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The Causes of Menstrual Cramps and What You Can Do About Them

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The causes of menstrual cramps are poorly understood and controversial, and because we don't know exactly what causes them, we don't really know exactly how to treat them. Adding to the confusion, menstrual cramps can be caused by different things for different women, so what helps one woman, may be useless for another.

This article describes some of the underlying problems most commonly associated with menstrual pain, and how you can treat them with simple, safe home remedies and lifestyle changes.

Because menstrual cramps can be caused by other conditions, including endometriosis, pelvic inflammatory disease, and others, it is highly recommended to seek the opinion of a doctor or gynecologist before beginning any self-treatment program, especially if you experience pain or bleeding in between menstrual cycles or right before your period begins.

Photo by hyperscholar

Photo by hyperscholar

Cause #1: Prostaglandins

Prostaglandins are chemicals naturally synthesized by the body's cells. They cause smooth muscles to contract and are required for the normal functioning of a number of organs, including the uterus. Prostaglandins are the chemicals that cause the uterus to contract every month and expel its unused endometrial lining in the process known as menstruation. However, if too much prostaglandin is produced, the uterus contracts too strongly and causes painful cramps. Women who experience menstrual cramps almost always have unusually high levels of prostaglandins. Because prostaglandins affect the muscles of the intestines, they are also responsible for the diarrhea or constipation that many women experience along with their menstrual cramps.

Eating Healthy to Reduce Cramps

How To Reduce Prostaglandin Levels

There are a number of ways to reduce the effect of prostaglandins on your body:

  • Start taking anti-inflammatory drugs regularly several days before your period is due to start. Anti-inflammatory drugs (I recommend Ibuprofen) act to inhibit the production of prostaglandins. If you suffer from menstrual cramps, taking these drugs regularly several days before you expect your period to begin will lower your body's production of prostaglandins and should reduce the severity of your cramps. If you wait until you are already in pain, they do not usually provide as much relief.
  • Reduce your consumption of meat and dairy products. The body synthesizes prostaglandins from essential fatty acids. Series two prostaglandins, the kind responsible for uterine cramps, are synthesized primarily from fatty acids found in animal fats, so by reducing your consumption of animal fats, you can reduce your body's production of prostaglandins.
  • Increase your consumption of Omega-3 fats (lineolic acid). Lineolic acid is used to manufacture series one and three prostaglandins, which have an anti-inflammatory effect and are beneficial to women who suffer from cramps. It can be found in olive oil, salmon, tuna, walnuts, grassfed meat, eggs, and dairy products, flax, soy, and leafy green vegetables such as kale or romaine lettuce.
  • Reduce your consumption of trans-fats. Trans fats, which are found primarily in hydrogenated vegetable oils, inhibit the production of anti-inflammatory prostaglandins.

Cause #2: Hormone Imbalance

Some doctors believe that an imbalance in the two hormones, estrogen and progesterone, that regulate the menstrual cycle may contribute to cramps. Excessive levels of estrogen are believed to overstimulate the growth of the uterus's endometrial lining. The body then increases its production of prostaglandins in order to contract the uterus and push the excess endometrial tissue out during menstruation, causing cramps.

Excess levels of estrogen are also associated with endometriosis, another common cause of menstrual cramps, uterine fibroids, many symptoms of PMS, and several types of cancer. Learn more about the symptoms of estrogen dominance.

Maintain a Healthy Hormone Balance

Estrogen is required for the normal function of the reproductive system, but a proper balance between the levels of estrogen and progesterone is important.

  • Consider the Pill. The Pill reduces cramps for many women by controlling hormone levels. However, in some women, it may worsen estrogen dominance. Consult your doctor for more information.
  • Maintain a healthy weight. Estrogen is produced by fat cells, so excess weight can lead to excess production of estrogen.
  • Reduce alcohol consumption. Drinking alcohol can damage your liver, which helps regulate estrogen levels in the body.
  • Eat a high-fiber diet. Excess estrogen binds to fiber in the body and is excreted in bowel movements. However, estrogen is reabsorbed into the bloodstream if stools remain for too long in the bowels. Eating a diet high in fiber, which is found in whole grains, beans and legumes, and many fruits and vegetables, prevents constipation and helps the body maintain its hormone balance. Learn more: 10 Best Ways to Get Fiber in your Diet.
  • Drink plenty of water. Staying hydrated encourages healthy liver and bowel function, both of which maintain the body's hormone balance.
  • Reduce your exposure to xenoestrogens. Xenoestrogens are artificial compounds that mimic the behavior of estrogen in the body. They occur in a wide range of household products.

