HOW TO DEAL WITH MENSTRUAL CRAMPS

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In addition to prostaglandins, there are several other factors that—it's speculated—contribute to dysmenorrhea.

Family history. It hasn't yet been established whether prostaglandin overproduction is hereditary, but studies do show that daughters of women with severe dysmenorrhea are likely to experience such cramps themselves.

IUD's. Painful cramping is a common effect of IUD usage . . . and it now appears that intrauterine devices actual ly stimulate prostaglandin production. Many women have had them removed for that reason.

Other common troublemakers include bladder infections, bowel problems, and yeast infections. It's also long been noted that women who suffer acute dysmenorrhea often become depressed and irritable as their periods approach (who wouldn't, when anticipating several days of severe pain?), and there was a time when doctors believed that depression in women caused menstrual discomfort . . . but I'd say it's more likely the other way around!

THE VARIETIESOF DYSMENORRHEA

Whatever their origins, there are three separate kinds of severe monthly cramping. Primary spasmodic dysmenorrhea is characterized by sharp, wavelike cramps—in the lower abdomen and inner thighs—which last for a day or two after the onset of menstruation. The condition usually subsides when a woman reaches her late twenties. Primary congestive dysmenorrhea, on the other hand, involves a dull, aching pain and the uncomfortable, bloated feeling of edema. This type of menstrual distress often persists until menopause, getting worse with age.

Secondary dysmenorrhea tends to occur suddenly, often after years of less painful periods . . . and it may be associated with one of several health problems, some of them as serious as pelvic inflammatory disease or reproductive cancers. This ailment, therefore, should be treated by a physician. The more common primary forms of menstrual discomfort, though, can usually be alleviatedor even eliminated—by following a carefully chosen program of self-care.

RELIEF IS UP TO YOU

The following list begins with "nonaggressive" approaches to dealing with menstrual pain, then moves on to more drastic measures. You should feel free to use whatever techniques suit your needs.

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