Photo by Shari Mahrdt
Period cramps 101
What causes menstrual cramps and tips for relief
Top things to know:
Period cramps are most likely caused by high levels of prostaglandins—compounds released from the uterine lining before your period
You can take the edge off with a heat compress and anti-inflammatory pain medication, like ibuprofen
Dietary supplements like calcium, vitamin D, zinc, and magnesium may help reduce cramps, but more research is needed
Tracking your cramps with Clue can help you identify patterns and know when to talk to your healthcare provider
What are period cramps?
Period cramps are uterine cramps experienced around the time of your period. They are typically felt in the abdomen, back, or thighs (1). You might also experience pain in the middle of your cycle during ovulation (2).
Menstrual cramps are very common. In the Clue app, about 3 in 4 people report experiencing cramps just before or during their period.
Most people first notice menstrual cramps within 2 years of getting their first period (menarche). Cramps typically occur for 1–3 days at the beginning of the menstrual cycle. They may start strong but improve as the hours pass, or they may come and go randomly (1).
Pain may vary from mild to severe cramps, and up to 3 in 10 people experience pain levels that can affect their quality of life. Period cramps may be accompanied by other symptoms like nausea, headaches, dizziness, or fatigue (1). Severe menstrual cramps are often associated with medical conditions like endometriosis or adenomyosis (3). Female pain is frequently overlooked and/or under-treated (4,5). It’s important to advocate for yourself and communicate your pain levels to a healthcare provider.
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Tracking your cramps in Clue can help you monitor their intensity and frequency, making it easier to spot patterns or changes. Knowing the basics of menstrual pain can help you decide if your pain is something to discuss with your healthcare provider.
What causes period cramps?
Period cramps can be “primary” or “secondary”. Primary dysmenorrhea (the clinical word for painful periods) is pain caused by the period itself. Secondary dysmenorrhea is period pain with another root cause, such as a health condition like endometriosis (3). This article discusses primary dysmenorrhea.
Prostaglandins
Period cramps most likely happen because the uterus releases chemicals called prostaglandins before the menstrual period. Prostaglandins help the uterus contract and relax so the uterine lining can detach and flow out of your body. High levels of prostaglandins can cause strong uterine contractions. These contractions reduce blood flow and oxygen to the uterus, which may increase pain (6).
Risk factors
We don’t know why some people experience period cramps more than others. Inflammation may play a role. Inflamed tissue tends to produce more prostaglandins (7). Inflammation has also been linked to the worsening of other premenstrual symptoms, including mood changes (8).
People are more likely to have painful periods if they experience heavy, long, or irregular bleeding (6). Starting your first menstrual period at an earlier age (before age 12) may also increase your risk of cramps. Other factors that have been associated with painful periods include smoking, having a body mass index (BMI) under 20, being under age 30, and having a pelvic infection (9).
Research done by Clue with Oxford University also found that Clue users with undiagnosed sexually transmitted infections (STIs) were more likely to experience certain premenstrual symptoms, including cramps, than those without STIs (10).
What helps with period cramps?
There are several science-backed ways to reduce period cramps. There are also many easy, low-risk, and inexpensive options you can try at home. If your periods are heavy, irregular, or extremely painful, finding and treating the root cause may be important for your health. It’s a good idea to speak to your healthcare provider about your symptoms to receive the correct diagnosis and treatment plan.
Medications
Anti-inflammatory painkillers are an effective way to get relief from period pain (11). NSAIDs (non-steroidal anti-inflammatory drugs), like ibuprofen, block the production of prostaglandins. Other over-the-counter painkillers may reduce pain but they are less effective for treating menstrual cramps (8,11). NSAIDs are also used to decrease heavy bleeding (12).
Hormonal birth control methods, such as the pill or the hormonal IUD, can relieve and prevent menstrual cramps (3). The synthetic hormones in these block ovulation, and/or prevent the typical growth and shedding of the uterine lining. This reduces levels of prostaglandins, muscle contractions, and cramps (6).
Heat therapy
Applying heat to your lower abdomen is a cheap, easy, and low-risk way to reduce cramps. Heat relaxes muscles and increases blood flow (13). It’s as effective as NSAIDs or aspirin for treating menstrual cramp pain (13-15). You could try a heating pad or hot water bottle (make sure to use a cover or towel so you don’t burn your skin).
Transcutaneous Nerve Stimulation (TENS)
TENS is another inexpensive and non-invasive treatment for menstrual cramps. It uses a small machine to deliver a low-voltage electrical current to the skin. Stimulating the nerves in your body with TENS blocks pain receptors and may also increase blood flow and release endorphins (8,16). TENS can be combined with other methods like heat and medication.
Diet changes
Note: The data on diet for managing cramps is limited, and there are no formal clinical recommendations.
Several studies have found that people who skip breakfast are more likely to experience cramps. It is unclear why, but could be related to overall nutrient deficiency (17,18).
There are also a few recent studies linking diets higher in sugar to period cramps. More research is needed to understand this relationship (19-22).
Including dairy products in your diet may decrease period cramps according to some studies. This may be because of how calcium affects muscle cells (18,23,24).
Studies have varied widely when it comes to diet and period cramps. Until more data is available to make a clear recommendation, aiming for a well-rounded diet containing fruits, vegetables, and whole grains, with limited added sugar is a good idea.
