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Painful Periods

Painful periods are known as cramps. This section looks at what causes cramps and how to ease the discomfort.

Doctors call painful periods or crampsdysmenorrhea.” They are caused by high levels of prostaglandins, a kind of hormone that increases the normal squeezing or contraction of the muscle in the wall of the uterus. Prostaglandins are made in the muscle and the lining of the uterus in response to increased pressure inside the uterus. Uterus pressure is increased to high levels during a period, especially in women who haven’t had a baby. Prostaglandins are also increased when hormones are out of balance. Imbalance occurs when estrogen levels increase and progesterone levels are too low for the estrogen levels.

Cramps are common in normal teenagers, usually go away with the first delivery (or with a miscarriage or abortion) and commonly return again when the hormones change in perimenopause.

Oral contraceptives or birth control pills are commonly used to treat cramps. However, this is not such a good idea for a teenager who doesn’t yet need contraception. Nor are oral contraceptives safe or appropriate in many perimenopausal women.

Anti-prostaglandin” therapies are very appropriate, because, as the name suggests, they prevent the formation of prostaglandins. Anti-prostaglandins, sometimes called non-steroidal anti-inflammatory drugs (NSAIDs for short) include ibuprofen and a number of other medicines that require a doctor s prescription. Ibuprofen is very effective and available without a prescription. Ibuprofen needs to be taken in quite a different way than usual medicines—it must start before cramps get bad. If a woman can note the “heavy pelvis” feeling that comes before cramps she can start ibuprofen and prevent formation of prostaglandins and cramps.

In summary: for cramps, take two ibuprofen tablets at the first hint. Take another pill as soon as cramps start to return (even if this is only an hour or two later). Keep this up until cramps are gone.

You ask, “Is it safe to take medicine that frequently?” The answer is “Yes.” Ibuprofen can sometimes cause stomach irritation so take it with food or milk. Teenager’s cramps rarely last longer than two or three days.

“How can I remember to take them soon enough?”

ALWAYS carry a couple of tablets with you. Especially when you expect your period.

Other things besides ibuprofen that will help cramps include exercise—it decreases the body’s estrogen production. Working to healthily manage stress will mean more regular ovulation and enough progesterone. If needed, cyclic progesterone can also be taken to help cramps.

Ibuprofen also helps with heavy flow. (See "Managing Menorrhagia".) Any time flow requires changing a pad or tampon more frequently than every three or four hours, take ibuprofen. The dose is one tablet every four hours during the day, and before bed.

Updated Date: 
May 26, 2014

Estrogen’s Storm Season: Stories of Perimenopause

Estrogen's Storm Season

by Dr. Jerilynn C Prior

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