treat the itch in her pussy

vaginal itching.

Every woman is familiar with the feminine hygiene aisle at grocery and drug stores alike, and every man knows to never go down one of those aisles. These aisles are huge and full of products for issues that men and women didn't even know were possible. It can be a scary aisle but it's one that every woman has been down at least once in her lifetime and if it was only once, it was most likely for vaginal itching. If this is true consider yourself lucky, it could be a much worse. The truth is that vaginal itching is much more common than men and women care to realize, mainly because its and embarrassing issue that no one wants to admit to having. But the fact that you are reading this and that there is an entire shelf on the aisle dedicated to relieving vaginal itching, means its obviously an issue that gets a lot of attention from women. Thankfully symptoms of an itchy vagina are not usually signs of a serious condition such as a sexually transmitted disease. It is something that can be pretty easily treated, and is most likely due to having bacterial vaginosis or a yeast infection.

The first thing a woman does when experiencing vaginal itching for the first time is hits the feminine hygiene aisle only to be overwhelmed with the plethora of products that promise to relive the condition. However if you are reading this article it is most likely because you've tried the over the counter stuff, it only worked temporarily and you're too embarrassed to talk to your doctor so you did what anyone would do, you googled vaginal itching and here we are. Well you've come to the right place, I'm gonna set this common and mistreated issue straight.

Stop treating the symptoms... treat the cause.

You've tried the local grocery or drug store over the counter remedies, but now your itching is back. This is because pretty much every product out there is designed to treat the symptoms (itching) and not the actual cause of the issue. The cause of the issue is simple, your body's ph is out of wack, which has allowed harmful bacteria to overtake the good bacteria that is in your vagina. The "good bacteria" also known as normal flora has been overtaken by harmful bacteria (which can come from many sources, more on that later) and causes a bacterial or yeast infection within the vagina which causes symptoms of vaginal itching, vaginal odor, vaginal burning and vaginal discharge. There are many reasons that your body's ph can be out of wack, which is a whole other discussion in itself which includes douching, antibiotics and even diet.

What you'll find in the drug stores will anti-itch creams, lotions and sprays and though these will make the itching subside initially they can actually cause the issue to get much worse if you irritate the delicate skin that is the vagina. Many women will use these store bought products and think they are curing themselves of an itchy vagina, and then think their issue has come back a few days later. The truth is it was never cured in the first place. In order to cure an itchy vagina you must restore the body's ph levels to normal where normal flora can restore and take back over the area of the vagina that is infected by harmful bacteria. The easiest way to restore your body's ph levels is to first eliminate what it is that is causing the imbalance in the first place. You'll then seek products and foods that help the body regain a normal ph balance. The best supplements are all naturalvaginal itching remedies. Products like these contain all natural herbs that are fantastic at taking ph levels that are too acidic and balancing them out to a neutral level
.

vaginal itching

Vaginal itching is a tingling or uneasy irritation of the skin of the vagina and the surrounding area (vulva). The itching may cause a desire to scratch the affected area.

Causes

Common causes of vaginal itching include:

• Chemical irritants such as detergents, fabric softeners, feminine sprays, ointments, creams, douches, and contraceptive foams or jellies.
• Menopause. A drop in the hormone estrogen causes vaginal dryness.
• Stress may increase vaginal itching and make you more susceptible to infections.
• Vaginal yeast infection
• Vaginitis. Vaginitis in girls before puberty is common. If a young girl has a sexually transmitted vaginal infection, however, sexual abuse must be considered and addressed.

Other possible, but less common, causes of vaginal itching include:

• Precancerous skin conditions of the vulva
• Pinworms (a parasite infection mainly affecting children)

Home Care

To prevent and treat vaginal itching:

• Avoid colored or perfumed toilet tissue and bubble bath.
• Avoid feminine hygiene sprays and douches.
• Change out of wet clothing, especially wet bathing suits or exercise clothing, as soon as possible.
• Cleanse the area by wiping or washing from front to back (vagina to anus) after urinating or having a bowel movement.
• Eat yogurt with live cultures or take Lactobacillus acidophilustablets when using antibiotics. Check with your doctor.
• Keep your genital area clean and dry. Use plain, unscented soap.
• Keep your blood sugar under good control if you have diabetes.
• Lose weight if you are overweight.
• Wear cotton panties or pantyhose with a cotton crotch. Avoid panties made from synthetic materials. For infants and toddlers, change diapers often.

If you are sure that you have a yeast infection, try over-the-counter creams or vaginal suppositories. See: Vaginal yeast infection

For itching related to menopause, your health care provider may consider estrogen cream or tablets to insert vaginally. See: Vaginal dryness

Teach children to resist and report any attempted sexual contact by another person. Do not try to remove any foreign object from a child's vagina. Take the child to a health care provider right away for removal.

When to Contact a Medical Professional

Call your health care provider right away if:

• You have increased thirst or appetite, unexplained weight loss, frequent urination, or fatigue -- these may be signs of diabetes.
• You have pelvic or lower abdominal pain or fever.

Call your health care provider if:

• You have blisters or ulcers on your vagina or vulva.
• You have burning with urination or other problems urinating.
• You have unusual vaginal bleeding, swelling, or discharge.
• Your partner also has symptoms or you think you may have a sexually transmitted infection.
• Your symptoms get worse, last longer than 1 week, or keep coming back despite self-care.

What to Expect at Your Office Visit

Your doctor will examine you, including doing a pelvic exam, and ask questions to help diagnose the cause of your vaginal itching. These questions may include:

• When did the itching begin?
• Have you had it before?
• Is the itching severe?
• Does it limit your activities?
• Where exactly is the itching? On the inside of the vagina or on the outside (vulva) as well?
• How often do you bathe or shower?
• Do you use scented soap, scented or colored toilet paper, or bubble bath?
• Do you frequently swim or participate in water sports? Do you change your clothes soon after such activities?
• Do you wear cotton panties or synthetic ones?
• Do you wear tight pants or tight pantyhose?
• Do you use douches or feminine hygiene spray?
• Are you sexually active? Do you use contraception? What type?
• Does anything make you feel better?
• Does anything make you feel worse?
• Have you tried any over-the-counter creams? Which ones?
• Do you have any other symptoms, such as vaginal bleeding, swelling, rash, or pain on urination?
• Do you have a personal or family history of diabetes?
• What medications do you take?
• What is your menstrual history? How old were you when your periods began? How often do your periods usually come? How long do they generally last?
• Do you have any allergies?

Diagnostic tests that may be performed include:

• Culture and microscopic exam of vaginal discharge
• Pap smear
• Skin biopsies of the vulvar area
• Urine and blood studies (including hormone levels)

The health care provider may prescribe drugs, such as:

• Antibiotics for bacterial vaginal infections, including sexually transmitted diseases
• Antifungal drugs for yeast infections
• Benzodiazepines or antihistamines for nighttime relief
• Ointments containing hormones
• Steroid creams or lotions to reduce inflammation

References

Biggs WS, Williams RM. Common gynecologic infections. Prim Care. 2009 Mar;36(1):33-51,

Superficial fungal infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 13.

Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, HIV infections. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 22.

Menstrual cramp pain

If you have abdominal pain or cramping in the middle of your menstrual cycle, when you’re ovulating, you may be experiencing mittelschmerz, a word derived from the German for “middle” and “pain.”

Mittelschmerz occurs when the follicle — a tiny sac in the ovary that contains an egg — ruptures and releases the egg. This mid-cycle pain and discomfort can range from a minor pinch or twinge that’s over in minutes to more severe cramping that lasts for hours.

“You’ll feel it only on one side of your lower abdomen, depending on which ovary is releasing an egg,” says Amy Autry, MD, clinical professor of obstetrics-gynecology and reproductive sciences at the University of California at San Francisco.

Some women don’t feel anything when the egg is released from the ovary; others feel cramping a couple of weeks before their menstrual period. Overall, about 20 percent of women experience some type of ovulation pain, according to Dr. Autry.

While it’s unknown exactly why women experience cramping or ovulation pain, several theories exist. Before the egg is released, the follicle grows. This may stretch the surface of the ovary, causing pain. It’s also believed that blood and other fluid is released when the follicle ruptures, causing irritation that disappears as the fluid is reabsorbed. Because the ovaries have no openings, there may be some pain when the egg breaks through the ovary wall.

Six Signs of Ovulation Pain

Ovulation pain differs from menstrual cramps that come on just before or during a woman’s menstrual period. “It’s easy to recognize ovulation pain because it has a number of symptoms that are different from menstrual cramps,” says Autry.

The six signs of ovulation pain are:

• It’s one-sided.
• It comes on suddenly and without warning.
• It’s a sharp pain, twinge, or cramping rather than a dull ache.
• It often lasts only minutes, but may last a few hours or even up 24 hours.
• It may switch sides from month to month.
• It occurs about two weeks before your menstrual period starts.

Mild bleeding (spotting) or vaginal discharge may occur during this time. Some women may also experience nausea, especially if the cramping is severe. Mid-cycle pain is most common in adolescents and women in their twenties, but it can occur all the way up to age 45.

Understanding Your Body’s Signals

Women who experience ovulation pain may actually be at an advantage if they’re trying to get pregnant. Cramping in the weeks before your menstrual period is a sign that you’re ovulating and probably fertile. “You’re most likely to conceive if you have intercourse right before ovulation, on the day of ovulation, or immediately after ovulation,” says Autry.

On the other hand, mid-cycle pain may also help women who would rather not get pregnant. But while avoiding intercourse during times when you feel ovulation pain can be an effective back-up to your regular birth control method, don’t rely on it as your sole method of preventing pregnancy. “Sperm can live up to five days in a woman’s body,” cautions Autry. So you could get pregnant from unprotected sex on the days before you feel mittleschmerz pain.

Preventing and Treating Mid-Cycle Pain

For minor or brief ovulation pain, treatment is usually not necessary. For cramping that lasts more than a few minutes, over-the-counter pain relievers, such as ibuprofen (Motrin, Advil, and others) or naproxen (Aleve and others) will usually relieve the discomfort. Applying a heating pad to the site of the abdominal pain or taking a warm bath can also help. Heat increases blood flow, which relaxes tense muscles and eases cramping.

If your mid-cycle abdominal pain happens every month and is particularly bothersome, hormonal contraception (birth control pills, patches, or the vaginal ring) is an option because it prevents ovulation. And without ovulation, you can’t have ovulation pain.

Mid-cycle abdominal pain that is extreme or lasts longer than a day should be evaluated by a doctor. Appendicitis, ovarian cysts, and ectopic (tubal) pregnancy can sometimes mimic ovulation pain, although pain from these conditions is typically much more severe.

A medical exam and diagnostic tests can rule out other causes for abdominal pain. “But in the vast majority of cases, abdominal pain or cramping in the middle of the menstrual cycle simply means that you’re ovulating and the pain will disappear soon,” says Autry.

treat menstrual cramps

For women, menstrual cycles or periods as it commonly called is one of most painful experiences every month. While some are fortunate enough to have a pain-free periods, a good number of others suffer from various symptoms. 
 
These symptoms may include excessive bleeding, nausea, headache, diarrhea, dizziness and most importantly pain in the lower abdomen, legs or even thighs known as cramps. The pain may at times be unbearable and might prevent the person affected from performing normal activities. A cramp basically happens due to contractions in the uterus while disposing off unwanted waste. And if you are one of those who hasn't cared to be physically active during your normal days, it might simply aggravate.
 
Ways to reduce menstrual pain 
- Use a heating pad on your abdomen and back which will provide a soothing effect and also reduce the pain to some extent. 

Avoid oily food, meat, caffeine at all costs during the menstrual cycle. 

- Banana is known to reduce the cramp sensation. So make sure you eat one.
- Boil three spoons of coriander seeds in water. Filter and have the decoction. This will help lessen the bleeding.
- There are some who crave for food during their menstrual cycle. So even while you binge on all your favourite foods, avoid junk food.
- Make walking everyday a habit, this would improve blood circulation and ensure less pain during the periods.
- There are certain asanas in Yoga specifically to reduce the menstrual pain. Do those asanas but strictly under supervision. The following asanas are known to reduce menstrual discomfort, but do consult a yoga expert before you do it:
1. Svastikasana
2. Virasana
3. Padmasana
4. Gomukhasana
5. Paschimothansana
6. Baddha-konaasana
- Poses like Sirshasana, Viparita Karani and Sarvangasana must never be performed during the menstrual period
- If you are weak and have a tendency to tire soon during your menstrual cycle, do not run around or engage in activities that need too much exertion. 

tips to treat menstrual cramps

Do you dread your monthly cycle due to painful cramps? Many women suffer from painful periods, unaware of the effective natural remedies that can make their periods more comfortable. In my practice as an acupuncturist, I have seen many patients go from taking maximum doses of ibuprofen or acetaminophen during their periods to using little or none at all, just by implementing a few simple strategies.

You may wonder why you have to suffer through cramps in the first place. The explanation lies in the fact that your uterus must shed its natural lining each month–a job that requires your uterine muscle to contract. As it contracts, blood vessels that supply the uterus become constricted, which reduces blood flow and results in pain. For some women, the hormonal changes that trigger menstruation may be more pronounced, causing the uterus to contract overzealously–and more painfully.

From the perspective of Traditional Chinese Medicine, excessive menstrual pain is considered a condition of “stagnation.” Stagnation refers to a lack of energy (in this case, blood) flowing through an organ. With menstrual cramps, stagnation is thought to lodge in the lower abdomen and become irritated or activated when the body tries to start shedding tissue.

To address the excess contraction and constriction that cause painful periods, try the following tips. The idea is to help regulate blood flow in the lower abdomen, normalize smooth muscle contraction, and reduce cramps.  You can try them one at a time and see which approach works best for you, or you can try them all together to achieve maximum effect.

1. Supplement Yourself

Take calcium and magnesium supplements throughout the month, as these nutrients work in concert to aid muscle relaxation. You should aim for a total of about 1000mg of calcium daily, and up to 500mg of magnesium daily.  If you experience loose stools, reduce the dose. (Note: we recommend you use calcium citrate, because it tends to be more easily absorbed into the system than calcium carbonate.)

2. Try a Tea

Raspberry leaf is considered to be a mild uterine tonic. Try a cup of raspberry leaf tea each day throughout the month. It is available at Whole Foods by the company Traditional Medicinals. Keep in mind you are looking for the herbal tea, not raspberry-flavored black tea!

3. Eat More Greens

Dark leafy greens are a dietary source of magnesium, calcium, and countless other micronutrients.  These nutrients are essential for mediating muscle contractions. In Chinese dietary therapy, dark green vegetables are also considered to be mildly cleansing, which is what the body needs in a “stagnation” condition. Some greens such as dandelion greens (very bitter, but very helpful) also have a mild diuretic effect, which reduces bloating.

4. Cut Down on Coffee

Caffeine, especially from coffee, is a well-known vasoconstrictor – it makes blood vessels constrict.  Indeed, it may cause the vessels that feed the uterus to tighten more than they do in non-coffee drinkers.  If you’re a diehard coffee drinker and can’t cut it out entirely, try avoiding it just in the week before your period and see if you notice a change.

5. Use a Heating Pad

A heating pad or hot water bottle is a simple, tried and true way to reduce muscle spasms.

6. Try Acupuncture

Certain acupuncture points are thought to regulate blood flow through the abdominal cavity and relax the nervous system, which can help calm muscular contractions. Studies show that acupuncture is just as effective as over-the-counter anti-inflammatory medicines for reducing pain.

In addition to pain relief, don’t be surprised if these changes also lead to better digestion, better sleep, and a steadier mood.  However, if these measures are not enough to improve your quality of life, an acupuncturist or naturopath can offer you further refinement of natural strategies.

Also, keep in mind that excessively painful menstruation can be a sign of a more serious underlying medical issue, such as endometriosis, a uterine infection, or a problem with the uterine anatomy. Don’t forget to consult your primary care provider to make sure these possibilities are addressed, especially if you just can’t seem to get your pain under control.

May you enjoy smoother cycles!

tackling menstrual cramps naturally

Menstrual cramps can be debilitating for some girls and women, which can severely affect their quality of life during that part of their monthly cycle. While medication can quickly bring relief to sufferers, some would prefer to handle their menstrual cramps naturally. What are some ways to manage menstrual cramps without medication?

Eat Little and Often

When you are suffering from menstrual cramps, the last thing you will want to do is eat, but you should still ensure you receive adequate nutrition. Not only do small, regular meals help boost your metabolism, but they can also help relieve bloating and cramps. If you cannot stomach much, have some dry toast with butter and jam with a hot cup of tea and then try to eat a little more later on in the day when you are feeling better.

Light Exercise

Light exercise can offer some relief to women who are suffering from menstrual cramps. But do not push yourself to try and meet your usual goals by working out vigorously for an hour. Keep the workout gentle and try just 20-30 minutes on your exercise bike or treadmill. If you develop nausea or the cramps worsen during the workout, stop what you are doing, sit down and drink a glass of water. Then after a few minutes, resume the workout.

Get Plenty of Rest

Menstrual cramps are physically and emotionally exhausting, which is why it is important to get plenty of rest during that time of the month. The day before menstruation starts, get a good night's rest and aim to go to bed early each night during your period, in order to give your body the rest it needs to recuperate and function properly. Starting off well rested will help your body cope more easily with menstrual cramps. Short power naps during the day can also help you to get the rest you need to overcome the pain of menstrual cramps.

Drink Water

It is important to stay well hydrated at all times, but especially when you are suffering from menstrual cramps, as the water will help flush out and cleanse your system. Keep a water bottle beside you throughout the day and take regular sips to help reach your daily quota.

Menstrual cramps affect many girls and women around the time of menstruation, but there is no reason why the pain of menstrual cramps should ruin your quality of life. Eat little and often, engage in light exercise and get plenty of rest. Drinking plenty of water can also help you to manage menstrual cramps without medication.

