“Most women have menstrual cramps,” says Lawrence Steigelman, M.D., an obstetrician and gynecologist. “About 40% of women have cramps that are bad enough that they need to do something about them.” Menstrual cramps, also known as dysmenorrhea, are caused by muscle contractions in the uterus.
“Anybody who has had a baby knows that the uterus can contract and contract very strongly,” Dr. Steigelman says. “Menstrual cramps are similar, though not as severe as labor pains in most patients – but they can be.” The hormone prostaglandin mediates muscle cramps in the uterus. Prostaglandin is used to induce labor because it can make the uterus contract.

What’s normal – and what isn’t

“It’s hard to define what a normal cramp is,” he says. “What’s normal to one person isn’t necessarily normal to somebody else.”

The most common, less severe muscle cramps occur only during a woman’s period, tend to be the same every month and often affect young women or those who haven’t had children. “Doctors divide menstrual cramps, or dysmenorrhea, into two categories,” Dr. Steigelman says.

• Primary dysmenorrhea is cramping not associated with other conditions. It can usually be treated with over-the-counter medications or simple prescription remedies.
• Secondary dysmenorrhea is associated with other conditions, such as endometriosis, adenomyosis, pelvic inflammatory disease, ovarian cysts, intrauterine devices (IUD) or uterine fibroids (muscle tumors in the uterus).

“With secondary dysmenorrhea, cramps will get worse over time,” he explains. “They’ll involve the entire menstrual cycle. They won’t occur just with the period and resolve when the period is over.”

If your cramps worsen, stop responding to over-the-counter medication, occur when you are not on your period or interfere with your lifestyle in any way, it’s time to see your doctor. 

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