In fact, at least 10 percent of younger women have symptoms so severe that they are unable to handle their normal range of activities. Many women have to miss days of work and important social functions because any movement or activity is too painful. For the first day or two of menstruation, only bed rest or curling up on the floor in the fetal position is tolerable until the symptoms finally pass. This often happened to me during my teens and twenties.

Besides the lower abdominal pain, cramp sufferers can also experience backache, pinching and pain sensations in their inner thighs, bloating, nausea, vomiting, diarrhea, constipation, faintness, dizziness, fatigue, and headaches. For those women who must curtail their activities because of cramps, these problems translate into billions of dollars of lost wages and productivity on the job, as well as a significant decrease in the quality of life for several days each month.

In fact, the gynecology textbook that I used during my medical training estimated that menstrual cramps caused the loss of 140 million work hours annually. It is no wonder that women with moderate to severe cramps regard their monthly period with apprehension and even dread.

Despite the many symptoms and the millions of sufferers, menstrual cramps have been traditionally considered by the medical community to be a "minor" female ailment. Doctors treated women as if the problem were "all in their heads." The problem was either ignored or else treated with powerful painkilling drugs and tranquilizers. Often these drugs had significant side effects and did nothing to alleviate or help prevent the problem on a long term basis. Luckily, the medical community's interest in menstrual cramps has increased during the past two decades. Researchers understand much more about what causes menstrual cramps on a physiological basis. This has led to newer, much more effective drug treatments, as well as nutritional and other lifestyle related therapies.

The Normal Menstrual Cycle
It is important to look at the normal menstrual cycle and see how it functions. This background will make it easier for you to understand why painful menstruation occurs.

First, understand why we menstruate. Menstruation refers to the shedding of the uterine lining, or endometrium. Each month the uterus prepares a thick, blood-rich cushion to nourish and house a fertilized egg. If pregnancy doesn't occur and the egg doesn't implant in the uterus, then the body doesn't need this extra buildup of the uterine lining. The uterus cleanses itself by releasing the extra blood and tissue so that a fresh buildup can occur all over again the following month, in preparation for a possible pregnancy.

The mechanism that regulates the buildup and shedding of the uterine lining is controlled by fluctuations in your hormonal levels. It begins each month when follicle stimulating hormones (FSH) and luteinizing hormones (LH) are released from the pituitary, a gland located at the base of the brain. Once FSH and LH are released into the bloodstream, their destination is the ovaries. The ovaries hold all the eggs a woman will ever have, in an inactive form called follicles. During each cycle, the FSH and LH from the pituitary gland cause one follicle to ripen, and normally one egg is released for possible fertilization. As part of this pro-cess, the follicles begin to produce the hormones estrogen and progesterone. Estrogen reaches its peak during the first half of the cycle as the newly released egg is maturing. Progesterone output occurs after midcycle when ovulation has occurred. Ovulation refers to the production of a mature egg cell.