Supplements
The evidence for using supplements to treat menstrual cramps isn’t well established. But you may find something that works for you if you’re open to experimenting. Consult with a nutritionally-trained practitioner, as supplements can have side effects and interfere with levels of other nutrients in the body.
Here’s where the evidence stands on supplements for period cramps:
Ginger: May be as effective as NSAIDs for reducing pain severity, but not pain duration. The amount of ginger used in the studies ranged from 700–1000 mg of dehydrated ginger powder per day (25). More high-quality research is needed to see how other preparations and doses of ginger affect period cramps.
Calcium and vitamin D: May play a role in the relief of period pain (26,27). These supplements are often taken together, sometimes along with magnesium. Calcium affects uterine muscle contraction, and vitamin D regulates prostaglandin levels (26). Doses of vitamin D and calcium taken per day vary widely between studies, so more research is needed to determine the best regimen.
Magnesium: Magnesium deficiency may increase the risk of period cramps. A recent randomized controlled trial found that magnesium supplementation improved period pain in a small sample of women. Both 150 mg and 300 mg doses decreased pain, though 300 mg was more effective (28). Magnesium has few side effects but can cause loose stools, so you may need to start slow.
Zinc: Like magnesium, supplementing with zinc may be effective. A recent meta-analysis of studies concluded that supplementing 7 mg of zinc per day may be enough to provide significant period pain relief (29).
Vitamin B1: This has also been studied for its potential to reduce period pain. One trial found that people taking 100 mg daily experienced less menstrual pain than those taking a placebo (a pill with no active properties) (30).
Omega-3 fatty acids: Supplementing omega-3 fatty acids can reduce period pain, but it isn’t entirely clear how. Research-based doses vary from 300–1800 mg per day, making it hard to pick a regimen. Results are typically seen within 2–3 months. Omega-3 fatty acids are typically well-tolerated with few side effects (31,32).
Other dietary supplements have also been researched for a possible role in easing cramps, such as vitamin E, B6, and vitamin K (33). Results thus far are promising, or mixed. Overall, more high-quality research is needed to determine the best supplement regimen for reducing period cramps.
Physiotherapy
Several types of bodywork can help reduce period cramps, such as physical therapy and biofeedback(3). Biofeedback is a technique where people use monitoring devices to get information to help them learn to control their bodily functions (34).
Progressive muscle relaxation might also be helpful. Techniques such as massage therapy, yoga, stretching, and dance may also provide relief (35).
Acupuncture
Acupuncture and/or acupressure may also reduce period pain (3). It isn’t clearly understood why, but acupuncture may have anti-inflammatory effects on the body (36).
Stress relief
Stress relief may help ease period cramps in some people. Several studies found that people with high levels of stress are more likely to report having painful periods (37,38). It isn’t clear from the research whether stress causes painful periods, or if cramps increase feelings of stress. Regardless, techniques that help you adjust your thoughts and feelings can help manage period cramps. These might include relaxation, hypnosis, and/or cognitive behavioral therapy (CBT) (39,40).
Quitting smoking
People who smoke have an increased risk of experiencing painful menstrual cramps (9,41). This might be because nicotine constricts blood vessels and can reduce blood flow to the uterus (41). Second-hand smoke has also been shown to increase menstrual cramps (42).
Exercise
Exercise has an anti-inflammatory effect on the body (43). Studies show that exercise, including aerobic exercise, stretching, and yoga, can decrease the intensity and duration of cramps (44). Physical activity can be used alongside other treatment options, like medications and heat. If doing yoga, you might try focusing on poses that stretch and stimulate the abdomen, like the cobra, cat, and fish poses (45).
Self-care
Talking about your cramps with a parent, friend, or healthcare provider can bring a lot of comfort to people. Other coping strategies people use are staying in bed, watching television, and other distractions like food, drinks, and exercise (46). Having a trusted friend or partner give you an abdominal or lower back massage (which also counts as physiotherapy) may also be helpful (35).
How can I tell if my cramps are caused by another health problem?
If your cramps are not eased by a typical painkiller, if they affect your ability to work, study, or do other everyday activities, it’s best to talk to a healthcare provider. You should also see your healthcare provider if cramping is suddenly or unusually severe, or lasts more than a few days.
Severe menstrual cramps or chronic pelvic pain could be a symptom of a health condition like endometriosis or adenomyosis. The pain experienced by people with endometriosis is different from typical menstrual cramping.
You can track the timing and severity of your cramps with Clue, and bring this information to your healthcare provider to help get to the root cause of your pain. Advocating for yourself when it comes to pain can be tough, but it can help you to feel heard and to get the treatment you need.
FAQs
How do you relieve period cramps fast?
The quickest and most effective ways to relieve period cramps are by applying heat and taking pain-relieving medications such as ibuprofen (3,13). Gentle massage, stretching, or yoga may also provide relief (35).
What should I drink for period cramps?
Though more research is needed, it may be best to avoid beverages that are high in sugar during your period (21). Hydration is important for your physical and mental health, so drinking enough water can help you feel your best (47). For people who consume dairy, cow and goat milk are high in calcium, and there is some evidence that calcium intake might help ease period cramps (26).
What's the best way to help your partner with period cramps?
If your partner is struggling with painful periods, the best thing you can do is stay present and support them. You could offer to rub their abdomen, back, or legs. You could offer to help them with their daily activities so that they can take space to rest or perform self-care. You might also ensure they stay hydrated and nourished by bringing them their favorite meal or snack. Remember to listen and take their pain seriously.
