Period cramps: Few women escape them entirely, and many downright suffer. More than 50 percent of women who menstruate report at least some pain from cramps one or two days each month, according to the American Congress of Obstetricians and Gynecologists, and period pain keeps 10 in every 100 women from their usual activities one to three days every month, according to information from the Institute for Quality and Efficiency in Health Care.
Meanwhile, across the pond, a study whose results were published in October 2017 found that bad period cramps cost employers in the UK more than 5.5 million sick days every year. An analogous Australian survey published on YouGov.au revealed that, of Australian women who soldiered on and went to work despite menstrual cramps, three-quarters said it negatively affected their job performance. That’s just affirmation of what females everywhere already knew. What was more surprising—and also more disturbing—was that just about half of the respondents to the British survey chalked up having to deal with heavy, painful periods to “just part of being a woman.”
Silently suffering in bitter resignation is not the way to go. Cramps can be managed, both by way of natural remedies and medications that bring period pain relief. Of course, figuring out which of the home remedies—or over the counter (OTC) solutions—are right for you takes a bit of careful consideration and, especially if the pain is severe, consultation with your gynecologist.
First: the basics of menstrual pain and discomfort, because understanding the nature of period cramps is an important step in learning how to get rid of them.
Why do we have menstrual cramps, anyway?
Period cramps are part and parcel of female bodily function, a necessary evil in a way. In order for the uterus to shed its lining each month, it has to tighten up and relax in an irregular rhythm. This detaches the tissue lining the uterus and essentially pushes it out of the body. Unsurprisingly, women who have a heavier flow during their monthly period tend to have stronger, and thus more painful, menstrual cramps.
While painful cramps can occur at any age, the nature of a woman’s period will change throughout her life, notes Jacadi Bignami, OB-GYN at St. Joseph Hospital in Orange, California. “How often periods come, how long they last, and how much bleeding occurs can vary from the teen years to menopause due to changes in hormonal balances, which changes the communication that occurs between the brain and the ovaries,” she explains.
Doctors split period pain, also known as dysmenorrhea, into two types: primary and secondary dysmenorrhea. If the pain is caused strictly by the uterine contractions, it’s called primary dysmenorrhea. Moderate to severe primary dysmenorrhea is more commonly experienced by women under the age of 20. In general, it tends to lessen the older a woman gets. Also, many women have less primary dysmenorrhea once they’ve given birth, especially if their first delivery is spontaneous as opposed to cesarean.
Secondary dysmenorrhea is period pain that occurs for reasons other than uterine contractions alone. These might include polyps, fibroids, or another health condition like irritable bowel syndrome, which is why it’s a good idea to talk with your gynecologist about the specifics of your menstrual pain, especially if you suddenly start experiencing pain when you’ve never had any before.
Worth noting: Period pain is different from premenstrual syndrome (PMS). PMS is actually a constellation of symptoms that can include weight gain, bloating, crankiness, and fatigue. Also, PMS often hits one to two weeks before your period starts, whereas period pain has a much shorter timeline, kicking in more or less right when your period starts (although secondary dysmenorrhea can start earlier in your cycle than primary dysmenorrhea, last longer, and even occur when you don’t have your period).
Why don’t all women get the same severity of period cramps?
It seems really unfair that you can barely leave your couch when your period hits while your best friend seems to breeze through her monthly cycle. Experts remain uncertain about why some women seem to luck out when it comes to period pain, but according to a National Cancer Institute resource published by PubMedHealth, the difference may have to do with how sensitive a woman is to prostaglandins, which are chemical messengers that trigger the uterus to tighten. In fact, research published in The Journal of Pain indicates that women who suffer from severe dysmenorrhea tend to be more sensitive to pain in general.
An Australian study suggested that smoking increases the risk of having painful period cramps. Another study from the National Institutes of Health pointed to a possible genetic link. Thus, like so many other things, it appears that if your mother always had bad period cramps, that ups the odds that you will too.
And pain and discomfort from periods often goes beyond pelvic cramps. Back pain that radiates from the uterus contracting is also common, says Bignami. “The changes in hormone levels that occur when women have their periods can cause headaches as well. Some women even have nausea and diarrhea from the hormonal changes and prostaglandins released,” she adds.
As if all that weren’t bad enough, Bignami also points out that sheer exhaustion can come along with periods, due again to hormone fluctuations and blood loss. In short, the manifestation of pain and discomfort can and does vary from woman to woman.
While the bad news is that menstrual pain and discomfort can take many forms and happen for many reasons—and a quick, sure cure is hard to pin down—the good news is that home remedies can alleviate much of the unpleasantry for many women. Among those natural remedies are:
According to Bignami, foods high in saturated fats and simple sugars have been shown to increase the pain and other uncomfortable symptoms felt during your time of the month. On the other hand, though, she notes that “foods high in omega-3s, calcium, or iron can improve unpleasant symptoms of periods.”
She goes on to say, “A healthy diet of lean meats, vegetables, fruits, and whole grains is recommended for those with painful periods.”
Camille Finamore, a mom of two in New Hyde Park, New York, discovered the power of a healthier diet in easing period cramps. She recalls reading about how diet adjustments can help. Fed up with being relegated to bed for one day a month, she decided it was worth a try.
“I made a real effort to avoid processed foods and all the snacks I was eating that were high in sugar or fat or both.” After several months of making a slate of swaps such as fresh fruit for donuts, she noticed a change. “While I can’t say my menstrual pain vanished, it was noticeably more tolerable. And just as good, I lost five pounds.”
Light to Moderate Exercise
It may not be the first thing you think about doing in the throes of a painful period, but exercise—in particular 10 minutes or so of gentle stretching—is a great way to improve circulation and reduce pain.
However, Bignami points out that “there is always a fine line between the right amount of exercise and too much.” If you have always been pretty sedentary, suddenly jumping into a high-intensity exercise routine can cause more problems than it solves. Bignami says regardless of your fitness level, “light, easy exercise, such as stretching, walking, or biking, can alleviate period symptoms greatly.”
“Stress can impact every aspect of your life, including your period,” Bignami says. “Stress can cause your cycle to become irregular in frequency or duration, can alter your immune response, and even make you more sensitive to pain. Understanding how stress impacts your cycle is complex and can be different for each person. But what is certain is that finding a healthy and safe way to combat stress that works for you is important for your overall health.”
Regular exercise is widely recognized as a healthy, effective way to keep stress in check. Learning to say no to unnecessary demands on your time doesn’t hurt either. But one hugely helpful technique to combat stress is practicing mindfulness. Being mindful amounts to being in the habit of focusing on the present moment, not wringing your hands about the past or worrying about the future, and calmly accepting your thoughts and feelings in the moment without judgement.
“Mindfulness activities have been shown to help with pain by decreasing stress and aiding relaxation,” says Bignami. In fact, a study published in the journal Clinical Psychology Review found that mindfulness has several benefits to overall health.
Bignami says she likes the Headspace App, especially for women who are short on time.
“It’s a great way to improve your health in 10-minute sessions.”
Massage and More
Bignami also notes that massage therapy is an effective way to boost circulation, aid in relaxation, and decrease period pain. Can’t get to the spa? Taking a leisurely warm shower can also help relax tight muscles and improve circulation.
“Acupuncture, as well as acupressure, when performed by a licensed practitioner, may decrease pain and inflammation in some women as well,” adds Bignami. (Acupressure applies firm pressure to touchpoints along the meridians of the body, but doesn’t employ the hair-thin needles of acupuncture.)
Also, according to not only our moms, but also to a period pain resource published by MedlinePlus, curling up with a heating pad or hot water bottle and/or taking a hot bath are all tried-and-true means of period pain relief.
As much as we’d all prefer to manage our pain with natural remedies, there may be times—the morning of a big job interview, say—when you need to be able to just take something to make the pain stop. OTC options for period cramps abound.
“Non-steroidal, anti-inflammatory drugs [NSAIDs], such as ibuprofen, Advil, and naproxen work by inhibiting a substance called cyclooxygenase, or COX. That ultimately decreases the prostaglandins which are made during your cycle. And by blocking the prostaglandins, you decrease inflammation and pain,” explains Bignami. Another benefit of NSAIDs, according to Bignami, is that taking one of those medicines a few days prior to your period may actually decrease blood flow in women who experience heavy bleeding.
Tylenol, which is the widely recognized brand name for acetaminophen, on the other hand, works by directly blocking the reception of pain. That old standby, menstrual cramp-specific Midol, combines acetaminophen with caffeine and an antihistamine. The caffeine increases energy levels and acts as a diuretic—decreasing water retention, also known as bloating, which may be just enough to give you the symptom relief you need.
When to Bring in the Professionals
Severe, debilitating period pain warrants a check-in with your gynecologist. They may consider prescribing you birth control pills, a Mirena IUD, or another prescription medication to regulate your cycle, decrease blood flow, and help control the pain. Some women, with the help of their doctors, even opt to use birth control continuously to stop their periods.
Still, Bignami cautions that severe pain with your cycle might be caused by something more than just your period.
“If you have pain that is not controlled with over the counter medications nor any of the natural lifestyle adjustments, you should be evaluated by a gynecologist.”
Endometriosis, fibroids, adenomyosis, and infections can all cause pelvic pain. In fact, in September 2017, the National Institute for Health and Care Excellence in the UK issued new recommendations on endometriosis, which state that women presenting with chronic pelvic pain should be routinely checked for the condition.
Let’s face it: Your monthly period is never going to be easy-peasy. For the most part, minor pain and other discomforts are normal, but that doesn’t mean you need to suffer through adverse impacts on your quality of life. Experiment with natural and OTC remedies, and if your pain is persistent or severe, be sure to rule out more serious health conditions with your gynecologist.