When to see a doctor for menstrual cramps

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.

Learn more about women’s care

Menstrual cycle and exercise | TRIA Blog

There are training days where everything clicks. You’re destroying sets and slaying goals – at the end, walking out of the gym with a spring in your step. Then there are those other days. You’re out of sync and barely reaching the ends of your reps. After you’re all done, you feel like you were hit by a bus – repeatedly.

Why do you rock certain days and struggle through others? Maybe it’s how much you prepare, maybe it’s how things went at work, maybe it’s something else entirely. But what if there was another explanation? Even better, what if you could flip the situation and take advantage of it?

And what if it had everything to do with your menstrual cycle?

Fortunately, sports medicine physicians and dietitians have been uncovering a close connection between an athlete’s menstrual cycle and how her body responds to training. By understanding how the different phases of your cycle affect your hormone levels, you can time your diet and training accordingly and tap into the greatest physical and mental benefits of exercise.

So what happens during these phases? How do you know what part of the cycle you’re in? How do you hack it? And why didn’t we discover this sooner? To start, let’s go back to health class.

How your menstrual cycle can impact exercise and athletic training

There are two main phases of the menstrual cycle: the follicular phase and the luteal phase.

What is the follicular phase? The follicular phase happens during the first half of your cycle. What is the luteal phase? The luteal phase is the second half of your cycle. These two halves feature distinctly different hormone levels, with lower levels during the follicular phase and higher levels during the luteal phase.

Researchers and physicians are discovering that these hormone levels have a big impact on muscle development and how an athlete’s body uses energy.

The follicular phase and athletic performance

With a lower level of hormones during the first phase of your menstrual cycle, your body is primed to maximize hard training efforts. This means your body is better able to access stored carbohydrates, making this an ideal time for high-intensity training. It’s also easier to build and maintain muscle, which means this is also a great time to emphasize muscle-building exercises.

The follicular phase starts with day one of your cycle. You’ve recently lost some blood, so your body has a greater need for iron. Also, due to the shedding of the uterine lining during this time, there are a few days of increased inflammation. But during this lower hormone phase, hydration is easier, and you have a more even, cooler body temperature.

The luteal phase and athletic performance

During the back half of your menstrual cycle, your body is preparing for your next period or pregnancy, if you happened to conceive during this cycle. This means your hormones are running at a higher level, due to an increase in estrogen and progesterone. More hormones means a decrease in anabolic, or muscle-building, capacity. This means that it’s time to take it easier, focusing on lower-intensity workouts with more recovery time.

Also, rather than being able to easily access stored carbohydrates, your increase in hormones has that energy locked up tight. Now, your body needs fuel from extra carbs and calories from the outside (that is, your plate). Plus, your body also needs more water during the luteal phase – more hormones means a greater risk of dehydration.

Why women’s athletic research is catching up – the role of hormones

Let’s address the big question in the room. Why haven’t we discovered this sooner? It all comes down to the primary focus of early sports medicine science: male athletes. As a result, many of the results from past nutrition and training research apply perfectly to men, but not so much for women.

Fortunately, as the field has become more diverse, more recent women’s sports medicine research has produced a wealth of information on how the female bodies interact with activity and nutrition. And it shouldn’t come as much of a surprise that the more we study, the more we discover just how distinct and different a woman’s needs really are.

Even more importantly, we’re finding that those needs aren’t particularly constant from week to week. A woman’s hormones – affected by age, maturity and pregnancy history – set the pace for her reproductive system and physical performance. On the below episode of the For Health’s Sake podcast, physical therapist Jackie Voight summarizes the current state of research on menstrual cycles and exercise, and she offers a few pieces of actionable advice.

For health’s sake · Menstrual cycle and exercise

We’re finding that hormone levels can influence everything from a woman’s susceptibility to certain injuries to how your body processes food and even how flexible your joints are. Of course, as physicians and dietitians, we’re just starting to scratch the surface – plenty more research needs to be done in a lot of areas. However, there’s a lot you can do with what we know now to hack your menstrual cycle and make it work for you.

