin patch, an implant placed under the skin of your arm, a flexible ring that you insert into your vagina, or an intrauterine device (IUD).

3. Surgery: If your menstrual cramps are caused by a disorder such as endometriosis or fibroids, surgery to correct the problem might help your symptoms. Surgical removal of the uterus also might be an option if other approaches fail to ease your symptoms and if you're not planning to have children.

Lifestyle changes can also help prevent menstrual cramps.
1. Exercise regularly: Physical activity, including sex, helps ease menstrual cramps for some women.
2. Use heat: Soaking in a hot bath or using a heating pad, hot water bottle or heat patch on your lower abdomen might ease menstrual cramps.
3. Try dietary supplements: A number of studies have indicated that vitamin E, omega-3 fatty acids, vitamin B-1 (thiamin), vitamin B-6 and magnesium supplements might reduce menstrual cramps.
4. Reduce stress: Psychological stress might increase your risk of menstrual cramps and their severity.

Symptoms
Throbbing or cramping pain in your lower abdomen that can be intense,Pain that starts 1 to 3 days before your period,Nausea,Headache,Dizziness,Loose stool
Conditions
Throbbing or cramping pains in the lower abdomen that starts before and during the menstruation
Drugs
Pain relievers like ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve)