Menstrual Period: Menstrual Cramps

Menstrual periods can be light and easy for some teens and young women, but for others, they can be heavy and/or accompanied by painful cramps. Cramps can be a big reason why girls are absent from school, why they miss sport practices, and why they may avoid social events with their friends.

What is Dysmenorrhea?

Dysmenorrhea (pronounced: dis-men-o-ree-a) is a medical term that means “difficult or painful periods.” There are two types of dysmenorrhea, primary and secondary.

Primary dysmenorrhea is the most common kind of dysmenorrhea. Cramps (pain in the lower abdomen (belly) area and/or lower back) can start 1-2 days before your period comes and can last 2-4 days.

Secondary dysmenorrhea is when cramps and, for some, lower back pain are a result of a medical problem such as endometriosis or pelvic inflammatory disease.

What causes menstrual cramps?

Menstrual cramps are caused by uterine contractions (when your uterus tightens and relaxes allowing blood to leave your uterus). The lining of your uterus releases special chemicals called “prostaglandins.” These substances can increase the intensity of the contractions, especially if the levels rise. High levels of prostaglandins may also cause nausea and lightheadedness.

*Some or all of these problems may start a day or two before your period and can last for part or all of your period. These signs could be caused by other medical conditions and therefore it is important to talk with your health care provider about your symptoms.

Is it normal to have some mild cramps during your period?

Yes, it is normal to have mild cramps during your period because of uterine contractions. The uterus is a muscle that tightens and relaxes which can cause jabbing or cramp-like pain. However, if the discomfort is not relieved with over-the-counter medications and causes you to miss school or other daily activities, it could mean that there is another reason for your symptoms.

It is common for young women to have irregular periods when they first begin to menstruate. This means that ovulation (when a woman’s body makes eggs) may not happen for a few months or even for a few years. So, you may not have menstrual cramps when you first begin your period. Menstrual cramps may be more likely in cycles in which you ovulate, and prostaglandin levels are higher. After one, two, or three years, when your hormonal system is more mature, you might have more painful menstrual cramps.  But you can have menstrual cramps from your first periods even when you are not ovulating.

If your cramps are severe and interfere with your daily activities, don’t ignore what your body is telling you. Make an appointment with your healthcare provider because there may be other reasons for your pain.

What other symptoms do girls have during their periods?

Girls may have other symptoms, such as:

• Nausea (feeling like you want to throw up)
• Vomiting (throwing up)
• Loose bowel movements/diarrhea
• Constipation
• Bloating in your belly area
• Headaches
• Lightheadedness (feeling faint)

Are menstrual cramps the same as PMS (Pre-Menstrual Syndrome)?

Menstrual cramps are not the same as PMS. Symptoms of PMS such as bloating, weight gain, and moodiness happen before a woman’s period begins, and get a lot better when her period starts. On the other hand, menstrual cramps usually get worse the first day or two of a period and have a different cause and treatment.

What medicine can I take for my menstrual cramps?

If you are having menstrual cramps, talk with your parents or health care provider about your options. If your menstrual cramps are painful, you may think about taking some type of over-the-counter medication for one to two days. These medications are “anti-prostaglandins.” They help relieve the discomfort, make your flow lighter, and cause your uterus to cramp less. Look for over-the-counter medications such as ibuprofen or naproxen sodium. Take this medicine when you first start to feel uncomfortable and continue taking it every 4-6 hours or as recommended by your health care provider. Since this kind of medicine can upset your stomach, you should take it with food. Make sure you read the label to see how much and how often you should take the medication. You should not take these products if you are allergic to aspirin-like medicine or have stomach problems. It is important not to take more medicine than is recommended or prescribed.

Is there anything else I can do to help my menstrual cramps?

Natural remedies such as a microwavable warm pack or a heating pad placed on your abdomen (lower belly) may help. Soaking in a warm bath may also relieve uncomfortable cramps. Some teens find that increasing their physical activity helps; others find that resting quietly for short periods of time helps.

Acupuncture is an alternative treatment that is sometimes recommended to treat menstrual cramps. A TENS unit is another form of alternative treatment that is often recommended for managing menstrual cramps. You should also eat healthy foods, drink lots of fluids, and get plenty of rest. Check with your health care provider about different treatments that work best for you.

Is it okay to exercise when I have my period?

Exercising is a good way to stay fit and healthy. Some girls like to exercise when they have their period because it helps lessen their cramps. Other girls are uncomfortable exercising when they have their period. You should find what works best for you. Talk to your coach or gym teacher if exercising is uncomfortable during your period.

What if nothing helps my menstrual cramps?

If your menstrual cramps are not relieved by over-the-counter medicine, make an appointment to see your health care provider. Use a period and symptom tracker for 2-3 months and then bring it to your next medical appointment. A record of your symptoms can help your health care provider figure out the best treatment choices for you.

My Monthly Period & Symptom Tracker

My Monthly Period & Symptom Tracker is an easy way to keep track of your menstrual flow, and it’s also a way to keep track of cramps, and/or PMS and period symptoms (if you have them) each month.

• Review the sample Monthly Period & Symptom Tracker.
• Print out copies of My Monthly Period & Symptom Tracker.
• Simply make a check mark in the appropriate box (or boxes) for each day of the month. If you don’t have any flow or any symptoms on any given day, leave the box empty. Refer to the Blood Flow Key at the bottom for “Flow” definitions.
• The dates at the top are the same as the dates in one month. Some months have 28 days, others have 30 or 31.
• Remember to bring My Monthly Period & Symptom Tracker or your smartphone app with you to your medical appointments.

Sample Monthly Period and Symptom Tracker

My Monthly Period and Symptom Tracker

Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.