Feeling that familiar twinge of pain in your gut is often the first sign that your period is starting. In those moments, many women can reach for a heating pad or ibuprofen to calm their cramps. But others have severe menstrual cramps that can’t be relieved using typical remedies and might linger through the entire period. Cramps like these can get in the way of your regular activities and make your time of the month an uncomfortable one.

According to the American College of Obstetricians and Gynecologists, over half of women who menstruate experience cramping during the first couple days of their periods. Period pain can often be managed on your own, but women who experience severe, chronic menstrual cramps often need medical treatment to relieve pain.

How do I know if my menstrual cramps are normal?

Menstrual cramps feel a little different to every woman. They can feel like a constant dull ache, occasional shooting pains or anything in between. Typically, women feel cramps in the lower stomach but they can also affect the groin, thighs and lower back.

Each woman experiences unique menstruation symptoms and there’s no true “normal.” Some women might have cramps during every period. Some might notice that their cramps lessen with age. Others might never experience period cramps. But up to 20 percent of women experience painful cramps, or what’s known medically as dysmenorrhea, making it difficult to enjoy their daily activities. Still, many women are afraid to speak to their doctor about their cramps.

There’s no reason to stay quiet about your cramps. Our OB-GYNs are here to listen to your concerns without judgement and help find a way to make your periods as painless as possible.

If you’re not sure whether medical treatment is needed to help with your cramps, just ask us! During your next appointment, talk to your doctor about:

  • The level of pain cramps cause you
  • How long your cramps last
  • The average length of your cycle
  • How much you bleed during your period
  • Other things you may have noticed, like spotting or pain outside your period

There’s no harm in asking your doctor about your medical concerns. In fact, talking to your OB-GYN about changes you’ve noticed or your questions is a great way to be proactive about your health. Find out more about how to choose an OB-GYN you can trust.

When should I talk to my OB-GYN about menstrual cramps?

Since each woman’s body is unique, it can be difficult to tell whether the cramps you’ve grown used to are actually chronic. Use these common symptoms of chronic, severe menstrual cramps as a guideline to decide if it’s time to talk to an OB-GYN about your cramps.

  • Your cramps interfere with your daily life (school, work, social plans, etc.)
  • The cramps last longer than two days
  • No or minimal relief from over-the-counter (OTC) pain medication
  • You have cramps outside of your period
  • You notice a change in how your cramps feel over time

How are severe menstrual cramps diagnosed?

If you have severe menstrual cramps, a visit to your doctor is the only way to determine the exact cause of your pain. During your visit, your doctor will talk to you about your symptoms. If we need additional information to confirm a diagnosis, a pelvic exam or ultrasound might be needed. These tests will help pinpoint the exact cause of your pain so your doctor can recommend the best treatment options for you.

How are severe menstrual cramps treated?

When the usual home remedies to relieve period cramps are no match for your cramps, an OB-GYN can help you find relief from the pain. The most common treatments for severe menstrual cramps are:

  • Hormonal birth control methods – If your menstrual cramps are caused by a hormone imbalance, your doctor might recommend using a hormonal birth control. In addition to preventing pregnancy, taking hormonal birth control can help correct the levels of estrogen and progesterone in your body, which effects the thickness of the uterine lining. Thinning the uterine lining can reduce prostaglandin and bring pain relief. Some birth control methods can cause women to skip their periods, eliminating cramps altogether.
  • Prescription medication – When over-the-counter (OTC) medicines don’t work, your doctor might prescribe nonsteroidal anti-inflammatory drugs (NSAIDs). These medicines are much stronger than similar ones you’ll find over-the-counter. They can significantly reduce prostaglandins in your uterus, which might thin the uterine lining and alleviate cramps. Prescription medication is used when a woman experiences severe, chronic cramps.

What causes menstrual cramps?

During our periods, the uterine contracts in order to shed its lining. Sometimes, the contraction of the uterus can feel painful and cause cramps.

There are two main types of menstrual cramps:

Primary dysmenorrhea

This type of menstrual cramps is more common. Primary dysmenorrhea is caused by prostaglandin in the lining of your uterus. Prostaglandin is a hormone found in the uterine lining that increases just before menstruation starts. Primary dysmenorrhea is usually worse around the time a woman starts getting her period and lessens with age. Women who experience primary dysmenorrhea are also more likely to have cramps only during the first couple days of their period, when menstrual bleeding starts.

Secondary dysmenorrhea

Secondary dysmenorrhea is the less common type of cramps and is caused by a medical condition like an infection, premenstrual dysphoric disorder (PMDD), endometriosis, uterine fibroids or ovarian cysts. These menstrual cramps often worsen with age and can last for the entire duration of your period. Women who experience secondary dysmenorrhea can usually find pain relief with help from a doctor.

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