Raise your hand if you've felt personally victimized by period cramps. Exactly. And if you experience them each month, you know that they tend to strike at the worst time and bring hell to your uterus for what seems like forever. But here's the thing: There's no Girl Scout badge for powering through cramps. If there's a way to make them suck less (whether it's backed by science or the anecdotes of fellow uterus-owners), why not try it?
First, let's go over what's actually happening when you have cramps. Menstrual cramps happen when the muscles of your uterus contract, which typically happens just before or during your period, Pari Ghodsi, M.D., a board-certified ob/gyn, tells. Those contractions are sparked by chemicals called prostaglandins, which are produced in the lining of the uterus, she says.
When endometrial cells are broken down during your menstrual cycle, the prostaglandins are released—and they're indirectly related to estrogen, Jessica Shepherd, M.D., an assistant professor of clinical obstetrics and gynecology and Director of Minimally Invasive Gynecology at The University of Illinois College of Medicine at Chicago, tells. On the flip side, prostaglandin (and cramps) are decreased when you're on hormonal birth control because you're not building up that endometrial tissue.
Your uterus is basically one big muscle, and those contractions happen to make the lining of the uterus shed, causing your period, Sherry A. Ross, M.D., women's health expert and author of She-ology: The Definitive Guide to Women's Intimate Health. Period., tells. And, as you probably already know, they tend to be more intense during the first day or two of your period.
So why are cramps mildly uncomfortable in some people and basically soul-crushing in others? That can be due to a few factors: like heavier bleeding in some women, larger blood clots being pushed through the cervix, health conditions like adenomyosis (which causes endometrial tissue to grow into the uterine wall), and differences in pain tolerance, Maureen Whelihan, M.D., an ob/gyn at the Center for Sexual Health and Education, tells. Endometriosiscan also cause menstrual cramps to be even more painful than usual, Dr. Ross says.
Since gynecologists know a lot about the ways of the uterus, they seemed like the perfect people to ask when it comes to dealing with cramps. Here are some tactics they recommend:
NSAIDs like aspirin and ibuprofen are a great way to stop the inflammatory process that comes with period cramps, says Dr. Shepherd
NSAIDs work to dampen the release of prostaglandins, leaving you with less pain and cramping. “It’s best to take an NSAID very early on rather than taking it when your pain is great—it can’t be as effective then,” Dr. Shepherd says. Try popping an NSAID up to 12 hours before you typically get cramps to help keep pain at bay. This doesn’t work for everyone, all the time, but it can be a good first line of defense.
You’ve probably heard of people going on birth control for cramps, and it’s not a myth—it actually works. “Hormonal birth control shortens the length, amount, and flow of period bleeding,” Dr. Ross says. “The end result is less cramps each month.” And, as already mentioned, they can have an effect on those pesky prostaglandins.
Some hormonal birth control methods (like the pill and the ring) work by preventing ovulation, which will keep the uterus from building up a thick uterine lining in the first place, Dr. Shepard says. Other methods, like the hormonal IUD, can also thin the uterine lining, leaving little to no lining to shed. So if you're already in the market for a birth control method—or you just cannot tolerate your cramps every month—it's worth asking your doctor which hormonal contraceptives might help based on your symptoms and overall heath.
Putting something warm on your lower abdomen, like a hot water bottle, heating pad, or warm washcloth can help relax your uterine muscle tissue, causing less cramps. “It’s such a great therapeutic way of decreasing cramping,” Dr. Shepherd says. If you don’t have the time to lay down with something warm on your stomach, try taking a hot shower and facing the spray—it should have the same effect.
BTW: This also works from the inside: Dr. Ross says you can drink something warm, like hot water or tea, to help relax your muscles internally, too.
You may crave salty stuff like fries and pickles during your period, but it’s really best to keep them to a minimum. Salty foods can dehydrate you, and when you’re dehydrated, your uterus will cramp more, Dr. Shepherd says. That’s why she recommends avoiding processed foods around your period (they tend to be sodium traps) and drinking plenty of water to make sure you’re well hydrated.
Unfortunately, scientists haven't researched this one, but having an orgasm can increase oxygenation in your body, which can help calm inflammation, Dr. Shepherd says. And, while your uterus contracts when you have an orgasm, it relaxes afterward which should put a temporary kibosh on cramps, she says. Plus, an orgasm will probably take your mind off the pain, at least temporarily.
Not only will the heat help soothe your cramping, but Epsom salts are often used to help provide pain relief in people with muscle cramps or tension, says Dr. Shepherd, so it might do the same for your uterus.
This is a study we would pay to participate in. But until then, Dr. Shepherd says that if your cramps are really horrendous, take it as an excuse to do nothing but relax and catch up on Orange is the New Black. Will it help with the pain? Probably not. Will it make dealing with the pain less awful than trying to actually put on clothes and be a person? Yeah, probably. "It’s really just about being in that relaxed mode," Dr. Shepherd says. "If watching TV relaxes you, why not?"