What's the Cause of Menstrual Cramps?

Menstrual cramps are a concern for many women who suffer from them month after month when they have their period but they don't always know the cause. There are, in fact, many causes, as well as many treatments.
What's the Cause of Menstrual Cramps?

Last update: 31 March, 2021

The cause of menstrual cramps is still a mystery for many women. This is because some of them go through their period without pain, while others experience them regularly. In some cases, this condition can significantly affect a person’s quality of life.

Menstruation is the normal vaginal bleeding women experience every month during their childbearing years. It’s a normal part of the menstrual cycle which, under normal conditions, lasts twenty-eight days.

What’s dysmenorrhea? Does it cause menstrual cramps?

Various menstruation items.
Menstrual bleeding is usually accompanied by moderate abdominal pain.

What seems like bleeding during menstruation is in fact the uterine endometrium. This layer of tissue forms in the uterus at the beginning of every cycle and comes out at the end of it if there’s no pregnancy. Hormones actively intervene to regulate this monthly process.

Pain during menstruation is clinically known as dysmenorrhea. The usual manifestation is in the form of cramps, intermittent pains that come and go rhythmically. Women feel menstrual pain in the lower abdomen.

Dysmenorrhea is quite common. Estimates indicate that about 10% of women have moderate pain associated with their menstrual cycle. Note that moderate pain is one that interrupts daily activities.

The main hypothesis about menstrual pain is that it’s due to an excessive amount of prostaglandins. These substances appear in abundance when the endometrium is about to come out. Their function is to deflate the pelvic area and facilitate the contraction of the uterus.

Types of dysmenorrhea

There are two types: primary and secondary and each depends on the cause of menstrual pain.

  • There’s no other disease to explains the pain in primary dysmenorrhea. In general, it’s a pain that begins the days before menstruation and lasts for as long as the bleeding lasts. It gets better with age and also after pregnancy, although this isn’t always the case. Prostaglandins are the explanation for primary dysmenorrhea. They’re natural but can lead to pain if there’s an excess of them.
  • The cause for secondary dysmenorrhea is other diseases that impact the female reproductive system. This means another disease has menstrual pain as one of its symptoms. The two most frequent causes of secondary dysmenorrhea are endometriosis and uterine fibroids. The former is more difficult to treat and diagnose, while you can treat fibroids either clinically or surgically.

Symptoms of menstrual cramps

Classic menstrual cramps are intermittent and start two days before menstruation. The usual location is the lower abdomen but may radiate to the back.

Along with the pain, some women also experience:

  • Headaches
  • Dizziness and vertigo
  • Nausea and vomiting
  • Diarrhea or changes in bowel movements

Particular situations

Dysmenorrhea is linked to particular situations that women may go through. This kind of pain is definitely connected to the reality of daily life. It occurs cyclically and monthly, so it responds to certain stimuli.

Studies recognize that stress is one of the triggers of menstrual pain. They become more evident and even more intense in stressful situations or moments of tension.

Also, women who smoke experience severe menstrual cramps and they worsen if the habit persists.

In contrast, physical activity can relieve menstrual pain as exercise improves circulation in the pelvic region, thereby decreasing pain.

Physical activity also releases tension and reduces stress, which eliminates some of the risk factors.

Treatments for menstrual cramps

A person holding some pills.
Oral contraceptives (OCPs) are very effective, despite their adverse effects.

Several medications are available for the treatment of menstrual cramps when these are due to primary dysmenorrhea. As for secondary dysmenorrhea, the underlying causes, such as endometriosis or fibroids, require treatment.

Some of the indicated drugs are:

  • Contraceptive pills regulate the menstrual cycle and soothe the pain. They reduce the effect of prostaglandins by decreasing their production. In fact, many women don’t experience this condition because these pills are their method of contraception. As you can see, they greatly benefit from this side effect.
  • Anti-inflammatory drugs (NSAID, non-steroidal anti-inflammatory drugs) are the choice to relieve pain associated with menstruation at specific times.
  • Science has failed to clearly demonstrate the positive effects of vitamin supplements in this case. However, isolated studies show that magnesium and zinc are good for women. Similarly, vitamin B has been studied as a possible adjuvant for treatment.

Consult a doctor if your periods are painful. That way, you can undergo the necessary complementary studies to find the cause and then establish treatment.

Reducing stress and incorporating physical activity are some of the pillars to approach the cause of menstrual cramps. As you can see, it’s possible to keep menstrual pain at bay.

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  • Domínguez, A. Rivera, et al. “Dolor pélvico de origen ginecológico como patología urgente.” Radiología 59.2 (2017): 115-127.