Normal Menstrual Cycle

Managing Menstrual Cycle Symptoms and Bleeding

Keep a calendar and mark the day you start your menstrual period each month. If your cycle is regular, it can help you predict when you'll have your next period. It's also important to know the date of your last menstrual period (LMP) when you're pregnant and need to estimate your due date.

If you're trying to figure out whether you have a pattern of premenstrual symptoms, it may be helpful to keep a premenstrual daily symptom diary(What is a PDF document?).

You can improve your body's ability to handle menstrual changes by getting regular exercise, eating a healthy diet, limiting alcohol and caffeine intake, and reducing stress. Non-prescription pain relievers can also help reduce some symptoms.

Medication for menstrual pain and bleeding

Try a non-prescription medicine to help relieve your pain and bleeding. Start taking the recommended dose of pain reliever when symptoms begin or 1 day before your menstrual period starts. If you are trying to become pregnant, talk to your health professional before using any medicine.

• Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (for example, Advil), reduce menstrual cramps, pain, and bleeding by lowering the level of the hormone prostaglandin.^{2, 3}
• If NSAIDs do not relieve the pain, try acetaminophen, such as Tylenol or Panadol.
• Take the medicine for as long as the symptoms would normally last if you did not take the medicine.

Be sure to follow all labels and instructions. Do not take ASA (Aspirin) if you are younger than 20 because of the risk of Reye's syndrome.

Additional measures for relieving menstrual cramps

• Apply heat to your abdomen with a heating pad or hot water bottle, or take a warm bath. Heat improves blood flow and may decrease pelvic pain.
• Lie down and elevate your legs by putting a pillow under your knees.
• Lie on your side and bring your knees up toward your chest. This will help relieve back pressure.
• Get regular exercise. This improves blood flow, produces pain-fighting endorphins, and may reduce pain.
• If you have vaginal pain with cramps, try using pads instead of tampons.

For more information on managing menstrual cramps, see:

Managing menstrual cramps

Managing menstrual bleeding

You can choose from a range of pad and tampon choices for managing menstrual bleeding. Follow all instructions included with the product of your choice.

• Tampons range from small to large, for light to heavy flow. You can place a tampon in the vagina by using a slender tube (that is packaged with the tampon) or by tucking it in with a finger. It's important to change a tampon every 4 to 6 hours. This helps prevent leakage as well as infection.
• Pads range from thin and light to thick and super absorbent. They protect your clothing, with or without using a tampon. Pads may be your best choice for use at night.

Whichever you use, be sure to change it regularly. Tampons are ideal for activities that pads aren't practical for, such as swimming. Tampons should be changed every 4 to 6 hours, so they aren't recommended for nighttime use. It may take some experimenting to find the right feminine care products for you.

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Author:	Shannon Erstad, MBA/MPH Marianne Flagg Carrie Henley	Last Updated: June 27, 2007
Medical Review:	Kathleen Romito, MD - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology Andrew Swan, MD, CCFP, FCFP - Family Medicine
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