HOW TO DEAL WITH MENSTRUAL CRAMPS

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Aspirin. This old standby is a mild prostaglandin inhibitor, but it's only 1/30 as potent as the powerful drugs listed below. Both plain and buffered aspirin can cause stomach upset or gastrointestinal bleeding, though, so be sure to take either of those medications on a full stomach or with milk.

If the nonaggressive approaches listed above don't provide enough relief, you probably ought to have a physical (including a pelvic exam) to rule out any organic problems . . . particularly gonorrhea. At any rate, you will need to see a doctor to obtain a prescription for any of the following medications.

Prostaglandin inhibitors. These are the "latest thing", which means they have both advantages and disadvantages. They do work very well to reduce cramping, but have also been known to cause such side effects as rashes, headaches, gastrointestinal upset, and/or severe bleeding. (Because the drugs are so new, other long-term effects have not yet been determined.) If you're not using any form of contraception in conjunction with the prostaglandin inhibitors, don't take then until your period actually starts. If you ingest the drug for a few days before you expect your menstrual flow, and it turns out that you've actually been pregnant for a month, you'll have bathed the first-trimester fetus in a possibly dangerous chemical.

Narcotics. Narcotics—especially codeine—have long been administered to women suffering severe cramps . . . and, although they're undoubtedly effective, the drugs can cause unpleasant side effects (such as drowsiness, nausea, and constipation). Personally, I'd suggest that you try to get by without narcotics and instead use some form of stress reduction. However, anyone with really debilitating pain needs the strength of narcotics . . . and, for such cases, I'm glad they're available. Addiction, by the way, won't be a problem for anyone who takes narcotics for only one or two days each month. It would require one or two weeks of steady high doses to create a physical dependence.

Birth control pills. As I mentioned earlier, the Pill prevents ovulation, which is the signal for a buildup of cramp-producing prostaglandin . . . so oral contraceptives can be quite effective in relieving menstrual pain. Each woman, I think, should weigh for herself the costs and benefits of the Pill. There are well-known health risks involved . . . but in some cases the disadvantages may be preferable to severe monthly pain.

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