The time just before and after your period arrives can be uncomfortable. You might feel bloated and irritable, or so lethargic all you want to do is lie on the couch and watch TV.
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For many people, their physical side effects mean period cramps. These can be mild or severe. However, Ob/Gyn Marissa Levine, DO, says that period cramp relief does exist.
When you get your period, you shed your endometrium, or the lining of your uterus. (That’s the reddish-brown discharge you typically see.) Shedding this material also causes your body to release prostaglandins, or chemicals that mimic the functions of a hormone.
“This release of prostaglandins causes your uterus to cramp and contract,” says Dr. Levine. “The pain associated with period cramps is literally your uterus contracting.”
Not everyone who has a period experiences cramps. And you might have bad cramps one month, and be fine the next month. However, those who do have cramps tend to start having them about two days before the onset of bleeding. These cramps can continue about three days into your period before slowly starting to taper off, adds Dr. Levine.
Period cramps are never a welcome visitor. But when they do arrive, there are some remedies you can rely on to manage pain and discomfort.
When you’re not feeling great, there are some home remedies for menstrual cramps you can turn to for relief.
When you have an aching muscle, you might turn to heat to loosen up any knots and ease your soreness. The same idea holds true for period cramps. A heating pad or stick-on heating wrap can provide pain relief.
When you have your period, the last thing you might want to do is hit the gym. However, exercising can help with pain from cramps. “Heat and exercise are actually our two first-line options for nonmedical treatment,” says Dr. Levine. “We’ve found that people who exercise during their periods do tend to have less pain.” Doctors aren’t quite sure why, although it’s suspected the relief comes from the release of chemicals called endorphins, which make you feel good.
When you’re not feeling great, warm beverages such as caffeine-free tea or hot water with honey can be soothing. Dr. Levine says these might not have any science-based benefit, “but if they make you feel better, these are perfectly acceptable to drink.” Applying essential oils as well can’t hurt, although these too don’t have any science-based benefit.
For period cramp relief, Dr. Levine recommends NSAIDs, or nonsteroidal anti-inflammatory drugs that are used to treat pain and inflammation. Ibuprofen (sold under brand names like Advil® or Motrin®) helps the best.
“We’ve found that the way NSAIDs work, they block the release of those prostaglandins,” says Dr. Levine. “They’re better at preventing those cramps.” You can take up to 600 milligrams of ibuprofen every six hours.
For people who can’t take ibuprofen, acetaminophen (Tylenol®) is also acceptable.
Dr. Levine does say you should be cautious about relying on over-the-counter supplements and vitamins to keep cramps at bay. “Certain ones, like St. John’s Wort, can make bleeding worse,” she cautions. “We tend to tell people who have heavier periods to stay away from over-the-counter supplements.”
You can’t control whether you’ll have cramps in a given month. But you can do things to make sure the pain isn’t too much to handle. Sticking to your exercise regimen and applying heat as a precaution are both good options.
Dr. Levine says you can also be prevention-minded and preemptively take ibuprofen to reduce the impact of cramps. “If you find that your cramps start two days before your period and are really bad for three to four days, taking ibuprofen in that time period can help prevent cramps from getting severe,” she says.
Period cramps themselves are normal. Cramps that act out of the ordinary can be a sign of a secondary concern or health condition, though.
The timing of cramps can signal you might have a secondary health condition. “We usually don’t see period cramps a whole week out from when your period actually starts,” notes Dr. Levine.
If your cramping is associated with heavy, abnormal bleeding, that can also be a sign that something more serious is going on. “If you’re soaking through more than a pad an hour over a two-hour time period, that’s abnormal bleeding,” warns Dr. Levine. “That’s worrisome. That’s not regular period cramps or regular period bleeding.”
Dr. Levine says if ibuprofen is no longer helping your period cramps feel better, that’s another sign to talk to your doctor. “We may need to evaluate you to see if there are secondary causes of the cramps. Or we might need to talk about other methods to help control your period cramps.”
“The way that estrogen works, it tends to prevent the endometrial thickening and shedding that can lead to the pain associated with periods,” Dr. Levine explains.
If you’re dealing with serious period cramps, doctors might not diagnose you with something right away. Instead, they’ll do a full examination to see what’s going on and see what other symptoms you’re having. For example, one major symptom of endometriosis is severe pain.
“However, period cramps themselves are not necessarily a sign of endometriosis,” says Dr. Levine. “That’s why it’s important for us to do a full workup before we actually diagnose you with anything specifically.”
She also adds that doctors might not start you on birth control right away. “We might wait a few months to see, ‘Was it just this month that things were really bad? Or is this a constant?’”