Menstrual Cramps: Duration, Causes & Relief

Menstrual cramps (primary dysmenorrhea) typically last 1–3 days, starting just before or at menses onset. Some women experience up to 7 days. Pain severity ranges from mild to debilitating.

Mechanism: Prostaglandins (PGF2α, PGE2) trigger uterine contractions, causing ischemia and pain. Higher prostaglandin levels correlate with worse cramps.

Secondary Dysmenorrhea (due to pathology): Endometriosis, adenomyosis, fibroids, PID, IUD, cervical stenosis—often begins later in life, worsens over time, may occur outside menses.

Relief Strategies

• NSAIDs (ibuprofen, naproxen): Start 1–2 days before expected menses; inhibit prostaglandin synthesis.
• Hormonal Contraception: Combined OCs, patch, ring, hormonal IUD—thin endometrium, reduce prostaglandins.
• Heat: Heating pad/hot water bottle on lower abdomen.
• Exercise: Regular aerobic activity reduces severity.
• Supplements: Magnesium, vitamin B1, omega‑3s have modest evidence.

If cramps disrupt daily life or worsen, consult a gynecologist to rule out secondary causes and discuss prescription options.