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Friday, August 31, 2012

What are Menstrual Cramps?

Cramps; they can be debilitating
Last week, I reviewed a book about men making healthier choices (while still having fun.)  Guys, if you haven’t figured it out, this one’s for the ladies; though most of you have a wife, girlfriend, roommate, mother, sister, client or close friend who is a female dealing with this and it might behoove you to know a little bit more about it.

But first, a little background

Working with women as a trainer for as long as I have, you can imagine the excuses I’ve heard from people who want to get out of their workout. To say that I’ve heard it all is an understatement.  Let’s just say, I could write a book (and most of the time the excuses are for sessions they have already paid for!)  The texts come through with just one word…“cramps.” The rest is understood.

So what are cramps exactly? 

The technical, medical term is dysmenorrhea which actually refers to painful periods.  Dys comes from the latin root for “abnormal” or “bad” (no kidding.) Bloating is no picnic either but cramps seem to be the symptom that causes the intense pain. Unless of course, a more serious medical condition is present in which case the dysmenorrhea can be considered secondary to other conditions like endometriosis, fibroid tumors, ovarian cysts or other abnormalities.

What causes menstrual cramps?

Each month, the inner lining of the uterus (the endometrium) 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 then decline, and the lining of the uterus becomes swollen and is eventually shed as part of the menstrual flow. It is replaced by a new lining in the next monthly cycle.  Female reproduction 101.

When the old uterine lining begins to break down, 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 to the endometrium. This contraction blocks the delivery of oxygen to the tissue of the endometrium which, in turn, breaks down and literally dies. With 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. Leukotrienes, (naturally occurring chemical substances that promote an inflammatory response) are also elevated at this time and may be related to the development of menstrual cramps.

Why are some cramps so painful?

Menstrual cramps are caused by the uterine contractions that occur in response to prostaglandins and other chemicals. The cramping sensation is intensified when clots or pieces of bloody tissue from the lining of the uterus pass through the cervix.

I’m not the only one who’s experienced menstrual cramps, at times severe cramps-and lived to tell about it (barely.)  Since I was nearly 17 years-old (yes, I know that’s very old for the “onset of menses,” as it were, especially considering today’s average onset, but that’s another story), I had to evaluate whether I was just being a complete wimp or if I was in “real” pain. Ultimately, everyone has a different pain threshold and while the wimpy types are out there, I believe that those who would stay home in bed all day with cramps are just as likely to stay home with a hangnail. These women are the exception, not the rule.  The rest of us “soldier” through it because the realization is made early on that there will be years of this ahead, so you learn how to deal with it and go on with your day and your workout-as painful as it can be.

The truth is most women, at some time in their lives, experience menstrual cramps that are quite painful-if not debilitating.  If you’re one of those guys, or women for that matter (there are some women who actually don’t experience cramps), who think it’s doubtful that something that happens on such a regular basis could be that painful that often, who believe that basically, we’re just being dramatic-you’d be very wrong.  

For most women, menstrual symptoms will change throughout their lifetime.  Certain symptoms will come and some will go.The intensity of these symptoms can also either increase or decrease as over the course of time.

How can you relieve the pain?

The few and the brave, tough it out; "un-medicated."  But most women reach for over-the-counter pain medications such as Ibuprofen (Advil), Naproxen (Alleve), or aspirin.  Acetaminophen (Tylenol) will help ease the pain but will not affect the prostaglandins. Acetaminophen is very toxic to the liver and is best avoided anyway. Cramps are fairly constant for the first day or two of the period which means that the medication must be taken throughout the day, at the first sign of pain-if you want to “stay ahead of it.”  Experiment until you find the pain relief that works best for you (other than Tylenol.)

If a woman does not ovulate, it is unlikely that she will encounter cramps during her period. This is why doctors often prescribe birth control pills (which are designed to prevent ovulation) to ease the pain caused by cramping. 

Natural Remedies that may help

  • Regular physical activity can reduce cramping in some women.
  • Natural progesterone (can be purchased over-the-counter; even Whole Foods carries it), may help reduce cramping.
  • Supplementing your diet with zinc and calcium may reduce cramps, bloating, and related PMS symptoms.
  • Herbal remedies, such as blackhaw (AKA stag bush), bliss wart (AKA skullcap) and black cohosh, have an antispasmodic effect that may reduce some menstrual cramps. Other useful herbs include cramp bark, squaw vine, unicorn root, bromelain, evening primrose oil, and blue cohosh.
  • Try taking a warm bath and using aromatherapy or a heating pad on your lower abdominal area or lower back may ease the pain a bit.
  • Letting those around you know that you are not your usual rock-solid self will help by reducing the stress of your everyday life (something that can contribute to your menstrual cramps.)



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Fitness expert and integrative performance coach Jini Cicero, CSCS, teaches intermediate exercisers how to blast through plateaus to create incredible transformations. Are you ready to take your fitness to a whole new level?  Find out now!  Take Jini's "Are you Ready?" Quiz at © 2011 Jinifit, Inc.

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