Dear Sexpert,

The pain I have felt during my last few periods has been debilitating. I have taken ibuprofen and that hasn’t really helped. I’ve had to miss classes because I was in too much pain to get out of bed. I’m embarrassed to tell my professors and preceptors why I missed classes. My roommate says everyone gets cramps and that I need to stop being so sensitive, but I’m worried it could be something more serious. What should I do?

—Cramping and Crying

Dear Cramping,

Ouch, I am sorry that you are experiencing so much pain. For some women, menstruating can be a very painful process, and the level of discomfort experienced is variable. More than 50 percent of all women who menstruate experience pain for one to two days of each menstrual cycle. If you are experiencing extreme pain that lasts longer than two days or interferes with daily activities when you are menstruating, you should make an appointment with your health care provider or a Sexual Health and Wellness clinician at McCosh.

The pain associated with menstruation is called dysmenorrhea and can be classified as two types: primary dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea is pain resulting from menstrual periods (commonly called menstrual cramps) and is quite common. It is caused by natural chemicals called prostaglandins that are made in the lining of the uterus. On the first day of your menstrual period, the prostaglandin levels are elevated and as your menstrual process continues and your uterus sheds its lining, the levels decrease and typically, so does the pain you might experience. To help alleviate this pain, you could try exercise, pain relievers, a moist heat pack, or relaxation techniques, such as meditation or yoga.

Secondary dysmenorrhea, however, involves pain that lasts much longer than typical menstrual cramps. It can even begin before the menstrual period starts and continue after the menstrual period has ended. This pain is caused by a disorder in the reproductive system.

If you are experiencing pain that lasts longer than typical menstrual cramps, or begins before you start menstruating, contact your health care provider. A pelvic exam can help determine what is causing the pain and inform the most effective method of treatment.

Birth control methods containing estrogen and progestin, such as combination pills, Ortho Evra, and NuvaRing, as well as an intrauterine device (IUD), can also be effective treatments for dysmenorrhea. To learn more about these methods and to determine if one is right for you, schedule an appointment at Sexual Health and Wellness at http://www.princeton.edu/MyUHS or call (609) 258-3141.

~The Sexpert

Information provided by the American College of Obstetricians and Gynecologists