Menstrual Pain: Causes, Symptoms, When to seek medical care, Medication and Prevention

Menstrual cramps are sharp pains in a woman's lower abdomen that occur when her menstrual period begins and may continue for two to three days. Symptoms can range in severity from a mild annoyance to severe pain that interferes with normal activities.

Menstrual cramps are the leading cause of absenteeism in women younger than 30. Although over half of women who have menstrual periods experience some discomfort, 10% are temporarily disabled by symptoms.

The following circumstances may make a woman more likely to experience menstrual cramps:
She started her first period at an early age (younger than 11 years).
Her menstrual periods are heavy.
She is overweight or obese.
She smokes cigarettes or uses alcohol.
She has never been pregnant.

Causes of Menstrual Pain
Prostaglandins are chemicals a woman's body produces that cause many of the symptoms associated with menstrual discomfort. The tissue that lines the uterus makes these chemicals. Prostaglandins stimulate the uterine muscles to contract. Women who have high levels of prostaglandin may experience more intense contractions of their uterus and more pain. Prostaglandins may also be responsible for vomiting, diarrhea, and headaches that accompany painful periods.

Other menstrual-type cramps can be caused by conditions of the reproductive tract, such as the following:
Endometriosis -- uterine tissue that appears outside the uterus
Fibroids and adenomyosis -- noncancerous (benign) growths in the uterus
Infections in the reproductive organs
Abnormal pregnancy, such as an ectopic pregnancy (pregnancy in the tubes, outside the uterus)
IUD (intra-uterine device) used for birth control
Ovarian cyst
Narrow cervix

If a woman has had menstrual pain ever since her periods started, the condition is classified as primary dysmenorrhea. If a physical condition such as pelvic inflammatory disease or endometriosis has developed and is causing the pain, this is called secondary dysmenorrhea. Once the medical condition is treated, the menstrual pain usually goes away.
Symptoms of Menstrual Pain

In addition to cramps in the lower abdomen, a woman may also experience some of these symptoms with menstrual cramps:

Lower back pain
Leg pain, radiating down the legs
Nausea
Vomiting
Diarrhea
Headaches
Irritability
Weakness
Fainting spells (in extreme cases)

When to Seek Medical Care
Most women have significant improvement with home care. However, a woman should call her health care provider in these situations:
Menstrual cramps continue to be painful for longer than usual.
The pain is suddenly worse or different from what she may have experienced before.
Bleeding is excessive, requiring more than one pad or tampon per hour.
Signs of infection, such as fever, chills, and body aches, are present at the time of the period.
Menstrual cramps began in a woman older than 25 years.
The woman suspects she may be pregnant and any of these symptoms occur.

The woman's doctor can help her manage most symptoms. However, she should go to a hospital's emergency department if any of the following problems occur:
She faints.
She experiences repeated dizziness when standing up.
A sudden, intense pelvic pain causes her to double over.
Tissue is passed in the menstrual flow. Tissue often appears silvery or grayish.
She thinks she might be pregnant and has menstrual-type pain.

Medications for Menstrual Pain
The best way to relieve painful menstrual cramps is to take an anti-inflammatory medication. Ibuprofen(Advil, Motrin), naproxen (Aleve, Naprosyn), and ketoprofen (Orudis) are available without a prescription and are effective at blocking the effects of prostaglandins.
These drugs work better if taken before the start of menstruation and can be continued as long as needed. If one type does not relieve the pain, try another, because these medications do not work the same in everyone.
Anti-inflammatory drugs like this can be harsh on the stomach. If there is a history of kidney problems or stomach problems (such as ulcers or reflux), consult with your health care provider before starting this type of medication. Taking the pills with meals may help prevent upset stomach.
Starting some form of hormonal birth control is another option to control or stop menstrual cramps. This can be a pill, an injection, a transdermal patch, or a hormone-containing IUD. These methods can reduce or eliminate the menstrual flow leading to less pain.


Menstrual Pain Home Remedies
If anti-inflammatory medicine is not an option or if additional relief is needed, the following strategies may help relieve menstrual cramps:
A heating pad to the pelvic area
Massage to the back and lower abdomen
Exercise, especially prior to the start of a period
Thiamine (100 mg daily)
Low-fat vegetarian diet
Calcium (1,200 mg daily)

Preventing Menstrual Pain
Prevent painful menstrual cramps with these techniques:
Keep a normal body weight.
Don't smoke.
Don't drink too much alcohol.
Exercise regularly.

Source: webmd.com