A menstrual cramp is a pain that comes from having a menstrual period. It is also called dysmenorrhea. The majority of menstruating women experience period cramps for one to two days a month. Dysmenorrhea can cause throbbing pain in the lower abdomen and other symptoms, including dizziness, vomiting, headache, loose stools, and painful hips, thighs, and lower back. Cramps usually come before and during your period. Some people are more prone to having dysmenorrhea than others. The risk factors include smoking, irregular period, family history of menstrual cramps, being below 20 years old, never giving birth, arriving at puberty before age 11, and experiencing heavy bleeding during periods.
Dysmenorrhea is classified into two types: primary dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea refers to menstrual cramps and is caused by prostaglandins, a natural chemical made in the uterine lining. Prostaglandins trigger muscular contractions in the uterus. These contractions cause pain and inflammation. Before menstruation begins, the level of prostaglandins in the uterine lining rises, and this causes pain. During the first day of menstruation, the levels remain high. The lining of the uterus starts to shed as menstruation resumes. With it, the levels of prostaglandins decrease. Pain also subsides as prostaglandin levels do.
Most of the discomfort and aching experienced during your time of the month is normal. But when the pain is excessive enough for you to miss work or school, secondary dysmenorrhea is the main reason. Secondary dysmenorrhea comes from a reproductive system disorder. Compared with primary dysmenorrhea, it comes with worse and longer-lasting pain than the usual period cramps. Painful contractions may begin several days before the period starts. As the menstrual period continues, the aching may feel worse, and the pain may not leave even after the period ends.
While some menstrual cramps tend to get better as people age or give birth, it is vital to know the common causes of period cramps.
1. Endometriosis
Endometriosis is a disorder where tissues from the uterine lining grow outside the uterus. The endometrium is supposed to grow inside, but it grows outside the uterus for people with this condition. It can grow in the fallopian tubes, ovaries, bladder, and behind the uterus. During your period, the tissue will still act as if it is inside the uterus. When hormonal changes occur, the endometrium will break down and bleed. Bleeding causes pain, and even more so if it leads to lesions. Since the blood cannot exit to its original path, it may go to surrounding areas, causing swelling and inflammation. This condition may lead to lesions and scar tissue. Scar tissue, also known as adhesions, may form inside the pelvis. Adhesions may result in organs pulling together, inducing pain. Endometriosis most commonly occurs in the ovaries.
2. Uterine Fibroids
Fibroids are tumors that can grow inside, outside, or in the walls of the uterus. Although these tumors are noncancerous, it can press against the uterus and cause abnormal menstruation and aching. Fibroids often don’t cause symptoms. However, if the fibroids are located in the uterine wall, this can cause aching.
3. Adenomyosis
Adenomyosis is a rare medical condition. It can happen when the endometrium or the tissues lining the uterus grows and tears through the uterus muscle wall known as myometrium. Adenomyosis can cause pressure, inflammation, and pain. It can also result in an enlarged uterus and heavier or longer menstrual periods. Like endometriosis, the displaced tissue in adenomyosis still acts accordingly during the menstrual cycle. It thickens, breaks, and bleeds. The causes of adenomyosis are unknown, but this disease commonly disappears after menopause. For people who experience intense discomfort due to adenomyosis, hormonal treatments are available. Hysterectomy or removing the uterus can completely cure the condition.
4. Pelvic Inflammatory Disease
Pelvic Inflammatory Disease (PID) is a bacterial infection that begins in the uterus and extends to nearby reproductive organs such as ovaries and fallopian tubes. Sexually transmitted bacteria typically cause this infection. PID causes inflammation and period cramps. If left untreated, PID can lead to scar tissue and abscesses in the reproductive tract, which will leave irreversible damage.
5. Cervical Stenosis
This rare condition is marked by a narrowing of the cervix, the lowermost portion of the uterus. When the cervix is too small, it interrupts the menstrual flow, resulting in a painful pressure in the uterus.
