Do I Need to See My Doctor for Menstrual Cramps?

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It's perfectly normal to experience mild cramps during your period, and the good news is that these cramps can usually be eased with simple therapies like a heating pad or an over-the-counter pain reliever.

However, some women's menstrual cramps may not feel better with these basic remedies. If this is the case for you, making an appointment with your doctor is important. This way you not only get the pain relief you deserve but also ensure there is nothing else going on.

Understanding Menstrual Cramps

The medical term for experiencing pain associated with your period is dysmenorrhea, and there are two types: primary and secondary dysmenorrhea. 

Primary Dysmenorrhea

According to the American College of Obstetricians and Gynecologists (ACOG), more than fifty percent of women who menstruate experience some pain for one to two days per months. In other words, menstrual cramping is very common. 

Prostaglandin production within the lining of your uterus is the culprit behind menstrual cramps. Since the prostaglandin level rises in the uterus just before menstruation starts, women generally experience cramping on the first day of their period. As the lining of their uterus sheds and bleeding continues, the prostaglandin level goes down and with that, the cramping.

It's interesting to note that menstrual cramps commonly start when a woman begins having menstrual periods, during her late childhood or early teenage years.

But in many women, the cramps become less painful as they get older.

Secondary Dysmenorrhea

Secondary dysmenorrhea means that a woman's menstrual cramping is not from the prostaglandin level increase within her uterus, but rather from another medical condition. Examples of conditions that may cause secondary dysmenorrhea include:

Unlike primary dysmenorrhea, secondary dysmenorrhea may begin later in life, and the pain associated with periods tends to get worse, not better, as a woman gets older. Moreover, while the pain of primary dysmenorrhea lasts only a day or two, that of secondary dysmenorrhea gets worse as the period goes on. In fact, the pain of a woman's period may persist even after her menstrual bleeding has ended.

Evaluating Menstrual Cramps 

Besides taking a careful medical history and performing a physical examination, including a pelvic exam, your doctor may order an ultrasound, in order to take a closer look at your reproductive organs (ovaries, uterus, and fallopian tubes). Ultrasound is particularly useful for detecting fibroids.  Less commonly, surgery is needed for your doctor to examine the organs within your pelvis. 

Additionally, your doctor may recommend a pregnancy test, as the combination of cramping and bleeding can indicate a miscarriage or ectopic pregnancy.

Treating Menstrual Cramps

Nonsteroidal anti-inflammatories (NSAIDs), like ibuprofen, are commonly recommended to treat dysmenorrhea, as they decrease prostaglandin levels in the body. Be sure, though, to discuss taking NSAIDs with your doctor first, as they may cause adverse effects like bleeding, stomach ulcers, and kidney and liver problems.

Combination birth control (for example, the pill, patch, or vaginal ring), as well as progestin-only methods (for example, an intrauterine device or implant), may also help treat dysmenorrhea.

Of course, there are nonmedical therapies too, like applying a heating pad to your lower abdomen. Interestingly, exercise has been found to also help relieve menstrual cramps.

If you are diagnosed with secondary dysmenorrhea, your doctor will treat the underlying condition to ease your menstrual cramps. For instance, hormonal birth control may be prescribed to treat endometriosis, and if fibroids are causing pain, they can be removed with surgery.

Lastly, some women choose complementary therapies (for example, acupuncture or yoga), either alone or in addition to medication, in order to soothe their pain—although, the evidence supporting their usefulness is limited.

A Word From Verywell

In the end, it's sensible to see your doctor if you are experiencing menstrual cramps, especially if they are not eased with simple strategies, and/or persisting throughout your menstrual period. 

Of course, anytime you are experiencing new and severe pelvic or lower abdominal pain, do not wait for a doctor's appointment. In this instance, seek medical attention right away.

Sources:

American College of Obstetrics and Gynecologists. (2015). Frequently Asked Questions: Dysmenorrhea: Painful Periods. 

Smith RP, Kaunitz AM. (2017). Primary dysmenorrhea in adult women: Clinical features and diagnosis. Barbieri RL, ed. UpToDate. Waltham, MA: UpToDate Inc.

Yu A. Complementary and alternative treatments for primary dysmenorrhea in adolescents. Nurse Pract. 2014 Nov 16;39(11):1-12.

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