Getting to know your cycle by tracking your period

Of course, the first step of taking advantage of your menstrual cycle’s phases is actually knowing when they are. Fortunately, there are many tracking apps out there on both Apple iOS and Android. Here are some popular apps:

• Clue
• Flo
• FitrWoman

You can also track your cycle through your Garmin, Apple Watch or Fitbit – both provide tools within their respective apps.

Exercise and nutrition tips for the two phases of your menstrual cycle

Once you start to see patterns emerge from the app that you choose, you can start to train and eat according to the phase that you’re in.

The follicular phase

• Go for it – As we mentioned earlier, this is the phase where your body is better able to use the energy from stored carbohydrates. Feel free to attack higher-intensity workouts that build fitness, as well as focus on resistance training to build muscle.
• Iron woman – At this phase, your body is craving iron. Familiar sources like red meat, dark chicken meat and shellfish should be on the menu. However, don’t forget that whole grains and legumes like beans, peas, chickpeas, lentils and soybeans can also deliver the iron you need.
• Get fishy – In addition, eating foods high in omega-3 fatty acids will help fight increased inflammation. Think salmon, mackerel, tuna, herring and sardines, along with nuts, seeds and plant oils. As with iron, you can use supplements to get what you need, but getting these nutrients from food is best.
• Relax with the water – Your body has an excellent handle on staying cool and hydrated during this phase. Definitely make sure you’re getting enough water, but don’t make it a massive priority.

The luteal phase

• Tread lightly – Your body is in prep mode, so it’s not a great time to go hard on your training. Switch up to low-intensity workouts with more recovery time than usual. You can try pushing the intensity, but listen if your body is begging you to stop.
• Eat up – This is when you need to get your fuel from carbohydrates both before and during workouts.
• Listen to your body – During these weeks, you will probably feel hungrier than usual. This is completely normal. In fact, your body uses up 5-10% more calories during this premenstrual phase. Don’t fight it and listen when your body is telling you to eat.
• Be “water aware” – It can be more difficult to stay hydrated during the luteal phase, so keep water at hand, especially during and after workouts.

Working with a sports dietitian

As physicians and dietitians at TRIA, we use this knowledge every day to help women improve their performance and prevent injury. We find that once women realize this close connection between their menstrual cycle and athletic performance, they understand that their period doesn’t have to be a negative thing. Once you know how your body functions, you can work with it and not against it. And that’s incredibly empowering.

Of course, every woman has a different situation with different needs. That’s why it’s a good idea for active females – exercise newbies and junkies alike – to make an appointment with a sports dietitian. During a visit, we can talk about your current training routine, diet and health history. Then, we can create a game plan that addresses your specific needs, helping you to be at your very best.

Even better, you don’t need a referral to meet with a dietitian. To make an appointment with a dietitian, give us a call. To make an appointment with a sports medicine physician or another expert on our Women’s Sports Medicine team, call or make an orthopedic appointment online.

Discover 5 Ways to Naturally Relieve Menstrual Cramps

Portrait young woman placing hands on stomach having bad aches pain isolated on gray wall background. Food poisoning, influenza, cramps. Negative emotion facial expression reaction health issues problems

Menstruation is a natural process that most women go through once they reach childbearing age. Although at first it is a process that is difficult to adapt to, with time and experience it becomes easier every day. However, there are some menstrual symptoms that make these days of each month difficult.

One such symptom is menstrual cramps . These cramps or spasms which may be felt in the lower abdomen can range from mild to extremely severe. Even recent medical studies have shown that the pain women experience during menstruation can be equivalent to the pain they experience during a heart attack .

For generations, grandmothers have shared natural home remedies to help ease the discomfort that may be felt these days with their daughters and granddaughters. They use everything from heating pads to anti-inflammatory herbal teas.

