Painful menstrual periods

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Female reproductive anatomy

Painful periods (dysmenorrhea)

Relieving PMS

Uterus

Menstruation - painful; Dysmenorrhea; Periods - painful; Cramps - menstrual; Menstrual cramps

The following steps may allow you to avoid prescription medications:

• Apply a heating pad to your lower abdomen (below your belly-button). Be careful NOT to fall asleep with it on.
• Take warm showers or baths.
• Drink warm beverages.
• Do light circular massage with your fingertips around your lower abdomen.
• Walk or exercise regularly, including pelvic rocking exercises.
• Follow a diet rich in complex carbohydrates such as whole grains, fruits, and vegetables, but low in salt, sugar, alcohol, and caffeine.
• Eat light but frequent meals.
• Try over-the-counter anti-inflammatory medicine, such as ibuprofen.
• Practice relaxation techniques like meditation or yoga.
• Try vitamin B-6, calcium, and magnesium supplements, especially if your pain is from PMS.
• Keep your legs elevated while lying down. Or lie on your side with knees bent.

If these self-care measures do not work, your doctor may prescribe medications such as:

• Stronger anti-inflammatories like diclofenac (Cataflam)
• Antidepressants
• Birth control pills
• Antibiotics
• Stronger pain relievers (even narcotics such as codeine, for brief periods)

Call your doctor right away if:

• You have a fever.
• Vaginal discharge is increased in amount or foul-smelling.
• Your pain is significant, your period is over one week late, and you have been sexually active.

Also call your doctor if:

• Your pain is severe or sudden.
• Self-care measures don't relieve your pain after 3 months.
• You pass blood clots or have other symptoms with the pain.
• Your pain occurs at times other than menstruation, begins more than 5 days prior to your period, or continues after your period is over.
• You have an IUD that was placed more than 3 months ago.

Your doctor will examine you, paying close attention to your pelvis and abdomen, and ask questions about your medical history and current symptoms, such as: