Why Do Women Have Menstrual Cramps?
Menstrual cramps in medical terms are called dysmenorrhea which can be primary or secondary. In case of the primary dysmenorrhea, the pain has no underlying cause to get worried about. Menstrual cramps may not start as soon as menarche is followed. It starts once ovulation sets itself which may be after months or may be years depending on the timing of ovulation. On the other hand in case of secondary dysmenorrhea, there is some abnormality in the women’s reproductive system. Menstrual cramps are found to be suffered by 50% of the women among whom approximately 15% women claim it to be severe.
Menstrual cramps comprise the pain in belly and pelvic region that is undergone by women during her period. Menstrual cramps and premenstrual syndrome are different even if they occur simultaneously in some women. Menstrual cramps vary from little which are hardly felt or can be detected to severe where it restricts a normal life for some days among women.
During the breakdown of the endometrium lining each month (except in case of pregnancy), molecular substances known as prostaglandins are released which cause contraction of the uterus leading to vasoconstriction. This situation cuts down the supply of oxygen to the endometrium. As such the tissue dies and breaks down and ultimately comes out of the body. During this cycle, chemicals like leukotriene’s levels are raised that cause menstrual cramps.
Menstrual cramps are painful for women who have narrow cervical canal and during passage of blood clots. The pain may be felt in the legs or lower back too. Menstrual cramps start sometime before the onset of the menstrual cycle and reaches its peak within 24 hours of the bleeding and lowers after a day or two. If high levels of prostaglandin are present then it leads to severe menstrual cramp and vice versa. Menstrual cramps can be due to tilting of the uterus backward. Lack of exercise is also a cause along with psychological factors like stress. Menstrual cramps may be followed by headache, constipation, diarrhea and nausea. Menstrual cramps can be measured by measuring the pressure within the uterus and the frequency and number of the uterine contractions.
Menstrual cramps can be treated by taking rest, sleep, doing regular exercise like walking, yoga. Abdominal massage or a heating bag applied at the abdominal area may bring relief. Aspirin or acetaminophen is also useful but only for mild cramps. For moderate cramps, nonsteroidal anti-inflammatory drugs like ibuprofen are taken. While in case of severe menstrual cramps doctors usually prescribe oral contraceptive pills to prevent ovulation to take place that in turns lessens the production of prostaglandins. Thus cramping diminishes. The above treatments were for primary dysmenorrhea.
Various reasons that cause secondary dysmenorrhea are endometriosis, adenomyosis, presence of fibroids in the uterus, disease leading to inflammation of the pelvic, adhesions and use of intrauterine device. Successful treatment for the underlying cause leads to disappearance of the severe menstrual cramps. There are many surgical solutions also like undergoing dilation and curettage operation, endometrial ablation and hysterectomy etc.