Dr. Kate is an OB/GYN at one of the largest teaching hospitals in Boston who lectures nationally on women’s health issues and conducts research on reproductive health. She regularly (and generously!) answers your health questions here on EMandLO.com. To ask her your own, click here.
Hello Dr. Kate,
I have a question about cramp severity. I’ve noticed that (for most women) generally cramps aren’t treated with medication, because they’re simply not strong enough to need it. Every month I have at least one day where the cramps lay me low —unable to move very well (because every movement causes pain), unable to eat (because the pain causes nausea), and bloated so badly my clothes don’t fit. (Usually it’s only one day–but sometimes it’s more than one.)
Now, this has *always* been the case for me, since my menstruation began in the first place. I’ve consulted with related female family members, and they, too, experience the same thing during their cycles. Having given you the background, this is my question: At what point do I decide these monthly pains aren’t normal and consult a physician about them? Or should I resign myself to this until menopause (something the women in my family spend their lives looking forward to)?
— Pain Jane
These monthly pains are normal…AND you can get help for them. For some women, disabling pain before or during their period is a sign of endometriosis, the most common cause of recurrent or chronic pelvic pain. But since your awful pain has been there since your first period, you are “just” one of the lucky gals with severe dysmenorrhea — the fancy pants term for “period pain that makes you want to die.” Pain that comes with nausea and bloating is unfortunately common, too. About 15% of women have the kind of pain you’re describing, so you (and the women in your family) are not alone.
There are two general ways to manage cramps like yours – treat them, or prevent them. For treatment, I recommend to my patients round the clock anti-inflammatory medication at prescription strength. You can use naproxen (two Aleve or its generic, every 12 hours) or ibuprofen (four Advil, Motrin or its generic, every 8 hours). But the trick is to start the medication at least one full day before you expect to get walloped with cramps. Even taking medication like this for two or three days before the pain begins is not dangerous, and can lessen the intensity of the cramps when they come.
The other approach is to prevent them altogether. Any hormonal contraceptive method that stops ovulation — the pill, patch, ring, injection or implant — will likely lessen or eliminate your cramps. For this, you need a visit to a clinician to see what methods you’re eligible for. The pain will come back when you stop the birth control, but at least will give you serious relief while you’re using it. You should NOT live with pain like this until menopause — and neither should your family members.
— Dr. Kate