Get Fit

More on Magnesium

Other Tips for Reducing Menstrual Cramps

  • Exercise regularly. Exercising helps maintain a healthy weight, improves blood circulation, and release chemicals called endorphins that reduce the feeling of pain.
  • Increase your intake of magnesium. Magnesium deficiency is commonly found in women who suffer from menstrual cramps. Magnesium, a muscle relaxant, can be found in leafy greens and other green vegetables like spinach and broccoli, coldwater fish like salmon and halibut, and many seeds, including pumpkin seeds, sesame seeds, sunflower feeds, and flax seeds.
  • Avoid caffeine. Caffeine exacerbates menstrual cramps.
  • Eat a low-sodium diet. Excessive sodium causes bloating, which can worsen cramps.
  • Stay warm. Heat relaxes muscles and improves blood flow, which relieves menstrual cramps.
  • Reduce stress. High stress exacerbates cramps for many women because it increases the perception of pain.

Learn More

Check out 20 Ways to Relieve Menstrual Cramps for more tips and tricks to help prevent and relieve menstrual cramps, or share your story at

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BN on November 15, 2012:

I have a close friend, who I have known all my life, who eats terribly and has no cramping (we are both in our 40s now). Her diet consists of refined carbs (mainly pasta), lots of refined sugars, fatty meats, butter, ice cream, creamy cheeses, fried food, alcohol, soda, coffee and chocolate. She hardly eats any vegetables or fruits. She doesn't buy organic either. She uses personal care and household products that are laden with parabens, fragrances and many 'dirty dozen' chemicals. She colors her hair and gets her nails done regularly. She microwaves her food in saranwrap or styrofoam trays and drinks tap water. She has a lot of stress at work, sleeps with the TV on and harbors a considerable amount of sadness, loneliness and anger. She does not exercise, except for her easy commute and some minor walking in the office. She never takes the stairs. She spends most week nights (including dinner) and weekends in front of the TV. As a result, she is overweight. Yet she has absolutely no health problems and experiences very little pain or troublesome symptoms during her periods. How is this possible?

I am not saying that what we eat or do doesn't matter. Of course it pays to eat and live healthy. But I just wonder how her body is working to keep her hormones balanced (apparently). I wonder if there is some important key that can help us figure out what's broken in people like us. The only good thing my friend does is that she drinks a lot of water.

You would think based on her diet, lifestyle and weight, that she would have problems from a high level of inflammatory prostaglandins, estrogen and xenoestrogens. But she doesn't. Maybe for some reason her body doesn't produce Series 2 prostaglandins? Does she have a super efficient liver that breaks down excess estrogen? Or is it simply that she produces enough progesterone to counteract all the excess estrogen? This makes me wonder if the real answer to our problems lies in our hypothalamus and pituitary glands, which is where the wrong signals come from in the first place. It would be great if there's a way to 'reset' them, because for me, as soon as I stop bending over backwards to eating super healthy, my body goes right back to being bad. And I've been doing so for over 10 years now.

What do you guys think?

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Learn to Know on June 27, 2012:

Great information to know after all these 50 years.

crissy on June 06, 2012:

I switched to a vegan diet and it helped so much. My periods are light and less painful. ***correct spelling***

Sarah on May 21, 2012:

Just finished my monthly screaming and rolling about on the bed. This is a good article. sherstone212 I totally agree that tampons make things ten times worse. Urghh I can't even think about them!

I've had terrible period pain since my periods started aged 13 and show absolutely no sign of slowing down even though I'm 26. I can't take the pill because it causes my skin to pigment how some pregnant women get the pregnancy 'mask'. This article has motivated me to take drastic action with my diet and lifestyle which is good overall but could definitely do with some tweaks specifically to tackle period pain. And thanks for the comments everyone. Always good to hear you're not totally alone.

HANNAH on December 04, 2011:

I'm 21, I started menstruation at the age of eleven & my menstrual cramps started at the age of twelve till date...i'm so happy i've gotten so many alternatives to treat my cramps .thanks alot !

Baby Lisa on December 03, 2011:

i get the worst cramps ever i cry

Alpha mirabel on October 10, 2011:

this is good i can't believe that this kind of site exsist. i've actually been carrying out this reasearch for several occassions, trying with different methods of question all talking about one thing but to no avail. you're doing a great deal of work and i commend you well keep on

Donna in Austin on September 17, 2011:

It's great to see such support for fellow sufferers. I've been researching for several weeks because I'm trying to avoid a hysterectomy--this is definitely a good article from what I've seen, but it's far from complete. It's so important to emphasize that there quite a few very different causes for excessive bleeding and pain, and so different things will work depending on the root cause. For instance if you are deficient in vitamin K your blood will not clot as easily, and arteries that supply blood the uterus can become fragile and cam be strengthened with beta carotene/vitamin A and certain bioflavanoids. TENs units are portable devices used to interrupt pain signals that are very popular in Europe and can be bought on Amazon. I have ulcerative colitis and so cannot take NSAIDS like Ibuprofen which not only can relieve pain but also reduce bleeding about 30% in many women, but I have found natural NSAID alteratives: 5 Loxin and Nexrutine. I have tried 5 Loxin and it works very well to relieve pain and over several days seems to reduce bleeding when I take 1.5 times the suggested dose 4 times per day. Also I got relieve from Cramp Bark and plan to try Black aw soon.

