The famous quote may go, “in this world nothing can be said to be certain, except death and taxes,” but we’d like to add a third thing to that list: period cramps. Every month like clockwork, they come around to ruin our week and leave us wanting to crawl under the covers with a heating pad and the remote control.

So what causes cramps? And what can we do about them? We got the lowdown:

What causes cramps?
You know they usually show up one to two days before you start your period, but what actually causes cramps in the first place? Blame prostaglandins — they’re the hormone-like substances that tell your uterus to contract and expel its uterine lining. Those contractions can cause your uterus to press against nearby blood vessels, inhibiting the oxygen supply to the muscle tissue of the uterus and causing pain. Experts think leukotrienes, which play a role in your body’s inflammation response, are also elevated around this time, exacerbating cramping. The result: throbbing pain that can last up to four days (though it feels like forever).

How to deal:

1. Massage with essential oils: A self-massage may not be as fun as splurging on a spa day, but it may help alleviate cramps. A study of 48 women with menstrual cramps found that massaging essential oils — they used lavender, clary sage, and marjoram — into the lower abdomen lessened pain and cut the duration of menstrual cramps from 2.4 days to 1.8 days.

2. Heat up: There’s a reason the heating pad remedy is so ubiquitous — it works! Sure, curling up on the couch with a heating pad has a certain coziness factor, but the pain relief factor is real. In fact, researchers have found that a wearable heat wrap offers even more pain relief than 1000mg of acetaminophen over the course of a day. (Even fatigue and mood swings showed improvement!)

3. Brew a cup of tea: Research shows chamomile tea has potential to relieve your cramps — it seems that drinking this tea increases your levels of glycine, an amino acid that’s been shown to relieve muscle spasms.

4. Optimize your diet: Stop period pain before it starts with a diet that addresses the inflammation factor. Vegetables, fruits, and whole grains that are packed with fiber can all help reduce inflammation. Adding magnesium may also help, according to researchers, so don’t be shy about piling leafy greens and legumes onto to your plate.

5. Order the fish (oil): Research shows that 500mg of fish oil a day taken at the beginning of the menstrual cycle and continued for two months can help with cramp pain.

6. Butt out: Need yet another reasons to quit smoking? Research has found that smokers are more likely to experience severe menstrual cramps — and the pain worsens as the number of cigarettes increases.

7. Last resort: pop a pain pill: While we usually like living la vida naturel, a nonsteroidal anti-inflammatory medication (NSAID) like ibuoprofen or naproxen inhibits your prostaglandin production, easing pain. Just make sure you don’t drink alcohol when you’re taking an NSAID — the combination of the two increases your risk for upper GI bleeding.

8. Consider the pill: There are plenty of important factors that go into deciding on a method of birth control, but if you’re thinking about the pill, good news — hormonal birth control reduces of the amount of prostaglandins your body releases, reducing or even eliminating cramping.

Still in pain? Don’t ignore it! if your period cramps are severe enough to interfere with daily activities or if you have other concerning symptoms (like super heavy periods), see your doctor to rule out causes like endometriosis.

Diana Vilibert is a freelance writer and copywriter living in Brooklyn, NY. She loves flea markets, martinis, to-do lists, traveling, and wearing leggings as pants. You can see more of her writing at www.dianavilibert.com and follow her on Twitter at @dianavilibert.