Abdominal pain/cramps

Many women experience light cramps in the abdomen during menstruation but the pain is not severe and passes quickly. For other women it is a different story with more severe pain in the lower abdomen just before and/or during the first days of menstruation. Pain is caused by contractions of the uterus, which is rejecting the uterine lining. The pain is often identifiable as a cramp or a stabbing sensation and can radiate to your back, hips or even your upper legs. Some women experience a heavy, dragging feeling in their belly. Abdominal pain can last for a few hours to a few days.

The uterus is a smooth muscle. It’s possible that cramps are caused by an increased secretion of lipid compounds which have a hormone-like action (prostaglandins). These compounds can raise prolactin levels, which increases the strength of contractions in smooth muscles. High levels of prolactin indicate that dopamine, the feel-good neurotransmitter, is absent. This makes menstrual cramps even more unpleasant for women.1,2

Abdominal pain occurs most frequently in young women (between 12-24 year). Often, these complaints decrease with age. If you use an intra uterine device (IUD), also known as the contraceptive coil, without hormones, it may exacerbate menstrual pain. If this is your situation, discuss the issue with your physician.

Helpful advice

Helping the muscles in your abdomen and back relax can ease muscle pain, tension and cramps
  • Place a covered hot water bottle against your belly or lower back. The warmth helps to relax your muscles and relieve pain.3
  • Treat yourself to a warm bath with chamomile, yarrow, parsley and/or rosemary. Warm water will help your muscles relax. A long, hot shower can help too. Aim the water at your belly for maximum effect.
  • Massage eases muscle tension and can reduce menstrual pain. Stay active, if you can. This will help take the focus off your pain and keeps your muscles working. Research shows that when you exercise, endorphins are released which reduce your perception of pain and trigger a positive feeling in your body. 4 Do some gentle exercise if you don’t feel like doing a full work out.
  • Research suggests that caffeine (in coffee, tea and other drinks containing caffeine) can exacerbate menstrual complaints.5,6,7 Drink no more than 4 cups of coffee per day. Even better: drink herb tea or mineral water. These can help relax your muscles and limit cramping.

When should you visit the doctor?

See your physician if you have severe pain and if the tips above do not provide enough relief. If your abdominal pain is accompanied by nausea and fatigue or you have vomited, see your physician.


1.Schellenberg, R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ 322, 134–7 (2001).
2.Prigent-Tessier, A. et al. Prolactin up-regulates prostaglandin E2 production through increased expression of pancreatic-type phospholipase A2 (type I) and prostaglandin G/H synthase 2 in uterine cells. Mol. Cell. Endocrinol. 122, 101–8 (1996).
3.Chaudhuri, A., Singh, A. & Dhaliwal, L. A randomised controlled trial of exercise and hot water bottle in the management of dysmenorrhoea in school girls of chandigarh, india. Indian J. Physiol. Pharmacol. 57, 114–122 (2013).
4.Viña, J., Sanchis-Gomar, F., Martinez-Bello, V. & Gomez-Cabrera, M. C. Exercise acts as a drug; The pharmacological benefits of exercise. Br. J. Pharmacol. 167, 1–12 (2012).
5.Gynecologists, T. A. C. of O. and. Premenstrual syndrome. Glob. J. Health Sci. 6, 121–125 (2014).
6.Mackay Rossignol, A. & Bonnlander, H. Caffeine-containing beverages, total fluid consumption, and premenstrual syndrome. Am. J. Public Health 80, 1106–1110 (1990).
7.Caffeine and Premenstrual Syndrome. 1980 (1987).

Tip: UsingNutri-Gyn MenstruComfort in combination with a healthy lifestyle can help ease physical discomforts during menstruation.