Treatments for Menstrual Cramps

November 07, 2009

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Treatments for Menstrual Cramps

by Marjorie Greenfield, M.D.
reviewed and revised by Marjorie Greenfield, M.D.

It is unfortunate but true that many women and girls experience menstrual cramps during their monthly period. For some, the discomfort is just an annoyance; but for others, the cramps actually can be quite debilitating. No matter what the situation, though, most women are likely to jump at the chance to make the belly pain, headache, and lower-back pain go away.

Treatment for menstrual cramps can be tried in stages, starting with comfort measures, then moving to over-the-counter (OTC) medications, prescription cramp medicine, and finally, hormonal treatments. While you may be tempted to jump right to one of the later measures, a majority of girls and women can save themselves the time and added expense and get effective relief from simple comfort measures or OTC pain relievers.

Comfort measures
Many people get some relief from cramps with the use of a heating pad or hot water bottle or by taking a warm bath. And while it may not seem intuitive, regular exercise also seems to help stave off bad cramps. Even involving yourself in distracting activities--something as simple as listening to music or calling a friend--can make you feel better. We all know that any pain hurts worse when we focus on the problem and don't give ourselves a reason to feel better.

Nonsteroidal anti-inflammatory drugs (NSAIDs)
Comfort measures can help but are not always adequate. Since uterine hormones called prostaglandins are responsible for causing menstrual cramps, medications in the nonsteroidal family of drugs, which prevent production of these hormones, work well to alleviate symptoms.

This class of drugs includes ibuprofen (Motrin, Advil, Nuprin) and naproxen (Aleve), available in nonprescription strengths. Most of the combination medications marketed for menstrual cramps, such as Midol, also contain NSAIDs.

If the over-the-counter strengths are not enough, prescription NSAIDs can be used. Acetaminophen (Tylenol) and aspirin usually are not effective.

Key points about NSAIDs

Doctors used to think that you had to start taking medication the day before your period began. Now it turns out relief starts within an hour of the first dose, which can be taken as needed. As with all pain treatment, though, it's easier to resolve menstrual pain early on, before it becomes excruciating.

Most cramps are worse the first day or two of the cycle, so a lot of girls and women find that they can get good control of their pain with just a few days of medication.

Studies have shown that these drugs also help to alleviate the nausea, diarrhea, and headache that may accompany a woman's period.

One well-known side effect of NSAIDs is that blood may not clot as well. However, if you usually have heavy periods and are avoiding NSAIDs because you don't want your flow to get any heavier, you might want to rethink your decision. The fact is, most people on NSAIDs do not see an increase in blood loss during their period, and NSAIDs have actually been shown to decrease the menstrual flow for some conditions.

People who are allergic to aspirin or NSAIDs, who take prednisone or other steroids, or who have had stomach ulcers or other gastrointestinal problems should consult a physician before taking NSAIDs.

Hormonal treatments
Birth control pills, the birth control patches and vaginal rings not only are an effective method of birth control, but they also work extremely well at diminishing menstrual pain. By the third or fourth month of using them, many women who suffered horribly in the past are pain-free.

This may not be a viable option for younger patients, though, for several reasons. First, many parents are concerned about the health effects of the Pill and these other similar methods. They also may worry that having their daughters take birth control pills to treat cramps will only encourage them to start sexual activity at an earlier age. (While it really would be better for everyone if birth control pills could be called "cycle control pills" and not packaged as contraception, this is not likely to happen.) It may be reassuring for parents to know, however, that studies have shown that using the Pill for medical reasons does not increase the likelihood of sexual activity in teenagers.

As for the girls themselves, some young teens might find it embarrassing to be on the Pill, and most teenagers worry about side effects, such as weight gain.

If you decide to take the Pill, the Patch or the Ring to treat your cramps, keep in mind that it doesn't reach its maximal benefit until a few cycles have passed. Try to be patient, and don't pass final judgment until about four months into the course of treatment. Cramps that don't respond to hormonal contraceptives and NSAIDs may be a sign of a medical condition. Be sure to see your doctor again if you have cramps between periods or if you do not see improvement after four cycles.


RELATED INFORMATION

			Menstrual Cramps
			Menstrual Cycle Basics
			Menstrual Issues
			Menstruation

Created July 17, 2001
Reviewed and revised August 25, 2004

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