Menstrual periods can be light and easy for some teens and young women, but for others, they can be heavy or accompanied by painful cramps. Cramps can be a big reason why girls are absent from school, why they miss sport practices, and why they may avoid social events with their friends. How do you know if you should be concerned? Read on to learn more about painful periods and what you should do if you have them.
What is Dysmenorrhea?
Dysmenorrhea (pronounced: dis-men-o-ree-a) is a medical term that means “difficult or painful periods”. There are two types of dysmenorrhea, primary and secondary.
Primary dysmenorrhea is the most common kind of dysmenorrhea. Cramping pain in the lower abdomen (belly) can start from 1–2 days before your period comes and can last 2–4 days, which may include lower back pain.
What causes menstrual cramps?
Menstrual cramps are caused by uterine contractions (when your uterus tightens and relaxes allowing blood to leave your uterus). The lining of your uterus releases special chemicals called “prostaglandins”. These substances can increase the intensity of the contractions especially if the levels rise. High levels of prostaglandins may also cause nausea and lightheadedness.
Is it normal to have some mild cramps during your period?
Yes, it is normal to have mild cramps during your period because of uterine contractions. The uterus is a muscle that tightens and relaxes which can cause jabbing or cramp-like pain. However, if the discomfort is not relieved with over the counter medications and causes you to miss school or other daily activities, it could mean that there is another reason for your symptoms.
When you first get your period, it is common for you not to have regular periods and you may not ovulate for a few months, or even for a few years. So you may not have menstrual cramps when you first begin your period. After one or two or three years, when your hormone system is more mature, you might have more severe menstrual cramps.
What other symptoms do girls have during their periods?
In addition to cramping during their periods, some girls may have other symptoms.
*Symptoms may be mild to moderate and can include:
- Nausea (feeling like you want to throw up)
- Vomiting (throwing up)
- Loose bowel movements/diarrhea
- Bloating in your belly area
- Lightheadedness– feeling faint
Are menstrual cramps the same as PMS (Pre-Menstrual Syndrome)?
Menstrual cramps are not the same as PMS. Symptoms of PMS such as bloating, weight gain, and moodiness happen before a woman’s period begins, and get a lot better when her period starts. On the other hand, with dysmenorrhea, cramps usually get worse the first day or two of a woman’s period and have a different cause and treatment.
What medications can I take for my menstrual cramps?
If you are having menstrual cramps, talk with your parents or health care provider about your options. If your menstrual cramps are painful, you may think about taking some type of the over-the-counter medication for one to two days. These medications are “anti-prostaglandins”. They help relieve the discomfort, make your flow lighter, and cause your uterus to cramp less. Look for over-the-counter medications that contain Ibuprofen or naproxen. Take this medicine when you first start to feel uncomfortable, and continue taking it every 4–6 hours or as recommended by your health care provider. Since this kind of medicine can upset your stomach, you should take it with food. Make sure you read the label as to how much and how often you should take the medication. You should not take these products if you are allergic to aspirin-like medicine or have stomach problems. It is important not to take more medicine than is recommended or prescribed.
Is there anything else I can do to help my menstrual cramps?
Natural remedies like a microwavable warm pack or a heating pad placed on your abdomen (lower belly) may help. Soaking in a warm bath may also relieve uncomfortable cramps. Some teens find that increasing their physical activity helps; others find that resting quietly for short periods of time helps.
Acupuncture is an alternative treatment that is sometimes recommended to treat dysmenorrhea. You should also eat a healthy diet, drink lots of fluids, and get plenty of rest. You can try different treatments to find out what works best for you.
What if nothing helps my menstrual cramps?
If your menstrual cramps are not relieved by over-the-counter medicine, make an appointment to see your health care provider (HCP). It is helpful to bring a “pain diary” (that you have kept for a couple of months) to show your HCP. A pain dairy is a tool to help you keep track of your pain; when it comes, the location of the pain, how long it lasts, and what relieves it.
For example: You had pain in the lower area of your belly that lasted for 4 hours. You took 2 Motrin (200 mg) with good relief and you used a heating pad that helped.
Is it okay to exercise when I have my period?
Exercising is a good way to stay fit and healthy. Some girls like to exercise when they have their period because it helps lessen their cramps. Other girls are uncomfortable exercising when they have their period. You should find what works best for you. Talk to your coach or gym teacher if exercising is uncomfortable during your period.
What if I have big clots of blood during my period?
Dark, chunky clots of blood can be perfectly normal. Many women get them during their period when they have days of heavy cramping and heavy bleeding. Your body usually makes things called “anti-coagulants,” that keep your blood from clotting as it moves to your vagina and out of your body. But during days of heavy bleeding and cramping, your body is pushing blood so quickly out of you that your body does not have time to release these anti-coagulants. Your blood then clots. If you have clots that are bigger than a quarter, it is a good idea to talk with your health care provider.
What if I get spots of blood on my underwear between my periods?
Bleeding in the middle of your cycle could mean different things. Some women bleed a little bit during the middle of their cycle, when they ovulate (when a mature egg is released from your ovaries). This is nothing to worry about. Other times, “spotting” occurs because of an infection such as a sexually transmitted disease (if you are having sexual intercourse). Sometimes, “spotting” can be because of a cervical polyp (a tumor that may need to be removed surgically). But this is not very common! You should talk to your health care provider if you have bleeding when you don’t have your period.