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Menstrual Cramps - Causes, Symptoms, Diagnosis, Treatment and Prevention

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Menstrual cramps are painful abdominal cramps that occur during menstruation. This article explains the cause, symptoms, treatment, and preventive measures.

Written by

Dr. Asha. C

Medically reviewed by

Dr. Manwani Saloni Dilip

Published At May 27, 2022
Reviewed AtApril 30, 2024

What Is a Menstrual Cramp?

Menstruation or normal vaginal bleeding happens as part of a woman's monthly cycle. In most cases, menstruation is accompanied by menstrual cramps; amongst that 3 in 4 females report experiencing cramps. Menstrual cramps are throbbing, aching cramps that women feel in their lower bellies just before and during their period. They may start strong and feel better as time passes or might come and go more randomly. In some people, cramps are barely noticeable or quite painful or severe.

What Causes Menstrual Cramps?

Menstrual cramps are caused mainly by an excess production of prostaglandins—hormone-like compounds released from the endometrium (uterine lying) as it prepares to be shed. Prostaglandins help in the contraction and relaxation of the uterus so that the endometrium can be shed off from the body. Contraction of the uterus is a necessary part of the process, but when it happens in excess, they cause pain in the uterus. In addition, during strong contractions, the blood flow is reduced, and the oxygen supply to the uterus muscle tissue decreases, causing pain.

For many people, the predisposing factors are still unknown. Inflammation may play a role in menstrual cramps. Inflamed tissue tends to produce increased levels of prostaglandins. People experiencing more menstrual pain have also been shown to have increased inflammatory markers in the blood. Inflammation has also been seen worsening other premenstrual symptoms, including mood changes.

Painful periods may also occur if women have long periods or heavy bleeding and if their periods are irregular or they start menstruating early in life. Few other factors that have been associated with painful periods include,

  • Smoking.

  • Being younger than 30.

  • Having a pelvic infection.

  • Being thin.

  • Family history of menstrual cramps.

  • Fibroids in the uterus.

  • Endometriosis (a condition in which the tissue lining the uterus grows outside of the uterus).

  • Adenomyosis (when your uterine lining grows into the nearby muscle).

  • Cervical stenosis (narrowing of the lower part of the uterus).

What Are the Symptoms of Menstrual Cramps?

  • Menstrual cramps usually refer to a dull, throbbing, cramping pain in the lower belly, just above the pelvic bone.

  • Pain that radiates to the lower back and thighs.

  • A feeling of pressure in the belly.

  • The pain usually starts one to three days before the period, peaks 24 hours after the onset of the period, and subsides in two to three days.

Some women also have the following symptoms,

  • Nausea.

  • Loose stools.

  • Constipation.

  • Headache.

  • Dizziness.

  • Bloating.

  • Faintness.

  • Sweating.

When to Consult a Doctor?

If cramping lasts more than two or three days, severe or unusual menstrual cramps, if the symptoms progressively worsen, if the menstrual cramps just started after age 25, or cramps disrupt life every month, consult a healthcare provider. Whatever may be the cause, menstrual cramps can be treated, so it is a wise decision to get checked.

If any women experience the following symptoms, immediate consultation may be required:

  • Severe pain that began suddenly or is new.

  • Fever.

  • Constant pain.

  • A pus-like discharge from the vagina.

  • Sharp pain that worsens when the belly is touched gently.

How Are Menstrual Cramps Diagnosed?

The doctor will ask about the symptoms and menstrual cycles.

A pelvic examination will be conducted, in which the doctor will use a tool called a speculum to see into the cervix and the vagina. A small sample of vaginal fluid will be taken for testing, and use their fingers to check the uterus and ovaries for any abnormalities. If it turns out that your cramps are not due to a period, other tests might be required to find the proper treatment.

The tests include,

  • Ultrasound - Using sound waves, images of the uterus, fallopian tubes, cervix, and ovaries are taken.

  • Other Imaging Tests. A CT (computerized tomography) scan or MRI (magnetic resonance imaging) scan provides more detail than ultrasound and can help the doctor diagnose underlying conditions. Both tests are painless and non-invasive.

  • Laparoscopy - Laparoscopy can help detect an underlying condition, such as endometriosis, fibroids, adhesions, ovarian cysts, and ectopic pregnancy. The doctor views the abdominal cavity and reproductive organs by making small incisions in the abdomen and inserting a thin tube with a small camera lens.

What Is the Treatment for Menstrual Cramps?

Following are the treatment options for menstrual cramps,

  • Pain Relievers - Over-the-counter medicines are often effective, like ibuprofen or naproxen sodium. Start painkillers only when you experience cramps.

  • Hormonal Birth ControlPills- these pills prevent ovulation and decrease the severity of menstrual cramps. In addition, these pills reduce the thickness of the uterus lining, reducing bleeding and cramping.

  • Surgery - If cramps are caused by disorders such as fibroids or endometriosis, surgery might help to prevent cramps.

How to Prevent Menstrual Cramps?

  • Drink More Water - Drinking water can reduce bloating during periods and reduce some of the pain it causes. Also, drinking hot water can increase blood flow throughout the body and relax the muscles and decrease cramps caused by uterine contractions.

  • Herbal Drinks - Herbal teas have antispasmodic compounds and anti-inflammatory properties that can reduce the muscle spasms in the uterus that cause cramping. Also, they have other benefits like helping with insomnia and stress relief. Drinking chamomile, fennel, or ginger tea is a natural way to relieve menstrual cramps.

