Most women have painful menstrual cramps
(dysmenorrhea) from time to time. Menstrual cramps are one of the most common
reasons for women to seek medical attention. The pain from menstrual cramps can
range from mild to severe and can involve the lower belly, back, or thighs.
You may also have headaches, nausea, dizziness or fainting, or diarrhea or
constipation with your cramps.
During the menstrual cycle, the
lining of the
uterus produces a hormone called
prostaglandin. This hormone causes the uterus to
contract, often painfully. Women with severe cramps may produce
higher-than-normal amounts of prostaglandin, or they may be more sensitive to
Cramping is common during the teen years, when a young woman
first starts having periods. Primary
dysmenorrhea is a term used to describe painful
menstrual cramping with no recognized physical cause. It is seen most commonly
in women between the ages of 20 and 24. It usually goes away after 1 to 2
years, when hormonal balance occurs.
Secondary dysmenorrhea is a
term used to describe painful menstrual cramping caused by a physical problem
other than menstruation. Physical problems that can cause this type of cramping
A condition in which cells that look and act like
the cells of the lining of the uterus (endometrium) are found in other parts of
the abdominal cavity (endometriosis) or grow into the
muscular tissue of the uterine wall (adenomyosis). Pain usually occurs 1 to
2 days before menstrual bleeding begins and continues through the period.
Pelvic infections. Your risk for developing an infection is higher after
menstrual bleeding has begun because the opening to the uterus (cervical canal)
widens during menstruation. But pelvic infections, especially those caused by
sexually transmitted infections, can occur at any
intrauterine device (IUD). An IUD may cause increased
cramping during your period for the first few months of use. If menstrual
cramping persists or gets worse, you may need to consider having the IUD
removed and choosing another birth control method.
Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.
Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Call your doctor now to discuss the symptoms and
arrange for care.
If you cannot reach your doctor or you don't have
one, seek care in the next hour.
You do not need to call an
You cannot travel safely either by driving
yourself or by having someone else drive you.
You are in an area
where heavy traffic or other problems may slow you down.
Make an Appointment
Based on your answers, the problem may not improve without medical
Make an appointment to see your doctor in the
next 1 to 2 weeks.
If appropriate, try home treatment while you
are waiting for the appointment.
If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
How this information was developed to help you make better health decisions.