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- Menstrual cramps facts
- What are menstrual cramps?
- How common are menstrual cramps?
- What is dysmenorrhea?
- What causes menstrual cramps?
- Why are some cramps so painful?
- Can menstrual cramps be measured?
- What other factors influence menstrual cramps?
- What are the symptoms of menstrual cramps?
- How are menstrual cramps diagnosed?
- What is the treatment for common menstrual cramps (primary dysmenorrhea)?
- What if the cramps are very severe?
- Are there surgical solutions?
- What is the treatment of secondary dysmenorrhea?
- What is the long-term outlook (prognosis) for menstrual cramps?
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What is dysmenorrhea?
The medical term for painful menstrual periods is dysmenorrhea. There are two types of dysmenorrhea, primary and secondary.
In primary dysmenorrhea there is no underlying gynecologic pathology causing the pain. This type of cramping may begin within six months to a year following menarche (the beginning of menstruation). Menstrual cramps typically are not experienced until ovulatory menstrual cycles (when an egg is released from the ovaries) begin. Menstrual bleeding usually begins before the onset of ovulation. Therefore, an adolescent girl may not experience dysmenorrhea until months to years following the onset of menstruation.
In secondary dysmenorrhea, some underlying abnormal condition (usually involving a woman's reproductive system) contributes to the menstrual pain. Secondary dysmenorrhea may be evident at menarche, but more often, the condition develops later.
What causes menstrual cramps?
Each month, the inner lining of the uterus (the endometrium) normally builds up in preparation for a possible pregnancy. After ovulation, if the egg is not fertilized by a sperm, no pregnancy will result and the current lining of the uterus is no longer needed. The woman's estrogen and progesterone hormone levels decline, and the lining of the uterus becomes swollen and is eventually shed as the menstrual flow. It is replaced by a new growth of lining during the next monthly cycle.
When the uterine lining begins to break down, molecular compounds called prostaglandins are released. These compounds cause the muscles of the uterus to contract. When the uterine muscles contract, they constrict the blood supply (vasoconstriction) to the endometrium. This contraction blocks the delivery of oxygen to the tissue of the endometrium which, in turn, breaks down and dies. After the death of this tissue, the uterine contractions squeeze the old endometrial tissue through the cervix and out of the body by way of the vagina. Other substances known as leukotrienes, which are chemicals that play a role in the inflammatory response, are also elevated at this time and may be related to the development of menstrual cramps.