How to cope with menstrual cramps

dreaded her periods each month. Her abdomen blew up like a balloon and ached terribly. The pain was so intense that she would become doubled over and couldn't even stand up. She felt like she would fall over because she hurt so much. She was incapacitated with her period every month since the onset of her menses six years before. She became hot all over, as if she had a fever, then cold and clammy. Her head and palms were covered with perspiration. She developed diarrhea, trembled, and "cried at the drop of a pin". She was totally incapacitated and lost all desire to eat and drink. To make matters worse, her periods came every 24 days. This was compounded by premenstrual anger and moodiness, in contrast to her usual loving nature. Tamara was lucky to have two good weeks each month. If offered a hysterectomy, even though she was only 20, Tamara might have seriously entertained the possibility.Menstrual pain (dysmenorrhea) is the most common gynecological complaint of women and the main cause of women missing work, school, and other activities. Statistics indicate that over 140 million working hours are lost annual as a result of dysmenorrhea. There is no way to begin to count all of those women who suffer through their workday with cramps while wishing they were home in bed.
Cramps have been associated with a number of conditions including endometriosis, ovarian cysts, and stress, however the precise cause of the imbalance is highly individual. The most common symptoms are mild to severe uterine or ovarian pain, sometimes along with leg or low back pain. The pain is often sharp, stabbing, and cramping. It generally begins with the onset of the menstrual flow and reaches its peak within 24 hours. There may also be nausea, and sometimes vomiting, bowel changes, and fatigue. Many women resort to anti-inflammatories, anti-prostaglandins (ibuprofen or naproxen), pain killers, or birth control pills. However, many effective natural therapies are available.
Ayurvedic Dietary Recommendations: I make dietary recommendations according to the woman's ayurvedic constitution, or body type. Women who experience cramps along with constipation, chilliness, gas, bloating, and anxiety are likely to have a Vata, or air, imbalance. They are likely to feel better from eliminating members of the Brassica (cabbage) family, such as cabbage, broccoli, and cauliflower, especially raw. For this group of women, it is best to minimize salads, dried fruits, sweets, and caffeine and to concentrate on whole grains, fruits, and cooked vegetables. These women need to drink lots of water and herb tea, either warm, hot, or room temperature. Oiling their bodies with warm sesame oil is also helpful.
Women who have an excess of fire, Pitta, will likely feel hot and have diarrhea with their menstrual pain. They may get flushed, feel a sensation of heat or congestion in the pelvis from the concentration of blood to the area, and may find themselves unusually irritable and impatient along with their menstrual pain. I advise these women to cut out garlic, ginger, onions, and cayenne as well as citrus and other acidic or sour foods. They should avoid hot tubs, very hot showers or baths, and getting overheated around their periods.
Women of the third body type, Kapha (earth and water), tends towards sluggishness and lethargy with their menstrual cramps. They may experience quite a bit of water retention and bloating and will generally want to do nothing but stay in bed. These women do best to eat very lightly, or even to fast, and, if they feel up to it, to take a walk. Hot, spicy food may help their cramps to pass more quickly as well as avoiding heavy foods such as fats, red meat, salt, and dairy. For all body types, I recommend eliminating or reducing caffeine, sugar, and alcohol.
Exercise: Many women find that engaging in regular aerobic exercise, running, swimming, jazzercise, or another form, help them to move through periods more comfortably.
Homeopathy: The correct constitutional homeopathic remedy can bring great relief to sufferers of dysmenorrhea. Some of the more common remedies are Belladonna ,Chamomilla ,
Kali carbonicum , Pulsatilla , Sepia , however the prescription is highly individual and only the one correct remedy will be effective. The appropriate homeopathic remedy will only need to be taken once or several times a year, rather than monthly regimens such as those which follow.
You may still be wondering if Tamara got the help she needed. She did. HomeopathicVeratrum album , white hellebore, brought her great relief. She was free of cramps. Her gas was at least 70% better and she had no diarrhea. Her stools were much firmer. She was no longer as hot during her period. She felt less angry and depressed before her period. She was glad to be a woman again! She was spared up to thirty years of menstrual misery.
Herbs: One of the most useful herbs for painful periods is Viburnum opulus (cramp bark).
Also helpful are Caulophyllum (blue cohosh), Dong quai (Angelica sinensis), and herbal sedatives such as Valeriana officianalis . Castor oil packs, applied to the abdomen, are Edgar Cayce's answer to abdominal and pelvic pain such as that experienced in dysmenorrhea.
Nutritional Supplements: Calcium and magnesium, taken in a three to one ratio, are good muscle relaxants and provide pain relief in some cases. Some women take B-6 during the menses, in a dosage of no more than 100 mg. per day, for relief of menstrual cramping.
Yoga and Deep Breathing: Pranayama, or yogic breathing, can be extremely beneficial in helping a woman relax. A simple technique to begin with is alternate nostril breathing. Breath- ing in and out through the left nostril only is also known to be calming and soothing in general.
Emotional exploration: Menstrual cramps may have a psychological origin. The source may be sexual abuse, dysfunctional sexual relationships, or messages from one's mother that periods and childbirth are painful and a problem. I find hypnosis very useful in such cases.
You do not need to be sentenced to a life of dreading your periods.Tamara found a natural way to eliminate her incapacitating menstrual pain, hopefully once and for all. So can you!