It should be emphasized that, according to gynecologists, feeling very severe pain these days or earlier is abnormal , and if you are going through this, it is best to consult a specialist doctor, as this may indicate some kind of condition .

If you want to learn about 5 home remedies to help you relieve your menstrual cramps naturally, continue reading the following article.

1. HOT WATER BOTTLE

Applying heat with a heating pad to the abdomen reduces muscle cramps and thus relieves menstrual pain. You can also use a thermal bag, wear warm cloths, or use seed packs with seeds inside that can be heated in the microwave.

2. HOT SHOWER

A hot shower helps to relax the muscles and therefore reduce menstrual pain that may occur. In addition, is a great way to stay cool and protected by these days of the month.

Ginger or kiyon tea is an excellent natural remedy for menstrual pain relief. This is because Ginger or Kion acts as a natural anti-inflammatory and antispasmodic , helping to not only reduce abdominal pain but also inflammation, which is normal these days.

To make this tea, simply boil a few pieces of ginger root in a liter of water for 15 minutes, strain it and drink twice a day. You can also use ginger powder if you don’t have the same plant.

4. ESSENTIAL OILS

Another good way to relieve menstrual pain is to apply essential oils to the abdomen with light circular massages in a clockwise direction. The best oils for this massage are marjoram, cinnamon, ginger or geranium. If you don’t have or can’t get one of these, another option is to make this with 1 tablespoon of almond oil.

5. CANELA

If you didn’t know, this delicious aroma and flavor spice is one of your best allies in the fight against menstrual pain. This is because he has excellent analgesic, antispasmodic and anti-inflammatory effects, which helps to relax muscles and reduce menstrual pain. To take advantage of it, you can sprinkle it on desserts and other recipes, or make an infusion.

You can use ground cinnamon, sprigs or tea bags to make tea. If you are making this with cinnamon powder, you will need to mix half a teaspoon of cinnamon with a teaspoon of honey. Once both ingredients are well mixed, dilute it with hot water. If you wish, you can combine it with other infusions that also help with pain, such as chamomile. It is recommended to drink this tea for menstrual pain twice a day so that it has a good effect.

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Period Pain: Why Your Stomach Hurts, How to Reduce the Pain, and What Not to Do

. Trainer’s advice and doctor’s commentary

Gynecologist Ilona Agrba explains how to deal with pain during menstruation

Updated February 27, 2023, 06:32

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For the first time in Spain, a law has been approved allowing women to take paid leave due to menstrual pain. We find out why they occur, as well as what can and cannot be done to get rid of unpleasant symptoms.

Contents

1. Causes of pain
2. Normal or not
3. How to relieve pain
4. What not to do
5. Expert comment

Why does the stomach hurt during menstruation

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During the period of menstruation, the uterus rejects the mucous membrane – the endometrium – through the contraction of internal muscles [1]. For many women, this process is noticeable, but does not bring serious discomfort. For others, it causes severe pain that interferes with the usual way of life. Doctors cannot formulate with absolute certainty the reasons why this natural process takes place with different symptoms. One of the versions is an increased concentration of prostaglandins, a group of lipid substances actively secreted by the body during menstruation [2].

Ilona Agrbavrach obstetrician-gynecologist, candidate of medical sciences, leading specialist of the network of clinics “Semeynaya”

“Painful contractions of the uterus with a feeling of general malaise due to excessive amounts of prostaglandins in the menstrual fluid (inflammatory mediators). ”

Painful menstruation is called dysmenorrhea. There are two types of dysmenorrhea – primary and secondary:

1. Primary dysmenorrhea occurs in people who experience pain shortly before and then during menstruation.
2. Secondary – manifested at some point, if the patient has not previously encountered similar symptoms. In this case, it is important to undergo an examination: the causes may be pelvic inflammatory disease, endometriosis, stenosis and benign tumors.

