More than half of us experience some discomfort during or just before a period. But up to 15% of women have severe pain and are actually unable to complete daily tasks.

At one time dysmenorrhea was thought to be in our heads only - an excuse to get out of school or work (you know - "Get a life" "Take an aspirin and get back to work"). Now it is known that menstrual cramps are very real (we knew that - the guys just needed proof!) and are caused by an elevation in the blood stream of a group of chemicals - prostaglandins. These chemicals are produced to some degree by all cells in the body, but are secreted in large amounts by the uterine lining and stimulate contractions, squeezing the blood vessels of the endometrial lining of the uterus to limit menstrual bleeding.

If the amount is excessive, they can cause prolonged contractions, pain, sweating, a cold/clammy sinking feeling, slow heart rate, headache, nausea, vomiting and/or diarrhea.

Menstrual cramps usually begin just before the period or on the first day and last 24 hours or more. Women typically experience cramping in the lower pelvic area, along with backache and, in some, a "pulling sensation" in the thighs. The low back and thigh pain are actually referred pain from the uterus.

The best treatment is a type of ibuprofen, taken at the onset of cramping. Ibuprofens are prostaglandin inhibitors and so reduce the effect on the uterus, decreasing cramping and the associated symptoms. There are many types of ibuprofen - Advil, Naproxen, Ponstel, Aleve, etc, and if one doesn't work for you personally another may do the trick. Never take these on an empty stomach. Aspirin works to an extent but Tylenol (acetaminophen) has little effect on cramps since it does not affect uterine prostaglandin production.

Moderate exercise works also, if you have the energy while in pain! The textbooks state that meditation and yoga are wonderful (I must confess I'm from New York - we in NY are skeptics and into quicker fixes but I'm open to suggestions from my west coast ladies).

Hot water bottles or hot showers can relieve mild cramps because heat decreases muscle spasms and increases blood flow to the area. An orgasm REALLY helps, if you can arrange it - and is more entertaining than a hot water bottle. (don't fake it)

Since this pain usually only occurs with cycles, women on any method of birth control that stops cycles like the continuous use of the pill, ring, patch, or depoprovera (the shot) have great relief of symptoms.

Oh - getting old reduces the symptoms, I might add. However, others do pop up to take their place!

Lynne Fiore, NP