Painful truths about menstrual cramps
By Lee Hye-jun
Nine out of 10 women suffer from menstrual cramps. Some women bear it taking it as merely being annoying, but others can end up fainting on the street. They may also experience nausea, diarrhea, or headaches during periods. We all know over-the-counter medications are available. But it does not feel right to some of us to keep taking medications every month.
“What if I get addicted to the medication?” “There may be something wrong with me.” “I need to fix it or else it might become chronic illness.” These are common complaints.
Most menstrual cramps are natural rather than problematic. During menstrual periods, the uterine muscle contracts to help expel its lining and prostaglandin is secreted in the uterus — and pain may result from this normal female physiological function.
The first choice of treatment is non-steroidal anti-inflammatory drugs (NSAIDs). These reduce menstrual cramps by decreasing prostaglandin production and menstrual flow. You start taking them as your period begins, or one or two days before you expect your period to begin in severe cases. Make sure to take NSAIDs with food. If you have a stomach ulcer, NSAIDs can cause bleeding. Try acetaminophen in that case, although it is not as effective.
What if taking NSAIDs does not work for you?
First, try different class of NSAIDs, such as switching from ibuprofen to mefenamic acid. Women show variable responses to different brands of medication.
Second, try birth control pills. They can benefit both in cramps as well as contraception. They contain hormones that inhibit ovulation, thereby reducing prostaglandin production and menstrual flow. These hormones can also be delivered in several other forms: an implant placed under the skin of your arm or a hormone releasing intrauterine device.
Third, try modification of life style. A vegetarian diet, vitamins B1, B6 and E, herbal medicine, exercise and heated abdominal pads may be helpful. Quit smoking. Being married or in a stable relationship and more children may lead to less cramps.
There are some common misconceptions.
Some people say you will not be able to handle the pain without medication once you get used to taking it. Do not hesitate to take it every month if it frees you from pain that disrupts your normal life. The benefits outweigh the rare complications you might have by taking it at most for several days a month.
They also think that your body will need more and more medication as you could get addicted. However, NSAIDs are not addictive like opioids. If you need more medication, it means the pain is worsening. Consult your doctor if there is any problem.
People often comment that if you do not fix it and rely on medication, it might become chronic. However, Cramps are a physiological response to having periods. So if you want to fix it, you need to stop having periods. They will lessen as you grow older, unless it is from any abnormal condition in your body.
Be aware of certain situations where you actually need a “fix.”
If you have just started experiencing severe menstrual cramps when you are older, or you fail to respond to NSAIDs and/or hormonal contraceptives, or you have worsening pain, see your doctor to exclude secondary causess such as endometriosis.
The writer is a doctor at Maria Fertility Hospital in Seoul. For further questions, send an email to the writer at hyejunlee@mariababy.com, or call the hospital’s English-speaking coordinator at 82 (Korea country code) 2 (Seoul area code) 2250-5577, or visit the hospital’s Website, https://eng.mariababy.com/.