Do I Need to See My Healthcare Provider for Menstrual Cramps?

It's perfectly normal to experience mild cramps during your period, and the good news is that these cramps can usually be eased with simple therapies, like a heating pad or an over-the-counter pain reliever.

However, some women's menstrual cramps may not feel better with these basic remedies. If this is the case for you, making an appointment with your healthcare provider is important. This way you can get the pain relief you deserve and you may also have a diagnostic evaluation if there's a concern that you could have an underlying problem.

Understanding Menstrual Cramps

The medical term for pain with your period is dysmenorrhea, and there are two types: primary and secondary dysmenorrhea.

Primary Dysmenorrhea

Primary dysmenorrhea, which is also referred to as "menstrual cramps," is pain with your periods that isn't caused by any medical condition.

Prostaglandin production within the lining of your uterus is believed to be the main culprit behind menstrual cramps. Since uterine prostaglandin levels rise just before menstruation starts, women generally experience cramping on the first day of their period. As the lining of their uterus sheds and bleeding continues, the prostaglandin level goes down, and with that, cramping decreases or disappears.

Menstrual cramps commonly start when a woman begins having menstrual periods, during her late childhood or early teenage years. But for many women, the cramps become less painful as they get older.

Secondary Dysmenorrhea

Secondary dysmenorrhea means that a woman's menstrual cramping is not explained simply by a high uterine prostaglandin level, but rather, is due to a medical condition.

Examples of conditions that may cause secondary dysmenorrhea include:

• Endometriosis
• Uterine Fibroids
• Adenomyosis
• Adhesions due to previous surgery
• A pelvic infection
• Hormonal imbalance

Unlike primary dysmenorrhea, secondary dysmenorrhea may begin later in life, and the menstrual pain can get worse, not better, as a woman gets older.

Moreover, while the pain of primary dysmenorrhea lasts only a day or two, that of secondary dysmenorrhea can become more severe as the period goes on. In fact, with secondary dysmenorrhea, the pain of a woman's period may persist even after her menstrual bleeding has ended.

Evaluating Menstrual Cramps 

Your healthcare provider will take a careful medical history and perform a physical examination, which might include a pelvic exam. Your healthcare provider may recommend a pregnancy test, as the combination of cramping and bleeding can indicate a miscarriage or ectopic pregnancy.

Depending on your initial evaluation, your healthcare provider may order an ultrasound to visually examine your reproductive organs (ovaries, uterus, and fallopian tubes). Ultrasound is particularly useful for detecting fibroids. 

Less commonly, exploratory surgery might be indicated as a method for your healthcare provider to directly examine your pelvic organs. 

Treating Menstrual Cramps

Nonmedical therapies, like applying a heating pad to your lower abdomen or exercise can help relieve the pain of primary dysmenorrhea.

And over-the-counter nonsteroidal anti-inflammatories (NSAIDs), like ibuprofen, are commonly recommended to treat dysmenorrhea, as they decrease prostaglandin levels in the body.

Combination contraceptives (for example, the pill, patch, or vaginal ring), as well as progestin-only birth control methods (for example, an intrauterine device or implant), may also help treat dysmenorrhea.

If you are diagnosed with secondary dysmenorrhea, your healthcare provider will treat the underlying condition to ease your menstrual cramps. For instance, hormonal birth control may be prescribed to treat endometriosis, and fibroids can be removed with surgery.

Lastly, some women choose complementary therapies (for example, acupuncture or yoga), either alone or in addition to medication, in order to soothe their pain—although, the evidence supporting their usefulness is limited.

A Word From Verywell

It's a good idea to see your healthcare provider if you are experiencing menstrual cramps, especially if they are not eased with simple strategies, and/or persist beyond just a day or two of your menstrual period. 

If you develop new or severe pelvic or lower abdominal pain, you should seek medical attention right away.