Painful menstruation, or dysmenorrhea, is of two kinds: congestive pain, which begins before there is any bleeding and is experienced as a continuous, painful tightening; and spasmodic pain, which begins with the period and is felt as distinct cramping that comes and goes.
Spasmodic pain is commonest from ages 16 to 25 and is usually ascribed to hormonal changes that make uterine contractions more intense, especially during the first days of a period. Cramps seem to occur only after a girl begins to ovulate. Young girls who are just beginning to have periods and who don’t necessarily ovulate before each period are often free of them, as are women who take birth control pills to prevent ovulation. The cramps often disappear after pregnancy.
A mild analgesic, such as aspirin, acetaminophen, or ibuprofen takes the edge off most pain due to menstrual cramps. Ibuprofen is said to be particularly effective, but anyone allergic to aspirin should avoid it. As with all drugs, read and observe the label precautions. If your pain doesn’t respond, consult a gynecologist.
Exercising regularly relieves cramps for many women. Others are comforted by curling up with a heating pad. See your doctor if you first experience pain after 3 or more years of pain-free menstruation or if pain is more severe than usual; either may indicate pelvic disease.