Ilona Agrba:

“In physiological (normal) dysmenorrhea, pain in the lower parts appears a few days before menstruation or begins with it at the same time. Pain peaks in intensity 24 hours after the onset of menstruation, after which the symptoms subside and disappear no later than two to three days after the peak condition. The rest of the cycle, the woman does not experience discomfort and leads a normal life.

The pain can be different: pulling, throbbing, dull, may radiate to the lower extremities.

Harmless dysmenorrhea appears most often in adolescence after the establishment of regular menstruation. During the examination, the pathology is not detected, in most cases it disappears with age, sometimes after childbirth.

Secondary dysmenorrhea, which appears as a result of a disease, occurs some time after the establishment of a regular cycle, is similar in symptoms, but it is accompanied by gynecological diseases (adenomyosis, fibroids, external endometriosis). In this case, the pain does not occur on its own, but is a symptom of the disease.

In addition to lower abdominal pain, prostaglandins affect the contraction of the smooth muscles of the gastrointestinal tract. Because of this, women often complain of problems with the gastrointestinal tract during menstruation: nausea, bloating and diarrhea may appear. Ilona Agrba clarifies that headache, constipation, frequent urge to urinate, vomiting can additionally disturb.

Pain during menstruation: normal or not

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Primary dysmenorrhoea is an individual feature of the organism. If you have experienced pain since your first menstrual cycle, it is likely that it will recur every month. Still, you should consult a doctor to rule out other causes of unpleasant symptoms. With secondary dysmenorrhea, a gynecological examination is strictly necessary. This is especially true in cases where the pain increases with each cycle or lasts for several days of menstruation.

The gynecologist will perform an examination, perform an ultrasound of the pelvic organs and, if necessary, prescribe urine and blood tests. Further treatment depends on the identified diseases. Even if serious causes of pain are not found, the doctor will select drugs and methods to get rid of it.

What to do if the stomach hurts during menstruation: how to reduce pain

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Menstruation is often accompanied by other unpleasant sensations: nausea and headaches against the background of general weakness. Therefore, it makes sense to put things off, take a day off and take care of yourself, ensuring peace. There are several ways to relieve period pain.

1. Pain tablets

If you’re used to dysmenorrhea, make sure you have over-the-counter pain medications in your first aid kit. “Non-steroidal anti-inflammatory drugs are used from medicines. Their action is based on a decrease in the level of prostaglandins, ”says the obstetrician-gynecologist.

If the tablets do not help, contact your doctor and describe the situation in detail. You may need more effective drugs, such as those based on codeine and naproxen. Consider contraindications. So, ibuprofen and acetylsalicylic acid are not prescribed if the patient has a history of diseases of the kidneys, liver and stomach.

2. Hormonal contraceptives

In addition to protecting against unwanted pregnancy, medicated contraception helps correct some other problems in the body. Hormones “turn off” ovulation, and the lining of the uterus becomes thinner. The body produces a smaller amount of prostaglandins, respectively, muscle contractions of the uterus are minimized.

In addition to oral contraceptives, you can use spirals, implants and hormonal patches – the best option is selected by the attending physician, but the choice is up to the patient.

3. Lifestyle

Often the cause of secondary dysmenorrhea is the general condition of the body. Many are familiar with cycle failures and increased unpleasant symptoms after prolonged stressful situations, long trips, physical and psychological fatigue. In order for the body to function normally, it is necessary to adhere to the basic rules: observe a sleep schedule, get rid of stress in time and play sports – at least provide yourself with sufficient daily physical activity. Studies have shown that regular yoga classes relieve unpleasant symptoms during menstruation [3].

4. Nutrition

What you eat affects all life processes and body functions in one way or another. It is important that the diet is complete and varied. Several studies have confirmed the positive impact of proper nutrition and nutritional supplements on the state of menstruation [4]. Talk to your doctor about whether you should take extra B vitamins, magnesium, and omega-3s.

5. Home Methods

Any drug will not work immediately at the time of taking. In anticipation of the effect, you can alleviate the condition in simple and affordable ways.

