Treatment depends on the severity and cause of the pain. Measures that may be helpful in relieving menstrual cramping include:
Mild cramps can be treated with pain medicines, such as aspirin or acetaminophen. Some over-the-counter products combine one of these medicines with a diuretic, or water pill.
For dysmenorrhea, healthcare providers often recommend medicines that lessen the production and effect of prostaglandins. These include ibuprofen, naproxen, and ketoprofen. It's best to take these on a scheduled basis. They are started 1 to 2 days before the woman's period and menstrual cramps begin. They should be continued 1 to 2 days into the woman's period. If over-the-counter medicines are ineffective, the provider may prescribe rofecoxib or mefenamic acid. Sometimes, low-dose oral contraceptives are prescribed to prevent ovulation and prostaglandin production.
Endometrial ablation is an option for women with very painful periods or heavy menstrual flow. This procedure uses a heat-generating device to burn away the lining of the uterus.
If a woman has secondary dysmenorrhea, treatment may focus on the underlying disorder. Leuprolide or nafarelin are used to treat fibroids or endometriosis. Antibiotics will be used if PID is suspected. Surgery may be used to treat certain conditions.
Pain medicines and antibiotics may cause stomach upset or allergic reactions. Medicines used to treat endometriosis or fibroids may cause hot flashes or headaches. Surgery may cause bleeding, infection, or allergic reaction to anesthesia.
Menstrual cramps often improve after a woman has given birth to her first child.
Any new or worsening symptoms should be reported to the healthcare provider.