When to See a Doctor for Menstrual Cramps
Ah, the dreaded menstrual cramps, also known as dysmenorrhea. Most women who've had periods have also had these pains, which come on either a day or two before or during menstruation. One study of young college women showed about 84% had experienced menstrual pain; about 43% had it with every period. Menstrual cramps can be so severe for some women that they disrupt their daily lives, causing them to miss work, school or other obligations. When should you see a doctor for menstrual cramps relief?
Most cramps are caused by menstruation itself. This type of period pain is called primary dysmenorrhea. During your period, your body produces hormones called prostaglandins that help your uterus shed its lining. The prostaglandins cause contractions, which you feel as cramps. Some women are believed to create more prostaglandins than others or be more sensitive to them, and thus have more cramps.
Other risk factors for dysmenorrhea are:
Having started your period early or late
Having long periods
Being new to menstruation (younger females tend to have more pain, which goes away as they get older)
Being a smoker (or secondhand smoker)
Never having been pregnant
Having a family history of painful menstrual cramps
Other conditions can cause cramps too. If your severe menstrual cramps are caused by something other than your period, you're considered to have secondary dysmenorrhea. Some common conditions that can cause cramps are:
Endometriosis (where the tissue lining the uterus is found outside the uterus)
Adenomyosis (where the lining of the uterus grows into the wall of the uterus)
Uterine fibroids or polyps
Pelvic infections including pelvic inflammatory disease
Using an IUD
Having a narrow cervix or other structural, congenital problems
You may be able to relieve your menstrual pain through at-home treatments, such as over-the-counter pain relievers, supplements, and lifestyle changes. Researchers also are studying other possible remedies, including Zumba dancing, yoga, and light therapy. More common menstrual cramp home treatments, which have been supported by research include:
Over-the-counter pain relievers: nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, relieve pain and reduce prostaglandins. (If you have stomach problems, such as ulcers, or if you have an aspirin allergy, ask your doctor before taking NSAIDs.) Acetaminophen is not quite as effective, but can offer some pain relief.
Vitamin and mineral supplements: vitamin E, vitamin B1 (thiamine), vitamin B6 and omega-3 fatty acids (fish oil) may cut pain. Magnesium also may help, but can have side effects and interact with many medications. Check with your doctor before taking magnesium.
Herbal medicine: pycnogenol and fennel.
Heat therapy: Taking a hot bath or using a hot water bottle, heating pad, heat wrap or other heat source of about 102 degrees Fahrenheit on your lower abdomen. (Place a cloth or wear clothes between your skin and the heat source to prevent skin irritation.) Studies show this can be as effective as ibuprofen for cutting pain.
Exercising at least 30 minutes daily, five days a week.
Reducing stress, such as by relaxing with yoga or meditation.
Getting enough rest.
Avoiding tobacco and alcohol.
You've tried the home remedies, and still your cramps are interfering with your life. That's one reason to make an appointment with your doctor to see what can be done. He or she might prescribe medications that can help, such as birth control pills or patches, or prescription-strength pain relievers. Other signs you need to visit your doctor include:
Your periods are getting heavier and cramps getting worse over a 2- to 3-month time period.
You experience pain when you're not on your period.
Your period pain isn't relieved by medication.
Your pain spreads to other parts of your body, such as into your back or down your leg.
Your cramps suddenly get worse.
You're older than 25 and get severe cramps for the first time.
You have a fever along with your cramps.
Some signs that your menstrual cramps need immediate medical attention—as in, call 911 or get to the emergency room:
Severe pain, such as pain that causes you to double over
Heavy vaginal bleeding coupled with feeling faint or dizzy
Sudden chest pain or trouble breathing
Your pain is extreme and paired with excessive bleeding
You're pregnant and having severe menstrual cramps
A gynecologist is a specialist with expertise in the female reproductive system, so if you have a gynecologist this would be the doctor you would most likely turn to for menstrual cramp problems. Your primary care physician (usually a family practitioner or internist) may also be able to advise you concerning these questions or can refer you to a specialist (some insurance companies may require referral to a specialist first).
It's always important to pay attention to your symptoms or to any changes in your health. You don’t have to live with very painful menstrual cramps. If cramps are disrupting your life, seek medical advice. Your doctor is your best resource for answering questions and providing treatment that can help relieve your dysmenorrhea symptoms.