Menstrual pain or cramps are pains in your lower abdomen that happen when your menstrual period begins (or just before). This pain may continue for 2 to 3 days. Cramps may be throbbing or aching, and they can be dull or sharp. Symptoms can range from a mild discomfort to serious pain that interferes with your normal activities.

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Causes of Menstrual Pain

Prostaglandins are chemicals the body makes that causes many of the symptoms associated with menstrual discomfort. The tissue that lines the uterus makes these chemicals. Prostaglandins stimulate the uterine muscles to contract. People who have high levels of prostaglandin may have more intense contractions of their uterus and more pain. Prostaglandins may also be responsible for vomiting, diarrhea, and headaches that accompany painful periods.

Other menstrual-type cramps can be caused by conditions of the reproductive tract, such as the following:

  1. Endometriosis — tissue similar to uterine tissue grows outside the uterus.
  2. Fibroids and adenomyosis — noncancerous (benign) growths in the uterus
  3.  Infections in the reproductive organs
  4. Abnormal pregnancy, such as an ectopic pregnancy (pregnancy in the tubes, outside the uterus)
  5. IUD (intrauterine device) used for birth control
  6. Ovarian cyst
  7. Narrow cervix
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If you have had menstrual pain ever since your periods started, the condition is called primary dysmenorrhea. If a physical condition such as pelvic inflammatory disease or endometriosis has developed and is causing the pain, this is called secondary dysmenorrhea. Once the medical condition is treated, the menstrual pain usually goes away.

Menstrual Pain Diagnosis:

The doctor will ask about your medical history, as well as questions about the menstrual pain and symptoms. Be prepared to talk about these details:

The timing of the cramps in relation to the start of the period

Type of pain

Your age when the cramps first started

Any recent change in the pain

Irregular periods

Vaginal discharge

Pain with intercourse


History of pelvic infections

Age when your first period happened

Current medications

What things seem to improve or worsen the pain

The doctor will perform a pelvic exam to check for any problems. If there are concerns about a possible infection, cervical cultures and a blood test will confirm the diagnosis.

The doctor may order a pregnancy test if your periods are irregular.

When to see a doctor:

Your menstrual cramps continue to be painful for longer than usual.

The pain is suddenly worse or different.

Bleeding is excessive, requiring more than one pad or tampon per hour.

Signs of infection, such as fever, chills, and body ache.

You think you might be pregnant and any of these symptoms happen.

Menstrual pain emergency:

You faint.

You get dizzy when standing up.

A sudden, intense pelvic pain causes you to double over.

Tissue is passed in the menstrual flow. Tissue often appears silvery or grayish.

You are pregnant and have severe menstrual-type pain.

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Menstrual Pain Prevention:

Keep a healthy body weight.

Don’t smoke.

Don’t drink too much alcohol.

Exercise regularly.