Do I need to See my Doctor for Menstrual Cramps

Answer: While it’s perfectly normal for girls and women to experience mild cramps during menstruation, there are times when women need to call the doctor about painful periods. Fortunately, the majority of women get effective relief from menstrual cramps using self-help remedies. However, if self-help remedies fail to provide effective relief from your menstrual cramps after 3 months, contact your doctor for diagnosis and treatment.

Of course, there are other times when you should call your doctor right away.

If you have menstrual cramps accompanied by a fever, an increased or foul-smelling vaginal discharge, if you experience severe pain, or if your period is more than one week late, and your have been sexually active you should seek immediate medical care.

While many women experience menstrual cramping the first few months after having an IUD inserted, you should have it removed if menstrual cramps continue after 6 months. You’ll also need to choose another type of contraceptive if you still want to avoid pregnancy.

Additionally, seek your doctor’s advice anytime you experience severe or sudden menstrual cramps. While menstrual blood clots and clumps of tissue are a normal part of your menstrual flow, when they occur together when severe, menstrual cramps or other symptoms contact your doctor for advice.

Finally, if you experience menstrual-like cramps at times other than during menstruation, more than five days before you expect your monthly period, or if your cramps last longer than your menstrual period, contact your doctor. You may have something as benign as Mittelschmerz. However, only your doctor can determine the cause of your menstrual cramps.

Anytime you have questions or concerns about your menstrual cycle or any other health issue, contact your doctor for advice.

how to relieve menstrual cramps at home

Answer: If you are one of the millions of women who experience menstrual cramps during your period, you’ll want to know what you can do to help relieve the pain. One of my favorite ways to reduce menstrual cramps is placing a heating pad placed on the lower abdomen, just below the belly button.

Other self-help measures include taking warm baths or showers, drinking warm beverages, and giving yourself a light massage by making circular motions with your fingertips around your lower abdomen. Make sure to schedule free time for yourself to relax and take care of yourself during the time of the month when you expect your periods.

Eating light, frequent meals and following a diet that is rich in complex carbohydrates (whole grains, fruits, and vegetables) and low in salt, sugar, alcohol, and caffeine also helps reduce painful menstruation for some women. It’s especially important for women who experience bloating or fluid retention during menstruation to lower their salt consumption, since excess salt intake can cause fluid retention.

Regular physical activity works wonders at reducing many of the symptoms of PMS, including menstrual cramps. If you’re under stress, like many of us are, you might also want to learn to distress and relax your body and mind through meditation or yoga.

Anti-inflammatory drugs, such as ibuprofen, which are available without a prescription, often provide effective relief from painful menstrual cramps.

If you have PMS as well as menstrual cramps, you may want to try taking supplements such as vitamin B complex, essential fatty acids, calcium, and magnesium. The following supplemental amounts are in addition to the amount in a daily multi-vitamin and mineral supplement, which all women should take regularly:

• 1200 mg of calcium in two divided doses
• 250 mg of magnesium
  (If you experience constipation or diarrhea while taking magnesium, talk to your doctor. You may need to increase or decrease the amount of magnesium you take.)
• Supplemental vitamin B6 varies from 50 to 200 mg
• 50 mg of vitamin B1

Fish oil capsules may be helpful for women who have PMS, as well as menstrual cramps. Fish oil capsules contain the essential fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The recommended schedule for fish oil capsules is 1000 mg of EPA and 700 mg of DHA, taken in two divided daily doses for two months. You should always take vitamin E supplement when supplementing with fish oil capsules.

Finally, some women find it helpful to keep their knees bent whenever they are lying down, which reduces the stretching of the pelvic muscles. If you sleep on your back, use a pillow under your knees to keep your legs bent. If you’re a side sleeper, try holding a pillow pressed to your lower abdomen with your knees bent.

_Source:

_{Painful Menstrual Periods; Medline Plus Medical Encyclopedia; http://www.nlm.nih.gov/medlineplus/ency/article/003150.htm; accessed 05/21/08. Cyclic Perimenstrual Pain and Discomfort: Nursing Management. Evidence Based Clinical psPractice Guideline; http://www.guidelines.gov/summary/summary.aspx?doc_id=7199&nbr=004302; accessed 06/23/08}

premenstrual syndrome

If you think you might have premenstrual syndrome or PMS, you are not alone. In fact, about three-quarters of all girls and women experience PMS during their reproductive lives. A syndrome is a group of symptoms that occur together and that are characteristic of a disease or condition. Premenstrual syndrome is present when certain physical and / or emotional signs or symptoms occur.

PMS Diagnostic Criteria

The University of California, San Diego has developed the most widely used and accepted diagnostic criteria for diagnosing PMS. Although over 150 symptoms have been associated with PMS, women must self-report at least one of the following physical symptoms of PMS and at least one of the following mental symptoms of PMS. Additionally, these symptoms must occur during the five days before menstruation begins to meet the diagnostic criteria for premenstrual syndrome.

The Physical Symptoms of PMS

• Sore, tender breasts
• Headache
• Abdominal bloating (the most common physical symptom)
• Swelling of the extremities

Mental Symptoms of PMS

• Fatigue (the most common mental symptom)
• Angry outbursts or mood swings
• Irritability
• Confusion
• Social withdrawal

All symptoms must disappear by Day 4 of the menstrual cycle and must not occur before Day 14 (of the average 28-day menstrual cycle) to meet the criteria for a diagnosis of PMS. The final requirement for a diagnosis of PMS is that symptoms must be present in the absence of any pharmacological treatments, hormone ingestion, or drug or alcohol use.

A true diagnosis of PMS causes identifiable dysfunction in social or economic performance and includes at least one of the following:

• Marriage or relationship problems which are confirmed by the partner of the woman seeking diagnosis of PMS
• Parenting difficulties
• Decreased performance and / or attendance problems, including being late, at school or work
• Less than normal amount of social activity during the premenstrual period of the menstrual cycle
• Legal issues
• Suicidal thoughts, words, or actions
• Seeking medical attention for physical symptoms of PMS

Some girls and women experience a more severe form of PMS called premenstrual dysphoric disorder, or PMDD. The diagnostic criteria for PMDD includes the above criteria as well as the presence of additional symptoms.

If you think, you have the symptoms of premenstrual syndrome see your physician for diagnosis and treatment. Getting a diagnosis of PMS requires keeping a menstrual cycle calendar for two or three menstrual cycles to reflect a pattern of symptoms.

_Sources:

_{The American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Washington, DC, American Psychiatric Association 1994.}

_{Robert F Casper, MD. Patient information: Premenstrual syndrome and premenstrual dysphoric disorder (PMDD), Clinical manifestations and diagnosis of premenstrual syndrome and premenstrual dysphoric disorder, UpToDate [online]; accessed 10/24/2006.}

Getting Your Period

Probably the most talked about event of puberty for a girl is her period. Getting your period is another way of talking about menstruation.

Within about a year after beginning her growth spurt, most girls will have their first period. This marks the beginning of a girl's life as a young woman. In some cultures, this is celebrated publicly. Others choose to be more private about it. Some girls can't wait for their first period to come, while others may dread it or feel neutral about it. No matter how you feel, it's an important event in your life and part of the normal process of becoming an adult.

Most American girls start their periods between the ages of 9 and 15. There really isn't any way you can tell the day or week you'll get your first period. There also isn't really any way you can make it come sooner or delay it from happening. But you can understand what is happening inside your body to know what is normal for you.

During each period, the inner lining of your uterus is shed through the vagina, the passage that connects your inner reproductive organs to your outer sex organs or genitals. This lining is mostly blood and other tissues that have been building up since your last period. The purpose of this blood is to provide nutrients for a fertilized egg if you were to become pregnant. Girls start having their periods early in heir lives, but most don't decide to start a family till they've already been having their periods for many years. Most women stop having periods when they are between 45 and 55 years old. This is called menopause.

You may have heard some women talking about their monthly cycle. This cycle begins on the first day of one period and ends on first day of the next period. While women's periods do tend to come about once per month, there is a wide range in the length of menstrual cycle from woman to woman. Some women's periods come as often as every 21 days, some as far apart as every 35 days. The most common range is 25-30 days. Some women have regular cycles and their periods start exactly the same number of days apart each time. For other women, the length of their cycle varies from month to month.

There is also a great range in how much blood flow each woman loses during her period. You may have a heavy flow and need to change your pad or tampon frequently. Or you may have a light flow with barely any blood loss. Usually your flow will be heaviest at the beginning of your period. It may start out light, get heavier, and then get lighter again until it's over. It's also common to see some small clots or pieces of tissue in your menstrual blood. Most women's periods last from 3 to 7 days.

Another thing that can vary is the color of the blood on your tampon or pad. Sometimes the blood from your period can be a dark, rust-like color. Other times it can be a bright red color. The color may vary according to where you are in your period or the heaviness of your flow. Pay attention to the rhythm of your body, so you'll know what is normal for you in terms of flow, cycle and period length, and color of your blood.

~Adapted from the Women's Health Information Center