Menstrual cramps are defied as the sudden contraction in the muscles that causes mild to moderate pain. The pain may last for few second to few minutes, but in case of menstrual cramps the dull pain may last for 2-3 days. The pain of the menstrual cramps may start before the occurrence of menstrual cycle and is classified under the symptoms of premenstrual syndrome. The menstrual cramps are caused due to the shedding of uterine lining that causes inflammation. The other symptoms related to menstrual syndrome includes bloating, belching, water retention, irritability, feeling tired and mood changes. Various medicines are available for managing the pain of menstrual cramps.
What Medicine Works Best For Menstrual Cramps?
- Muscle Relaxant: Muscle relaxants are the drugs which reduces the spasm of the muscles and helps them returning in the previous position of relaxation. Muscle relaxant works by inhibiting the action of neurotransmitters such as acetylcholine and relaxes the muscles. Most of the muscle relaxant are habit forming and thus should not be given for a long period. Further, muscle relaxants has sedative effect thus should not be taken when you have to drive a car or works that requires active presence. Various muscle relaxants that can be used for menstrual cramps are dicyclomine, cyclobenzaprine, and baclofen.
- Pain Relievers: It has been seen that the muscle spasm is due to the inflammation in the uterine lining. Every month, the lining of the uterus, if not impregnated with the zygote, sheds itself. This causes inflammation in the uterine lining leading to generation of inflammatory mediators. These inflammatory mediators muscle ischemia leading to muscle spasm. Thus, anti-inflammatory drugs should be used to reduce the number of inflammatory mediators and relive muscle spasm. Various anti-inflammatory drugs used in the treatment of menstrual cramps include mefenamic acid, naproxen and ibuprofen. These drugs act by inhibiting the production of inflammatory mediators. As these drugs may cause gastric side effects, they should be taken only if required. Generally, muscle relaxant and anti-inflammatory drugs are used in combination for effectively managing the muscle spasm.
- Hormonal Birth Control: Generally, birth control pills are the combination of synthetic hormones. Ovulation is a prerequisite for pregnancy and these pills stops ovulation. Further, the other mechanism through which they work is by increasing the thickness of cervical mucus. This thick mucus does not allow the sperm to reach egg for fertilization. Birth control pills are also known to reduce the amount of prostaglandin being produced in the uterus. This prostaglandin is known to cause muscle contraction which results in muscle spasm. It has been found that birth control pills taken for consecutive 21 days with 7 days off results in less menstrual pain.
- Surgery: Menstrual cramps are not only the result of shedding of uterine lining and increase in inflammation rather it may also be due to some serious underlying disease. The disease which may cause cramps other than menstrual cycle includes endometriosis, fibroids, adenomyosis or pelvic inflammatory disease. Such disease may involve the removal of uterus through surgery if other management approaches fail.
- Pamabrom: Water retention, bloating and benching are also adding up to the muscle cramps. In such cases pamabrom can be administered. Pamabrom is a mild diuretic that prevents the retention of water and edema. This drug can be use with NSAID or muscle relaxant to effectively manage the symptoms of menstrual cycle.
Symptoms of menstrual cycle can be experienced both in 2-3 days before the start of menstrual cycle and during the menstrual cycle. In both the phases, symptoms are almost similar. The symptoms related to menstrual cycle includes muscle cramps, water retention, bloating, irritability and mood swings.
Menstrual cramps are effectively managed by various drugs available in the market. Either a single drug or the combination of drugs can be used to relive pain and spasm. Use of the drug depends upon the severity of spasm. Drugs such as muscle relaxants, NSAIDs and hormone control pills are used. Other drugs such as mild diuretic also relieve water retention. Surgery is also an option in some cases.