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Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• 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?
• Menstrual Cramps At A Glance
• Patient Comments: Menstrual Cramps - Adolescent Girls
• Patient Comments: Menstrual Cramps - Experiences
• Patient Comments: Menstrual Cramps - Effective Treatments
• Patient Comments: Menstrual Cramps - Other Causes
• Patient Comments: Menstrual Cramps - Symptoms
• Find a local Obstetrician-Gynecologist in your town
• Menstrual Cramps Index

The diagnosis of menstrual cramps is usually made by the woman herself and reflects her individual perception of pain. Once a woman has experienced menstrual cramps, usually with the adolescent onset of her monthly menstrual flow (menses), she becomes well aware of the typical symptoms. If there are other medical conditions contributing to menstrual cramps (secondary dysmenorrhea), the doctor may suggest diagnostic testing including imaging studies.

Every woman needs to find a treatment that works for her. There are a number of possible remedies for menstrual cramps.

Current recommendations include not only adequate rest and sleep, but also regular exercise (especially walking). Some women find that abdominal massage, yoga, or orgasmic sexual activity may bring relief. A heating pad applied to the abdominal area may relieve the pain and congestion and decrease symptoms.

A number of nonprescription (over-the-counter) agents can help control the pain as well as actually prevent the menstrual cramps themselves. For mild cramps, aspirin or acetaminophen (Tylenol), or acetaminophen plus a diuretic (Diurex MPR, FEM-1, Midol, Pamprin, Premsyn, and others) may be sufficient. However, aspirin has limited effect in curbing the production of prostaglandin and is only useful for less painful cramps.

The main agents for treating moderate menstrual cramps are the nonsteroidal antiinflammatory drugs (NSAIDs), which lower the production of prostaglandin and lessen its effect. The NSAIDs that do not require a prescription are:

• ibuprofen (Advil, Midol IB, Motrin, Nuprin, and others);
• naproxen sodium (Aleve, Anaprox); and
• ketoprofen (Actron, Orudis KT).

A woman should start taking one of these medications before her pain becomes difficult to control. This might mean starting medication 1 to 2 days before her period is due to begin and continuing taking medication 1-2 days into her period. The best results are obtained by taking one of the NSAIDs on a scheduled basis and not waiting for the pain to begin.

Prescription NSAIDs available for the treatment of menstrual cramps include mefenamic acid (Ponstel) and meclofenamate (Meclomen).