  • Anti-inflammatory Foods - Anti-inflammatory foods can help in promoting blood flow and relaxes the uterus. For example, tomatoes, pineapples, berries, and spices like ginger, garlic, turmeric, leafy green vegetables, walnuts, almonds, and fatty fish, like salmon, have high anti-inflammatory properties and help in reducing inflammation.

  • Skip the Treats- Foods high in trans fat, sugar, and salt can cause bloating and inflammation, which leads to muscle pain and cramps. Try a banana or another fruit to fight sugar cravings or unsalted nuts instead of fast foods.

  • Avoid Coffee - Caffeine can worsen cramps by narrowing the blood vessels and constricting the uterus, making cramps more painful, so stay away from coffee before and during your period. Also, avoid soda, chocolate, energy drinks, or tea. If a morning or midday coffee is required, try an alternative like a smoothie packed with veggies instead, or eat a snack high in protein.

  • Try Dietary Supplements - Vitamin D, vitamin E, omega-3, and magnesium, can help reduce inflammation and make the periods less painful. Take daily supplements, not just during the periods for best results.

  • Apply Heat - Applying heat can help the muscles relax, relieve tension and improve blood flow. Try taking a hot shower, sitting with a heating pad, or relaxing in a hot bath.

  • Exercise - Gentle exercise releases endorphins; it reduces the pain and relaxes the muscles. Light stretching, yoga, or walking might make the cramps feel better.

  • Reduce Stress - Stress can make the cramps worse. So try stress relief techniques like meditation, yoga, deep breathing, or your favorite way of relieving stress.

  • Massage Therapy - Massages may reduce the spasms by relaxing the uterus. Focus on the abdominal area while massaging to manage menstrual cramps effectively. A full body massage that reduces overall stress also helps to relieve menstrual cramps.
  • Over-the-counter (OTC) Medicines - The increased hormone prostaglandin causes muscle contractions and pain. Anti-inflammatory medicines like ibuprofen can be relieved by reducing the number of prostaglandins in the body. Take OTC medicines only when the menstrual cramp starts.
  • Alternative Medicine - Alternative medicine practices like acupuncture and acupressure can give relief from menstrual cramps. Acupuncture stimulates the body by placing needles on the skin. Acupressure stimulates the body without any hands but by putting pressure on specific body points. These practices can improve blood flow throughout the body and release muscle tension.


Menstrual cramps are painful abdominal cramps that are a common problem around the time of the monthly period. Various home remedies are there to comfort the painful cramps. However, if the cramps are severe and the daily activities are disturbed because of the cramps, consulting the doctor will be helpful.

Frequently Asked Questions


What Does a Menstrual Cramp Feel Like?

Menstrual cramps is an intense cramping or throbbing pain in the lower abdomen. Typically, the pain will start 1 to 3 days before the period and peak 24 hours after the period, and the pain subsides in 2 to 3 days. It can also be dull and continuous. The pain can also radiate to the thighs and lower back.


What Can Worsen the Menstrual Cramps?

- Menstrual cramps can be worsened by eating high-carb and sugar food, salty food, dairy products, fatty food, chocolates, and processed food.
- Lack of physical activities.
- Inadequate sleep.
- Drinking caffeine.
- Smoking.


What Foods Are Useful to Reduce Menstrual Cramps?

Foods that help in reducing the menstrual cramps are the following:
- Drink more water.
- Green leafy vegetables.
- Ginger.
- Salmon.
- Fruits.
- Chicken.
- Dark chocolate.
- Turmeric.
- Nuts.
- Eggs.
- Flaxseed oil.
- Quinoa.


Does Menstrual Cramps Get Worse With Age?

Menstrual cramps can worsen with age, this can be due to an underlying condition or a can be some factors like stress. The worsening menstrual cramps can be accompanied by other symptoms like irregular periods, pain during sex, bleeding between periods, and foul-smelling vaginal discharge.


Why Does Frequent Bowel Movement Happen During Periods?

Just before the periods, the prostaglandins relax the smooth muscles inside the uterus causing the lining of the uterus to shed. A similar impact happens on the bowel causing an increased tendency for bowel movement.


Why Does Severe Pain Occur During the Periods?

It is common for many women to have pain for a couple of days during the periods because the uterus relaxes and tightens to move the blood out. Other symptoms such as nausea, vomiting, constipation, diarrhea, bloating in the belly area, and, headaches can be experienced during the periods.


Does Menstrual Cramp Occur Days Before the Periods?

Mostly cramps occur when the period starts, but it is also possible to have cramps days before the period. This condition is referred to as premenstrual syndrome (PMS). It occurs due to the hormonal changes in the body right before a period. It can be accompanied by symptoms like mood swings, fatigue, and tender breasts.


Does Cramp Occur Before Pregnancy?

In some cases, cramp occurs anywhere from 6 to 12 days after fertilization of the egg. This is called implantation cramps. These cramps resemble the period cramps. So some women mistake it for period cramps.


What Kind of Cramps Occur During Pregnancy?

During early pregnancy, a mild cramp in the lower abdomen is common. It can occur during infrequent intervals. As the belly grows, tugging, slight pulling, or stretching of the uterus occurs causing cramps similar to menstrual cramps.


How Long Does a Menstrual Cramp Last?

Menstrual cramps usually start one or two days before getting a period or when bleeding actually starts. The pain ranges from mild to severe in the lower abdomen, thighs, or back. The pain can usually last for 12 to 72 hours and it might also have symptoms like fatigue, nausea, vomiting, diarrhea, and constipation.
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Dr. Manwani Saloni Dilip
Dr. Manwani Saloni Dilip

Obstetrics and Gynecology


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