Mensvärk

Mensvärk is the Swedish term for menstrual cramps, pain associated with the menstrual cycle. It commonly causes lower abdominal cramps and may involve the lower back or thighs. Most people have some discomfort during menses, but the severity varies. Cramps are termed primary dysmenorrhea when no other pelvic disease is present, and secondary dysmenorrhea when an underlying condition contributes to the pain.

Primary dysmenorrhea results from prostaglandins released by the uterine lining, which trigger strong uterine contractions and reduced blood flow. It typically begins within the first years after menarche and often improves with age or after childbirth. Secondary dysmenorrhea stems from conditions such as endometriosis, adenomyosis, fibroids, or pelvic inflammatory disease, and its pain may persist or change with time.

Symptoms include abdominal cramps, back pain, nausea, fatigue, and headaches. The timing is usually at the start of menstruation and lasts 1–3 days, though duration varies.

Diagnosis is mainly clinical. A clinician will assess history and may order tests (e.g., pregnancy test, ultrasound) if a secondary cause is suspected or red flags appear.

Management aims to relieve pain and reduce prostaglandin production. First-line treatment is NSAIDs (ibuprofen, naproxen) started at the onset of cramps. Acetaminophen may be used if NSAIDs are unsuitable. Hormonal contraception can lessen or stop pain by suppressing endometrial shedding. Nonpharmacologic options include heat, regular exercise, adequate sleep, hydration, and stress management. Evidence for supplements like magnesium or calcium is mixed.

Seek care if cramps are unusually severe, unresponsive to treatment, or accompanied by heavy or irregular bleeding, fever, vomiting, or signs suggesting another condition such as endometriosis.

Prognosis depends on cause: primary dysmenorrhea often improves with age or parity; secondary dysmenorrhea requires management of the underlying disease.