Drs. Judyth Reichenberg-Ullman is a naturopathic and homeopathic physician and cofounder of the Northwest Center for Homeopathic Medicine in Edmonds, WA. She is coauthor of The Patient's Guide to Homeopathic Medicine and Beyond Ritalin: Homeopathic Treatment of ADD and Other Behavioral and Learning Problems. She can be reached at (206) 774-5599.

from healtynet.com

menstrual cramps and its causes

Menstrual cramps (dysmenorrhea) are dull, throbbing or cramping pains in the lower abdomen. Many women experience menstrual cramps just before and during their menstrual periods. For some women, the discomfort is merely annoying. For others, it can be severe enough to interfere with everyday activities for a few days every month.

Menstrual cramps may be caused by identifiable problems, such as endometriosis or uterine fibroids. Treating the underlying cause is key to reducing the pain. Menstrual cramps that aren't caused by some underlying condition tend to lessen with age and often disappear once a woman has given birth.

Symptoms of menstrual cramps include:

• Dull, throbbing or cramping pain in your lower abdomen
• Pain that radiates to your lower back and thighs

Some women also experience:

• Nausea and vomiting
• Loose stools
• Sweating
• Dizziness

When to see a doctor

If you've started menstruating within the past few years and are experiencing cramps, chances are your menstrual pain is not a cause for concern. However, if menstrual cramps disrupt your life for several days a month or if you're older and just started experiencing severe menstrual cramps, see your doctor.

Causes

During menstrual periods, your uterus contracts to help expel its lining. Hormone-like substances (prostaglandins) involved in pain and inflammation trigger the uterine muscle contractions. Higher levels of prostaglandins are associated with more severe menstrual cramps.

Many experts believe that severe contractions constrict the blood vessels feeding the uterus. The resulting pain can be compared to the angina that occurs when blocked coronary arteries starve portions of the heart of food and oxygen.

Menstrual cramps also may be caused by:

• Endometriosis. In this painful condition, the tissue that lines your uterus becomes implanted outside your uterus, most commonly on your fallopian tubes, ovaries or the tissue lining your pelvis.
• Uterine fibroids. These noncancerous growths in the wall of the uterus rarely may be the cause of pain.
• Adenomyosis. In this condition, the tissue that lines your uterus begins to grow into the muscular walls of the uterus.
• Pelvic inflammatory disease (PID). This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.
• Cervical stenosis. In some women, the opening of the cervix may be so small that it impedes menstrual flow, causing a painful increase of pressure within the uterus.

Menstrual Cramps

What is dysmenorrhea?

The medical term for painful menstrual periods is dysmenorrhea. There are two types of dysmenorrhea, primary and secondary.

In primary dysmenorrhea, there is no underlying gynecologic problem causing the pain. This type of cramping may begin within six months to a year following menarche (the beginning of menstruation), the time when a girl starts having menstrual periods. Menstrual cramps typically do not begin until ovulatory menstrual cycles (when an egg is released from the ovaries) occur, and actual menstrual bleeding usually begins before the onset of ovulation. Therefore, an adolescent girl may not experience dysmenorrhea until months to years following the onset of menstruation.

In secondary dysmenorrhea, some underlying abnormal condition (usually involving a woman's reproductive system) contributes to the menstrual pain. Secondary dysmenorrhea may be evident at menarche but, more often, the condition develops later.

What causes menstrual cramps?

Each month, the inner lining of the uterus (the endometrium) normally builds up in preparation for a possible pregnancy. After ovulation, if the egg is not fertilized by a sperm, no pregnancy will result and the current lining of the uterus is no longer needed. The woman's estrogen and progesterone hormone levels decline, and the lining of the uterus becomes swollen and is eventually shed as the menstrual flow and is replaced by a new lining in the next monthly cycle.

When the old uterine lining begins to break down, molecular compounds called prostaglandins are released. These compounds cause the muscles of the uterus to contract. When the uterine muscles contract, they constrict the blood supply (vasoconstriction) to the endometrium. This contraction blocks the delivery of oxygen to the tissue of the endometrium which, in turn, breaks down and dies. After the death of this tissue, the uterine contractions literally squeeze the old endometrial tissue through the cervix and out of the body by way of the vagina. Other substances known as leukotrienes, which are chemicals that play a role in the inflammatory response, are also elevated at this time and may be related to the development of menstrual cramps.