Clinical Reference Systems: Pediatric Advisor 10.0
Menstrual Cramps (Dysmenorrhea) for Teenagers
- cramps during the first 1 or 2 days of a menstrual period
- pain in lower abdomen
- pain that sometimes radiates to lower back or both thighs
- similar cramps in the past with menstrual periods
- nausea, vomiting, diarrhea, or dizziness in some girls.
More than 50% of girls and women have cramps during their
menstrual periods. The cramps are caused by strong
contractions (and sometimes spasms) of the muscles in the
uterus as it expels menstrual blood.
Menstrual periods usually are not painful during the first 1
to 2 years after a girl has started having periods.
However, once ovulation (the release of an egg from the
ovary) begins, the level of progesterone in the bloodstream
increases and leads to stronger contractions and some
Cramps last 2 or 3 days and usually occur with each
menstrual period. There are several drugs that can lessen
the pain to a very mild level. The cramps often disappear
permanently after the first pregnancy and delivery, probably
because the opening of the uterus (the cervical os) has
- Ibuprofen (Advil, Motrin, and Nuprin are three brand
Ibuprofen is an excellent drug for menstrual cramps. It
not only decreases the pain but also decreases
contractions of the uterus. It can be obtained without
a prescription in 200-mg tablets.
You can take 2 or 3 tablets four times a day. Always
take 3 tablets (600 mg) as the first dose. Start taking
the drug as soon as there is any menstrual flow, or even
the day before, if possible. Don't wait until your
menstrual cramps begin. Ibuprofen should make you feel
well enough not to miss anything important.
If you don't have ibuprofen, you can take acetaminophen
until you can get ibuprofen.
- Local heat
A heating pad or warm washcloth applied to the area of
pain may be helpful. A 20-minute warm bath twice a day
may reduce the pain.
- Aggravating factors
If you are tired or upset, the pain will seem more
severe. Try to avoid getting exhausted or too little
sleep during menstrual periods. If you have troubles or
worries, talk to someone about them.
- Full activity during menstrual cramps
Do not miss any school, work, or social activities
because of menstrual cramps. If the pains are limiting
your activities even though you are using ibuprofen, ask
your physician about stronger prescription medication.
- Common mistakes
A common mistake is to go to bed when the cramps are
bad. However, people who are busy usually notice their
pain less. There are absolutely no restrictions on your
activities. You can go to school, take gym, swim, take
a shower or bath, wash your hair, go outside in bad
weather, date, etc. during your menstrual periods.
CALL YOUR PHYSICIAN IMMEDIATELY IF:
- The pain becomes severe and is not relieved by ibuprofen.
- You develop an unexplained fever (over 100 degrees F).
- You start feeling very sick.
CALL YOUR PHYSICIAN DURING OFFICE HOURS IF:
- Ibuprofen doesn't give adequate pain relief.
- The menstrual cramps cause you to miss school or other
- You have other concerns or questions.