From the Guidelines
Perimenstrual abdominal cramps and nausea are primarily caused by prostaglandins released during menstruation, which trigger uterine contractions and can affect the gastrointestinal tract. These symptoms typically occur before and during menstruation due to hormonal fluctuations, particularly the drop in progesterone that triggers the release of prostaglandins 1. Other contributing factors include endometriosis, adenomyosis, uterine fibroids, and pelvic inflammatory disease.
For relief, NSAIDs like ibuprofen (400-600mg every 6-8 hours) or naproxen (500mg initially, then 250mg every 6-8 hours) can be taken 1-2 days before expected menstruation to block prostaglandin production. Heat therapy, gentle exercise, and dietary changes (reducing salt, caffeine, and alcohol) may also help. Antiemetics such as ginger supplements (250mg four times daily) can address nausea, as supported by studies on nausea and vomiting during pregnancy 1.
Some key points to consider in managing perimenstrual symptoms include:
- Identifying and avoiding specific triggers, such as certain foods or activities
- Using the Motherisk Pregnancy Unique Quantification of Emesis score to quantify the severity of nausea and vomiting 1
- Considering hormonal contraceptives as effective long-term solutions to prevent ovulation and reduce prostaglandin production
- Recognizing that stress, sleep deprivation, and hormonal fluctuations can trigger episodes of cyclic vomiting syndrome, and developing strategies to mitigate these triggers 1
If symptoms are severe or accompanied by heavy bleeding, unusual discharge, or fever, medical evaluation is necessary as these could indicate underlying conditions requiring specific treatment. Hormonal contraceptives are effective long-term solutions as they prevent ovulation and reduce prostaglandin production, and should be considered for women with severe perimenstrual symptoms 1.
From the Research
Perimenstruation Abdominal Cramp and Nausea Causes
- Dysmenorrhea is a common menstrual complaint in young women, with a prevalence as high as 90% 2
- It is characterized by abdominal cramps and other symptoms such as nausea
- The exact causes of perimenstruation abdominal cramp and nausea are not specified in the provided study, but dysmenorrhea is known to be related to menstrual cycles
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen have been shown to be effective in relieving pain and other symptoms of primary dysmenorrhea 2
- The study compared the efficacy and safety of OTC doses of naproxen with other pain relievers such as acetaminophen and ibuprofen, and found that naproxen provided greater pain relief than these alternatives 2
Symptoms and Treatment
- Symptoms of dysmenorrhea include abdominal cramps, nausea, and other menstrual complaints
- Treatment options include NSAIDs such as naproxen, which have been shown to be effective in relieving pain and other symptoms 2
- The study found that naproxen had a good safety profile and was well-tolerated by the population studied 2