The article doesn't mention that many women have achieve very quick relief from acupuncture and traditional CVhinese medicine based on studies. For estrogen dominance, my integrative medical practitioner put me on a high dose of DIM (diindolylmethane) which helps the body eliminate excess estrogen and is equivalent to eating several pounds of cruciferous vegetable per day for it active substance. Vitex is also generally highly recommended in the holistic health world.

Finally, if you are in significant pain which is interfering with your quality of life, you owe it to yourself to see a physician who is qualified to assess dysfunctional uterine pain and bleeding. One cause of DUB is cancer. Other causes that may be best addressed by means other than herbs, tonics, and the likes, include bleeding polyps, fibroids, endometriosis,blood disorders and hormone disorders such as hypothyroidism and polycystic ovary sydrome. I really hope that women will care for themselves by taking their pain seriously enough not to put up with it because they are strong, because they do not have to. There are many options to be explored, there are respectful, empathetic doctors (I had to fire my first one who didn't believe how much I was bleeding or how fatigued I was). Please don't suffer needlessly or just experiment with self-measures as a substitute for a medical evaluation and advice. I wholeheartedly support using all of these great suggestion as long as you have ruled out any other condition that would not be more effectively addressed by other means. Wishing you the best.

mildred stacey on March 16, 2011:

I thank u 4 the great article wit xcelent tips how to put a curb to menstrual disorders. I will make good use of it now because i am presently suffering from it just finished crying and screaming., God bless u all

Jenelle on January 18, 2011:

I do a lot better when I take a calcium supplement with magnesium and avoid caffeine. The 800 mg ibuprofen is the real cure though. Thermacare patches are a godsend too.

dynamag on October 13, 2010:

Great Hub!

Very well presented info, for a situation that affects so many people.

sherstone212 on July 24, 2010:

Thank you so much for this piece on menstrual cramping. I'm 49 years old and have suffered with extreme menstrual pain since I was 15! NO ONE knew how to help me, especially Doctors. I had to learn over the years what would cause them to be worse and what would help get rid of or reduce them. Needless to say I've tried it ALL!!!

My period routine for YEARS was: wake up at around 5am with horrific pain and blood, take a Motrin, jump in a HOT bathtub, sweat profusely, get out to puke, pain getting even worse, back into tub, finally giving up and getting in bed, laying in a ball crying, rocking back and forth moaning, getting back out of bed and jumping up and down thinking that would create more blood flow, getting back into bed crying, rocking and moaning, throwing a fit and screaming, then finally crying myself to sleep in some weird position because I was afraid to move a muscle.

If this sounds familiar PLEASE try some of my techniques! Now I am pretty much pain free or low pain. My cramps used to be at a level 9, now they are a 3 at worst. I can even go out and do things on my first day... no way that could have happened before.

What has worked BEST for me is to get the 800 MG Ibuprofen in at the FIRST SIGN of pain and keep a steady level going, get a HOT water bag on my abdomen and lay in bed in an upright position.( Moving around or laying flat made them worse)

Important things I've learned:

* If you take Ibuprofen on an empty stomach you will be very sorry. You will either be throwing up, which seems to make cramps even worse because of the wretching or you will feel like a hole is burning through your stomach.

* Keep your hot water bottle HOT; changing out water when needed. Also, don't place it on your stomach because this will make you nauseous. Place it on your lower abdomen, directly where the cramping is.

*Tampons always made my cramps 10 times worse. Use pads for the first 2 days then use the tiniest tampons ( Tampax Lites or Juniors )

* If you are stuck taking around the clock Ibuprofen, don't be surprised to get what I call a " Motrin hangover". After taking a lot of this drug, I tend to get headachy and feel like crap for a day... but it's worth it to get rid of the pain.

* DO NOT take more than 800 MG of Ibuprofen... you WILL throw up. Also, for me, any dose under 800 MG was ineffective. Figure out which amount works for you.

*** Finally, DO NOT drink ANY caffeine!!!!! I have proven this over and over to myself. Caffeine causes horrific cramping for me. In fact, I found that when I converted my Coke to decaf Coke and severely limited my overall caffeine consumption THROUGHOUT the MONTH, I get cramps that are so minor I don't need ANY pain reliever at all!!! I highly recommend trying this... it's proven to be the ONE thing that has gotten RID of my pain.

Note: I did test it several times by adding Caffeine back into my diet and sure enough, the cramps came back full force!

I hope my advise will help at least a few women because I suffered for so many years of my life and I really feel for anyone in that position. : )

Edwin on June 20, 2010:

Excellent hub with good information!

I also tried a magnet therapy for two consecutive months with my 15 years old daughter and the results were astonishing. The menstrual pain were gone!

Gloria Siess from Wrightwood, California on March 22, 2010:

Very professional Hub--check out my Hub on Endometriosis, which as you probably know, is a disease that causes internal scarring from misplaced menstrual tissue. I had it for years and finally had to have major surgery.

helenathegreat on February 23, 2008:

Wow, these are excellent tips! You covered pretty much every single recommendation I've ever heard, offered explanations for them, and then listed ten more. Great, great hub!

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