Menstrual Cramps

Causes

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. 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 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

To ease your menstrual cramps, your doctor might recommend:

Pain relievers. Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB, others) 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. Start taking the pain reliever at the beginning of your period, or as soon as you feel symptoms, and continue taking the medicine as directed for two to three days, or until your symptoms are gone.
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).
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.