Menstrual Cramps (cont.)
How are menstrual cramps diagnosed?
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 menses (monthly menstrual flow), she becomes well aware of the typical symptoms.
What is the treatment for common menstrual cramps (primary dysmenorrhea)?
Every woman needs to find a treatment that works for her. Perhaps the most common treatment, especially in the past, has been to lie down at the first sign of pain. It used to be that many women's restrooms contained a cot or a couch so that a woman who felt "indisposed" could lie down. A bed in the school nurse's office served the same purpose and girls were routinely excused from physical education or other classes because of 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 help. A heating pad applied to the abdominal area may relieve the pain and congestion.
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:
A woman should start taking one of these medications before her pain becomes difficult to control. This might mean starting medication 1-2 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).
Next: What if the cramps are very severe? »
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