Dysmenorrhea, or menstrual cramping, is one of the most uncomfortable symptoms to have during your menstrual cycle. It is also one of the most likely symptoms you may get each month.
Although cramping is a common part of your monthly cycle, understanding the root cause of it is still important. Learning what causes your period pain can help you control it and reduce your discomfort. When the cramping is less severe, you can lead a more comfortable life.
Not all menstrual cramping is normal. You may experience menstrual cramping as a symptom of a more serious medical condition without realizing it. If the condition goes untreated, the consequences may be permanent. Therefore, it is essential to recognize any changes in the frequency or intensity of your menstrual cramps. Seek medical help if you suspect a more serious ailment is the cause. Below is more information about the specific causes of menstrual cramping and how to differentiate between them.
Primary Versus Secondary Menstrual Cramping
Primary dysmenorrhea is the medical term for normal menstrual cramping caused by your menstrual cycle. During your menstrual cycle, prostaglandins are produced, which are chemicals like hormones. They are necessary to encourage the uterine muscle contractions used to shed your uterine lining. The uterine contractions push the blood and tissue out of your uterus, expelling it from your body and creating your period.
However, along with causing uterine contractions, prostaglandins can also cause inflammation and pain. The precise pain level you experience varies according to the amount of prostaglandins present in your body. That is why your menstrual cramping experience may differ from someone else’s menstrual cramps. It is also why the intensity and amount of period cramps you experience can vary from one menstrual cycle to the next. Your prostaglandins levels are not the same each time.
The reason normal menstrual cramping is called primary dysmenorrhea is to differentiate normal cramping symptoms from secondary dysmenorrhea. Secondary dysmenorrhea is cramping in your uterine or abdominal region not caused directly by your menstrual cycle.
However, it may be related to your menstrual cycle or reproductive system in general. For example, there are several medical conditions that can cause excessive menstrual cramping and bleeding or cramping when you are not menstruating.
Factors That May Make Normal Menstrual Cramping More Likely
You cannot predict how much menstrual cramping you have during each cycle. There is also no way to stop cramps from occurring with 100 percent accuracy, other than to get on a specific type of birth control regimen to stop your menstrual cycles completely. However, scientists and medical experts say there are factors that may make primary dysmenorrhea worse.
A University of Michigan study conducted in 1996 indicated lifestyle choices can have a profound effect on your predisposition for menstrual cramps. Making simple changes may decrease the severity of your cramps or stop them entirely. The study results also show that being overweight is a key factor that could amplify your menstrual cramping symptoms.
According to the researchers who conducted the study, smoking and drinking alcohol can also increase menstrual cramp risks. Additionally, a separate Harvard School of Public Health study found stress significantly increases your risk of menstrual cramp pain as well. Additional risk factors for severe menstrual cramps include:
- Having your first menstrual cycle while under 12 years of age.
- Being under 30 years of age.
- Heavy or irregular menstrual bleeding.
- Family history of cramps during menstruation.
Secondary Menstrual Cramping from Endometriosis
One of the most common causes of secondary dysmenorrhea, or abnormal menstrual cramping, is endometriosis. The tissue that lines your uterus during your menstrual cycle is called endometrium.
It is meant to stay in your uterus until it is flushed out at the end of your menstrual cycle. However, in some individuals, the tissue can appear in the wrong location. When endometrium grows outside your uterus, such as in areas like your ovaries or Fallopian tubes, you have endometriosis.
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Endometrium that grows outside your uterus is not eliminated from your body during your menstrual cycle. However, the tissue does thicken and break down as normal during that time. Since it cannot be flushed out of your body in the standard way, it often clings to surrounding tissues. As a result, scar tissue, cysts and adhesions may form in your body. Endometriosis causes severe pain you may mistake for primary dysmenorrhea while menstruating. You may also bleed more during menstruation, if you have it. Additionally, it may cause pain even when no bleeding is present. Risk factors for developing endometriosis include:
- Having your first menstrual cycle at a young age.
- Short or irregular menstrual cycles.
- Family history of menstrual cramps or medical conditions that may cause cramps.
- Late onset of menopause.
- Excessive estrogen in your body.
Diagnosing Other Unusual Menstrual Cramps
Endometriosis is not the only condition that causes unusual or severe menstrual cramps. You may have growths in your uterus, such as polyps or fibroids. Another possible reason for severe cramping is a pelvic infection called pelvic inflammatory disease (PID).
If you suspect your menstrual cramping is abnormal or caused by a condition other than your menstrual cycle, see your doctor right away to minimize risks to your health and future reproductive complications. You must also see your doctor immediately if your cramps seem normal in intensity but last longer than a few days or continue beyond when your normal bleeding stops.
Medical diagnosis begins with your doctor giving you a pelvic exam. This entails him or her feeling the inside of your uterus to detect unusual growths. He or she may recommend further testing after the exam, based on preliminary findings. If so, the recommended tests may include ultrasound to pinpoint the cause of your cramping.
If your doctor finds your menstrual cramping is caused by a serious medical condition, such as endometriosis, he or she must suggest a treatment plan for you. For instance, if you have endometriosis, hormone therapy may reduce your symptoms. Surgery may also be needed to treat your menstrual cramping, depending on the cause. If you have severe menstrual cramping caused by endometriosis, laparoscopic surgery is a way for your doctor to diagnose your condition and treat it simultaneously.
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