Q. Lately I’ve been having extremely heavy, painful periods. Can you help?
Dysmenorrhea is the medical term for painful menstrual cramping. The culprit is often high levels of prostaglandins – chemicals released as the lining of the uterus (the endometrium) is sloughing. These chemicals are what stimulate the uterine muscles to contract. All women, but especially those suffering from painful periods, should see a gynecologist every year for a physical examination including a full history. An exam can rule out certain treatable causes of dysmenorrhea such as pelvic inflammatory disease and uterine fibroids. A physician can also look for signs of endometriosis. Therapies for period cramps include use of an abdominal heating pad, regular exercise, and vitamins (500 IU/day of vitamin E, 200mg/day of vitamin B6, 100mg/day of vitamin B1, and fish oil). Pain relievers like ibuprofen (Advil, Motrin) or naproxen (Aleve) are other first-line treatments because they block the production of prostaglandin. Oral contraceptives can also effectively treat dysmenorrhea. Other birth control methods associated with improved rates of dysmenorrhea include Depo-Provera, an injection, Nexplanon, a skin implant, and Mirena, an intrauterine device.