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Most women feel mild to severe cramping during menstrual bleeding. These cramps may not be a signal of some gynecological problems that simply appear by themselves. Dysmenorrhea begins a few days before or on the day of menstruation.

Cramps occur as pains in the form of amplitude–rapid amplification and reduction. They mainly occur in the lower and middle part of the stomach, although they may extend to the hips and rump. Also, uterine contractions can cause stomach and thigh muscle spasms. During this period, women generally may feel bad which is accompanied by weakness, dizziness, and chills. In the case of very strong menstrual cramps occur nausea, vomiting, and diarrhea.

Predisposition to develop this type of dysmenorrhea, also called primary dysmenorrhea, usually occurs in girls who get their first period very early. However, menstrual pain can indicate the existence of certain gynecological disorders, such as endometriosis. Women older than 25 are more predisposed to develop secondary dysmenorrhea.

Menstrual Cramps Causes

Menstrual cramps occur as a result of increased secretion of prostaglandin, a substance that is found in the uterine lining. Prostaglandin increases uterus contractions, which causes the occurrence of pain. Also, during menstruation, veins and arteries enlarge which pool blood instead of circulating it. This leads to the accumulation of blood in the pelvis, which creates a feeling of bloating and heaviness. In addition, blood flow and the passing of blood clots can be a problem because of the extremely small opening of the cervix. If the pain is caused by this factor, it is a good sign, because in most women with this problem, cramps disappear after the first delivery.

Drugs For Menstrual Cramps

Non-steroidal anti-inflammatory drugs (ibuprofen, naproxen) are usually used for eliminating dysmenorrhea. They stop the production of prostaglandin and reduce the pain. These drugs are based on Aspirin, so there is very little probability of an allergic reaction. They don’t belong to a group of narcotics and don’t create addiction.

Dysmenorrhoea is a common gynaecological problem consisting of painful cramps accompanying menstruation, which in the absence of any underlying abnormality is known as primary dysmenorrhoea. Research has shown that women with dysmenorrhoea have high levels of prostaglandins, hormones known to cause cramping abdominal pain. Nonsteroidal anti?inflammatory drugs (NSAIDs) are drugs that act by blocking prostaglandin production. They inhibit the action of cyclooxygenase (COX), an enzyme responsible for the formation of prostaglandins. The COX enzyme exists in two forms, COX?1 and COX?2. Traditional NSAIDs are considered 'non?selective' because they inhibit both COX?1 and COX?2 enzymes. More selective NSAIDs that solely target COX?2 enzymes (COX?2?specific inhibitors) were launched in 1999 with the aim of reducing side effects commonly reported in association with NSAIDs, such as indigestion, headaches and drowsiness.
  • We searched the following databases in January 2015: Cochrane Menstrual Disorders and Subfertility Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, November 2014 issue), MEDLINE, EMBASE and Web of Science. We also searched clinical trials registers ( and ICTRP). We checked the abstracts of major scientific meetings and the reference lists of relevant articles.
  • We included 80 randomised controlled trials (5820 women). They compared 20 different NSAIDs (18 non?selective and two COX?2?specific) versus placebo, paracetamol or each other.
  • NSAIDs versus placebo - Among women with primary dysmenorrhoea, NSAIDs were more effective for pain relief than placebo (OR 4.37, 95% CI 3.76 to 5.09; 35 RCTs, I2 = 53%, low quality evidence). This suggests that if 18% of women taking placebo achieve moderate or excellent pain relief, between 45% and 53% taking NSAIDs will do so.
  • When NSAIDs were compared with each other there was little evidence of the superiority of any individual NSAID for either pain relief or safety. However, the available evidence had little power to detect such differences, as most individual comparisons were based on very few small trials.
  • Only two of the included studies utilised COX?2?specific inhibitors (etoricoxib and celecoxib). There was no evidence that COX?2?specific inhibitors were more effective or tolerable for the treatment of dysmenorrhoea than traditional NSAIDs; however data were very scanty.
  • NSAIDs appeared to be more effective for pain relief than paracetamol (OR 1.89, 95% CI 1.05 to 3.43, three RCTs, I2 = 0%, low quality evidence). There was no evidence of a difference with regard to adverse effects, though data were very scanty.
✓ Fact confirmed: Nonsteroidal anti?inflammatory drugs for dysmenorrhoea Jane Marjoribanks, Reuben Olugbenga Ayeleke, Cindy Farquhar, Michelle Proctor, and Cochrane Gynaecology and Fertility Group; 2015 Jul

However, women with a sensitive stomach or a stomach ulcer shouldn’t take this medication without simultaneous intake of food because they have a slightly irritating effect on the digestive organs. Also, these drugs should not be taken during pregnancy.

Prostagladin, after its production breaks down very quickly from about half an hour. Following the PMS symptoms, cramps can be very easily anticipated. One of these drugs can be taken several days before the expected period or upon the occurrence of the first signal of cramps. This way, the painful process of creating spasms can be effectively avoided.

Women have access to numerous brands of medications to relieve menstrual symptoms. Since the formation of prostaglandin is a complicated process that involves many stages, different drugs target specific phases. Because of this, the appropriate remedy varies from woman to woman, sometimes the same woman corresponding to different drugs. Therefore, it is necessary to listen to your own body and choose a remedy that suits you the most.

It is best to start with ibuprofen. Besides being the cheapest, it is suitable for those women with stomach troubles. Also, it’s good for young girls and women with demanding jobs because it provides the effect of up to 12 hours.

If the NSAIDs prove ineffective, oral contraceptives can be used to relieve heavy bleeding and severe menstrual cramps. If the pain is persistent and intolerable, use narcotic pain relievers.

In addition to drugs, physical activity has huge benefits for relieving menstrual symptoms. Also, there are many alternative ways to overcome problems with dysmenorrhea, such as herbal and natural remedies.

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