Menstrual cramps

What are they?

Around 80% of women have menstrual cramps (dysmenorrhea) the day before and for 36 hours into their period, sometimes with disabling cramping pain in the lower abdomen.

Once the period is established, the cramps tend to subside.

What are the symptoms?

Pain in your lower abdomen that reaches a crescendo, fades then rises again – the cramp.

Alternatively, the pain may be a constant dull ache. Or it may radiate down the front of your thighs or into your lower back.

It’s not uncommon to have a headache, loose stools and nausea.

What causes it?

Menstrual cramps are due to an excessive amount of a hormone called prostaglandin or an undue sensitivity of uterine muscle to it.

Prostaglandins are involved in birth and menstrual cramps and can be likened to a “mini birth” with pain similar to labour pains.

In addition to prostaglandins, menstrual cramps can also be caused by:

„ Endometriosis Small cysts of menstrual tissue on your Fallopian tubes, ovaries and pelvis become swollen and painful.

„ Uterine fibroids These benign growths in the wall of the uterus can cause pain.

„ Pelvic inflammatory disease An infection of the female reproductive organs.

What’s the treatment?

„ Pain relievers Some painkillers are anti-prostaglandins, for instance naproxen and ibuprofen, and treat the cause of dysmenorrhea. Take them before your period starts and until the pain subsides.

„ The Pill Contains hormones that prevent ovulation and reduce the severity of menstrual cramps.

„ Surgery Can remove an underlying condition such as fibroids and endometriosis.

Self help

„ Exercise regularly Any physical activity eases menstrual cramps.

„ Heat A hot bath or hot water bottle might relieve the pain.

„ Supplements Vitamin B1 (thiamine), vitamin B6, vitamin E, omega-3 fatty acids and magnesium supplements may help.

The flu virus mutates so fast we need to tweak the vaccine every year. And while it’s a concern that Covid could throw up a new variant resistant to our vaccines, Danny Altmann, a professor of immunology at Imperial College London, thinks there’s little chance the virus will mutate leaving our vaccines ineffective.

Coronavirus seems to evolve at a slower rate than flu. “It’s quite a sluggish virus,” Altmann says. For comparison, the measles virus hasn’t dodged the immunity triggered by the measles vaccine which is 60 years old and still going strong. Our Covid vaccines might do the same.

If we measure the efficacy of vaccines in terms of their ability to prevent illness serious enough to warrant hospital admission, the variants of Covid which have emerged so far are still sensitive to our vaccines.

So confident is Pfizer that it recently announced its vaccine is effective against a virus which carries a mutation common to both the UK (Kent) and South African variants.

Spread of the virus facilitates the emergence of new variants. The longer a virus circulates, the more people it infects, the more it can mutate. So one of the ways to lower the chance of mutation is to contain the spread, then the virus has less chance to multiply inside our bodies. A virus like Covid which mutates comparatively slowly could be contained with annual boosters to keep up with any new mutations. So how long vaccine protect people for?

As yet we don’t know. We might have to get booster shots every year or every other year, like the flu shot. Or it may confer longerterm immunity, as vaccination does for measles or polio, because those viruses don’t mutate readily. If we’re lucky, immunity from a single jab might last as long as with polio and measles.

Here’s some good news. A new study from the Department of Biology and Centre for Infectious Diseases at The Pennsylvania University suggests that once enough people have gained immunity from Covid-19 – either through vaccination or natural infection – the virus may become “no more virulent than the common cold”.

In the future it may come to resemble the other cold viruses, in that once you’ve been exposed to it in childhood, it will cause only mild symptoms or no illness at all.

Altmann predicts Covid-19 could be reduced to seasonal outbreaks like flu, or it could become rare. And, like flu, every winter there’ll be people who die of Covid, with many patients in hospital and the world will accept it. will the

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Once exposed to it in childhood, it could cause only mild symptoms