Period Cramps and Pains: Causes, Relief Methods and When to See a Doctor

Written By: Dr. Katherine Cheng 

Period cramps, or menstrual cramps or dysmenorrhea, are a common experience for many individuals during their menstrual cycle. These cramps can range from mild to severe and can disrupt daily activities. 

Understanding period cramps 

What causes period cramps? Period cramps are related to the following factors: 

• Prostaglandins: The release of prostaglandins, hormone-like substances, triggers uterine solid contractions and inflammation, leading to period cramps 
• Hormonal Imbalances: Imbalances in hormone levels, notably higher estrogen and lower progesterone can contribute to more intense and painful cramps 
• Endometriosis: This condition occurs when the tissue lining the uterus grows outside of it, leading to severe pain and cramping during periods 
• Adenomyosis: Adenomyosis is characterised by the abnormal growth of endometrial tissue within the muscular walls of the uterus, causing intense period pain 

Relief Methods for Period Cramps 

• Heat Therapy: Applying a heating pad or taking a warm bath can help relax the uterine muscles, alleviate pain, and increase blood flow to the area 
• Over-the-Counter Pain Relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen sodium can effectively reduce pain and inflammation associated with period cramps 
• Exercise: Engaging in light activities, such as walking or gentle yoga, can stimulate endorphin release, improve blood circulation, and ease menstrual cramps 
• Dietary Adjustments: Consuming a balanced diet that is rich in fruits, vegetables, whole grains, and lean proteins while minimising caffeine, alcohol, and processed foods may help reduce inflammation and ease cramps 
• Relaxation Techniques: Practices like deep breathing exercises, meditation, and gentle stretching can promote relaxation and reduce the intensity of period cramps 

Does Chocolate Help with Period Cramps?

While chocolate is often craved during periods, its effect on cramps can vary. Dark chocolate (at least 70% cocoa content), rich in magnesium, may help relax muscles and alleviate pain. However, moderation is critical as high sugar in some chocolates can counteract these benefits by enhancing inflammation.

Types of Period Cramps 

Concerning the types of period cramps, it is essential to note that there are no distinct categorisations of menstrual cramps. However, the severity, duration, and characteristics of period cramps can vary from person to person. Here are some common ways in which individuals may describe their period cramps: 

• Mild Cramps: Some individuals experience mild and tolerable cramps during their menstrual cycle. These cramps are often described as a dull, achy sensation in the lower abdomen and may not significantly impact daily activities 

• Moderate Cramps: Moderate period cramps are characterised by a more noticeable discomfort that may require over-the-counter pain relievers. These cramps can cause some disruption to daily routines but are generally manageable 

• Severe Cramps: Severe period cramps can be intense and debilitating, significantly affecting a person's quality of life. Sharp, shooting pains may accompany these cramps and require more potent pain medications or interventions for relief 

• Spasmodic Cramps: Some individuals experience intermittent or spasms-like cramps during their menstrual cycle. These cramps can be sudden and intense, causing a gripping or squeezing sensation in the lower abdomen 

• Back Pain: Menstrual cramps can also manifest as lower back pain for some individuals. The pain may radiate from the lower abdomen to the back, making it uncomfortable to sit or stand for extended periods 

• Pre-Menstrual Cramps: Pre-menstrual cramps, also known as premenstrual syndrome (PMS) cramps, occur in the days leading up to the start of the menstrual period. These cramps can vary in intensity and may be accompanied by other PMS symptoms such as bloating, mood swings, and breast tenderness 

Why Do I Have Cramps but No Period?  

Experiencing cramps without a period can be a source of confusion and concern. Several factors can contribute to this phenomenon, including: 

• Ovulation: Some individuals may experience cramping during ovulation, typically occurring approximately two weeks before their next period. This is known as mittelschmerz, a German term for "middle pain." Ovulation cramps are usually mild and occur on one side of the lower abdomen. They are typically short-lived and may be accompanied by other signs of ovulation, such as changes in cervical mucus 

• Implantation: If you are sexually active and trying to conceive, you may experience cramping due to implantation. Implantation occurs when a fertilised egg attaches to the uterine lining, and it can cause mild cramps and spotting. These symptoms typically occur around 6-12 days after conception 

• Hormonal fluctuations: Fluctuations in hormone levels throughout your menstrual cycle can cause uterine changes and cramping. Estrogen and progesterone levels rise and fall during different phases of the menstrual cycle, leading to mild cramping even in the absence of a period 

• Pelvic inflammatory disease (PID): PID is an infection of the reproductive organs, such as the uterus, fallopian tubes, or ovaries. It can cause abdominal pain and cramping, even without a period. Other symptoms of PID may include abnormal vaginal discharge, pain during intercourse, and fever. If you suspect you have PID, it is crucial to consult a doctor for diagnosis and treatment 

• Endometriosis: Endometriosis is a condition where the tissue that usually lines the uterus grows outside. This can cause pelvic pain, cramping, and discomfort, even outside of the menstrual period. Endometriosis often requires medical evaluation and treatment 
• Adenomyosis: Adenomyosis occurs when the tissue lining the uterus (endometrium) grows into the muscular wall of the uterus. This condition can result in heavy, prolonged periods, cramping, and pelvic pain, which may occur even when you're not menstruating 

When to See a Doctor 

While period cramps are a normal part of the menstrual cycle for many individuals, there are instances where it is advisable to consult a doctor: 

• Severe or Debilitating Pain: If your period cramps are severe and significantly impact your quality of life, it is important to seek medical attention to rule out any underlying conditions 
• Irregular Menstrual Cycles: If your periods are irregular, accompanied by excessive bleeding, or if your cramps suddenly become more intense, it may be necessary to consult a doctor 
• Symptoms of an Underlying Condition: If you experience additional symptoms like heavy bleeding, prolonged periods, pain during intercourse, or difficulty conceiving, it is important to discuss these with a doctor 

Period cramps, though often uncomfortable, can be managed effectively with various relief methods, such as heat therapy, over-the-counter pain relievers, exercise, dietary adjustments, and relaxation techniques, which can provide significant relief. Everyone's experience with period cramps is unique, and finding the right approach to managing them may require trial and error.  

If you experience period cramps and are concerned about your symptoms, it is advisable to consult with a doctor.