MENSTRUAL PAIN   

Menstrual cramps are sharp pains in a woman's lower abdomen that occur when her menstrual period begins and may continue for 2-3 days. Symptoms can range in severity from a mild annoyance to severe pain that interferes with normal activities.

Menstrual cramps are the leading cause of absenteeism in women younger than 30 years. Although over half of women who have menstrual periods experience some discomfort, 10% are temporarily disabled by symptoms.

The following circumstances may make a woman more likely to experience menstrual cramps:

• She started her first period at an early age (younger than 11 years).
  
  
• Her menstrual periods last 5 days or longer.
  
  
• She is overweight or obese.
  
  
• She smokes cigarettes or uses alcohol.
  
  
• She has never been pregnant.

What are the symptoms of menstrual cramps?

Menstrual cramps are pains that begin in the lower abdomen and pelvis. The discomfort can extend to the lower back or legs. The cramps can be a quite painful or simply a dull ache. They can be periodic or continual.

Menstrual cramps usually start shortly before the menstrual period, peak within 24 hours after the onset of the pains, and subside again after a day or two.

Menstrual cramps may be accompanied by a headache and/or nausea, which can lead, although infrequently, to the point of vomiting. Menstrual cramps can also be accompanied by either constipation or diarrhea because the prostaglandins which cause smooth muscles to contract are found in both the uterus and intestinal tract. Some women experience an urge to urinate more frequently.

What is dysmenorrhea?

The medical term for menstrual cramps is dysmenorrhea. There are two types of dysmenorrhea, primary and secondary.

In primary dysmenorrhea, there is no underlying gynecologic problem causing the pain. This type of cramping may begin within six months to a year following menarche (the beginning of menstruation), the time when a girl starts having menstrual periods. Menstrual cramps typically do not begin until ovulatory menstrual cycles (when an egg is released from the ovaries) occur, and actual menstrual bleeding usually begins before the onset of ovulation. Therefore, an adolescent girl may not experience dysmenorrhea until months to years following the onset of menstruation.

In secondary dysmenorrhea, some underlying abnormal condition (usually involving a woman's reproductive system) contributes to the menstrual pain. Secondary dysmenorrhea may be evident at menarche but, more often, the condition develops later.

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