Period cramps affect nearly 90 percent of women at some point in their lives. They’re generally worse in the first five years after one’s first period and are usually much less severe after childbirth. The time in between those two transformational life events? A cramp free-for-all. Here’s what you need to know about cramps — and how to outsmart them.

What causes cramps?
Cramps, the vague, frustrating, sometimes debilitating condition also known as dysmenorrhea, is caused by a hormone called endometrial prostaglandin. Prostaglandins are a group of hormones that target many organ systems, especially the uterus, gut, blood platelet cells and nervous system. Prostaglandins are produced by the endometrial lining, which builds up and then sloughs off each month during the menstrual cycle. The thicker the lining, the more prostaglandins are released and the more likely a women is to have cramps. Therefore women with heavier, longer periods are more likely to get cramps.

What are they like?
Cramps usually start on the first day of bleeding and may continue for several days. There is no specific test to make a diagnosis for cramps, and there’s no blood test to check a women’s prostaglandin level. Rather, dysmenorrhea is a clinical diagnosis based on symptoms which include menstrual cramps and/or any combination of backache, nausea, diarrhea, headache, fatigue, or flu-like symptoms. Severe dysmenorrhea impacts a woman’s day-to-day life and can cause depression and anxiety in addition to the physical manifestations of this all-too-common disorder. Imagine feeling like you have the flu for three days every month!

How can I make them go away?
We know that cramps are more common in adolescent women and tend to diminish in adulthood, especially after pregnancy and childbirth. As hormone levels find a happier equilibrium in one’s 20s and 30s, the pain and severity of cramps often diminishes. In the meantime, there are a few ways to help remedy.

Over the counter painkillers
For less severe symptoms, ibuprofen, which interferes with the actions of prostaglandins, is a common and readily available treatment. Don’t wait — the best time to start taking ibuprofen is with the first twinges of cramp pain.

Hormonal birth control
Taking hormonal birth control can also reduce the severity of menstrual cramps. Hormonal contraception (pills, rings, patches) and hormonal intrauterine devices (IUDs) reduce the buildup of the endometrium, reducing the amount of prostaglandin produced. This is the gold standard treatment for severe dysmenorrhea.

Holistic and natural remedies
There are also holistic and natural remedies out there worth giving a try. Eating a healthy, well-rounded diet, drinking plenty of water, and getting regular exercise are good first steps in cramp prevention. In addition, adding (or subtracting) certain foods like salt or processed sugars from your diet, and taking supplements like ginger, magnesium, and vitamin D may help alleviate cramps by reducing bloating and discomfort.

You can also try massaging your abdomen or back with essential oils. Oils like capsaicin, lavender, chamomile, or geranium can trigger your senses with a relaxing aroma and provide local stimulation of the nerve fibers in the skin for relief.

Cramps can be a painful fact of life and even a rite of passage for many women, but it doesn’t hurt to know your options and find the one that works best for you.

Dr. Lisa Stern joined the LOLA team in 2016 as a go-to medical expert, bringing with her 25 years of experience in pediatric medicine. A leading pediatrician, she is passionate about promoting health and wellness among children and young adult.