1. Herbal tea. Some plants have an analgesic effect and promote muscle relaxation. Try brewing tea with chamomile or mint, fennel, and ginger.
2. Self massage. Light strokes in the lower abdomen help relieve pain and relax the muscles. The method will not help to completely remove the pain, but it will come in handy until painkillers have taken effect [5].
3. Heating pad. Ilona Agrba clarifies that this is one of the ways to help yourself with unpleasant symptoms. But be careful not to use too hot a heating pad for a long time: heat promotes vasodilation, which often increases bleeding.

To the question “Is it possible to get rid of menstrual pain forever?” there is no clear answer. For many with primary dysmenorrhea, it becomes less noticeable over the years, sometimes disappears after the birth of a child. But neither case applies to everyone without exception. One thing is certain: there is no point in enduring pain. Therefore, if once a month you consistently fall out of the schedule, seek help from a doctor, select and adjust a program to restore the body.

What not to do during menstruation

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Do not forget about the safety rules that are relevant during the menstrual period. Very important:

• refuse to go to the bathhouse and sauna. Severe fever can cause profuse bleeding;
• abstain from unprotected sex. During this period, the uterus is vulnerable to infections and viruses;
• Do not bathe or swim in open water. Contrary to popular belief, a tampon will not protect the body from bacteria;
• change hygiene products in time in accordance with the manufacturer’s recommendations and individual characteristics (the amount of discharge).

Check out other common questions that cause a lot of controversy.

Is it possible to go in for sports during menstruation

Everything here is very individual. You definitely don’t need to force yourself to go for a run with pain, nausea and weakness. But if you feel good, do not give up training. Choose low-intensity exercise, long walks, yoga, Pilates.

Maria GrudtsovaTrainer of personal training studios Pro Trainer

“If your health allows, there are no acute pains and discomfort, you can go in for sports, but with some restrictions. For example, exclude exercises that use a lot of weight, reduce axial loads and tension in the press. Inverted postures are not recommended in Pilates and yoga. But it all depends on your condition. Cardio training will be useful if you feel normal.”

Is it possible to do douching during menstruation

Washing the vagina during menstruation is strictly contraindicated. Douching can disturb the microflora, cause irritation and lead to infectious diseases.

Is it possible to donate blood during menstruation

The total amount of blood lost during menstruation is 50-150 ml. It’s not very much. But when donating blood, up to 500 ml are taken from donors, so even such a small amount can become critical. You should not donate blood during menstruation and another five days after, while the body is recovering. At the same time, menstruation is not a contraindication for surgical interventions [6].

Can I drink alcohol

Although alcoholic beverages may have a slight analgesic effect, they affect the body differently depending on the day of the menstrual cycle. Even small amounts of alcohol can lead to less tolerance during periods.

Is it possible to carry out cosmetic procedures

During menstruation, the level of estrogen in a woman’s body decreases. Because of this, you feel more pain: the usual epilation and injections can feel much more painful and unpleasant. This will not affect the effect, but it is hardly worth giving yourself even more discomfort in this already difficult period.

Expert commentary

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Ilona Agrba:

“About half of women experience pain during menstruation. Many consider this a variant of the norm, and in most cases it is true, but sometimes pain during or before menstruation can be a symptom of the disease.

It is really possible to relieve and relieve pain without drugs: sports (for example, yoga) and sex (always with an orgasm), dietary changes (restriction of meat and fat, addition of dairy products) and vitamin therapy (group B, omega-3, magnesium).

If secondary dysmenorrhea is not caused by malformations of the uterus and vagina, it appears already in adulthood. Unlike primary, or normal, dysmenorrhea, there is no bloating, nausea, or vomiting. The pain increases during menstruation, may begin 3-10 days before it, often accompanied by additional complaints of painful defecation, blood during urination, pain in the lower back and legs. Often, the nature of menstruation also changes: they can become more scarce or, conversely, abundant, intermenstrual bleeding is diagnosed.