Heavy Menstrual Cramps: What Are My Options?

May 18, 2023

Normal menstrual periods take place when prostaglandins, substances similar to hormones, are released, causing the uterus to shed its lining, call the endometrium. As the uterus contracts to shed this inner lining, it gets less oxygen, which can cause a cramping sensation and discomfort.

What can I do for heavy menstrual cramps?

When heavy menstrual cramps interfere with normal life and comfort, the first thing to do is to make sure you are getting enough rest and minimizing stress. Simply getting 8 hours of sleep a night and learning to take stressful situations in stride can make a difference. Exercise is helpful to many women, so get out and walk the dog or hit the gym a few days a week. Placing a warm heating pad onto the lower abdomen can also bring comfort. Vitamins B1 (thiamine), B6, and E, as well as omega-3 fatty acids and magnesium have been found effective in some studies.

What if lifestyle changes aren’t enough?

If these lifestyle changes aren’t enough, the next step is over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs). Aleve (naproxen), or Advil (ibuprofen) should be started the day before or the first day of your period, and continued for 2 to 3 days or until the end of your period, according to instructions on the label. Stronger NSAIDs are available by prescription. Mobic (meloxicam) and Celebrex (celecoxib) are two popular prescription NSAIDs.

Hormonal birth control medications can be highly effective. They can consist of the hormones estrogen and progesterone or progestin alone.

A physician can determine whether unusually troublesome menstrual cramps can be caused by an abnormality. A pelvic examination and ultrasound can reveal a diagnosis such as endometriosis, in which uterine tissue grows outside the uterus. In some cases a CT scan is performed to confirm the diagnosis, or even a procedure to “look inside.”

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