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What are menstrual cramps?
These are cramps that are usually felt in the lower abdomen, back or both.
They start during the first 1 or 2 days of a person’s period.
The medical name for painful menstrual cramps is dysmenorrhea.
What causes menstrual cramps?
The blood that comes out during a period is caused by the contractions of the uterus.
A hormone called prostaglandin causes the uterus to contract and that is what causes the cramps.
The cramps cause the pain, as this part of your body is inflamed and irritated.
This is all a normal body process.
Cramps are felt during the portion of a period when there is bleeding.
Hormones change a lot over the first two years of periods, so cramps don’t usually start until one to two years after a period starts.
About 60% of people who have a period, have cramps with their periods.
What are the symptoms of cramps?
You may feel throbbing or squeezing in your lower belly, back, or both.
The cramps usually start in the first day or two of a period and maybe worse during this time.
You may have nausea, vomiting, diarrhea or a combination of these with your cramps.
Cramps can range from mild to severe.
Pain Scale
Mild. Your child feels pain and tells you about it, but the pain does not keep your child from any normal activities. School, play and sleep are not changed.
Moderate. The pain keeps your child from doing some normal activities. It may wake them from sleep.
Severe. The pain is very bad. It keeps your child from doing all normal activities.
What can help with cramps?
Here is some care advice that should help.
Pain Medicine
Ibuprofen can be a helpful medication for cramps. Advil and Motrin are some of the brand names. Follow package directions for dosing. No prescription is needed.
If your child has tried ibuprofen and it has not been helpful, switch to naproxen. The brand name is Aleve. You may also try a combination product for cramps such as Midol or Pamprin. Follow package directions for dosing. No prescription is needed.
These medications should be taken as soon as your period starts. If you can, start these medications the day before, to try to get ahead of the pain. You don’t have to wait until the cramps start.
Be sure to take these medications with food to avoid irritating your stomach.
Note: acetaminophen products (such as Tylenol) are less helpful for menstrual cramps, as it helps with pain, but ibuprofen and naproxen help with pain and inflammation.
Use Heat for Pain
Use a heating pad or warm washcloth on the lower belly, or where you feel the cramping. Do this for 20 minutes 2 times per day. Use the heating pad with caution to avoid any burns and never fall asleep with it on.
This may help to reduce pain.
A warm bath or a bath with epsom salt may help.
Stay Active
It's important to go to school while having a period.
It is safe to take part in sports during a period.
It is fine to swim, bathe, or shower like normal during a period.
Exercise helps with cramps.
What to Expect
Cramps last 2 or 3 days.
They will often happen with each period.
When to call your child’s provider:
Neither ibuprofen nor naproxen (naprosyn) help the pain.
Cramps cause missed school or other events.
Pain lasts over 3 days.
You think your child needs to be seen.
You have other questions or concerns.
Author: Barton Schmitt MD, FAAP and Julia Michie Bruckner, MD, MPH, FAAP
From Pediatric Patient Education, American Academy of Pediatrics
Reviewed by: JW, M.D., TT, D.O. | 07/2025