Hello Doctor,I suffer from severe cramps during that time of the month menstruation. All the pain killers and injections don’t really work for me because the pain only stops for a while and then resumes. A friend of mine advised me to resort to Coca Cola soda and hot water with lots of tea leaves. When I tried it, it worked for me although other people told me that coke and strong tea are harmful? What do you advise me to do?Leonie 24, Kimicanga resident

------------------------------------------------Dear Leonie,It is really very distressing to be "sick”, for 4 to 5 days every month. But almost more than 20% of young women suffer from painful cramps during menstruation. Sometimes the pain is so severe that one becomes incapacitated. Actually before menstruation, the inner wall of the uterus is prepared for receiving a baby. But when fertilisation does not occur, this breaks down causing bleeding. Release of prostaglandin and uterine contractions are said to be the cause of this pain. Usually the problem reduces or is solved after the first delivery. It also reduces with advancing age.Most of the times, the pain is relieved by pain killer tablets, which should be taken  in full dose at least 2 to 3 times, at intervals of 8 to 12 hours, for the number of days severe pain lasts. But these tablets pose the risk of causing burning pain in the abdomen with nausea and vomiting as adverse effects.Hormonal treatment is given for severe pain, but it can cause many adverse effects like prolonged bleeding, risk of clotting, heart disease, e.t.c. Some studies suggest that using supplements of vitamin B. complex helps in alleviating painful cramps during menstruation.Along with pain relieving drugs, you can try doing some hot fomentation. Using a hot water bag will also help reduce the pain.   You need to take sufficient sleep before and on those "days” of the month. Overworking or fatigue can also aggravate pain or prevent adequate reprieve. Total relaxation by means of meditation or yoga is also said to help women feel comfortable during days of monthly periods.  The pain can be kept in control also by doing regular stretching exercises.  Good perineal hygiene will ensure prevention of pelvic infections. Drinking a lot of water will prevent urinary tract infections. Thus, one can avoid these 2 causes which can also cause and aggravate discomfort during menses. Try these measures first.If the problem continues, get yourself examined for some other problem of the uterus causing dysmenorrhoea, like uterine fibroids or endometriosis.  If that is the case, taking treatment for it shall cure the problem completely. But using a lot of soda or strong tea is not advisable for the cramps. You may feel good after taking them because of the sugar content of the soda or brain stimulant effect of amphetamine present in the tea. Also, coke and other sodas work as carminative, reducing any discomfort or bloating sensation, thus making one feel good. But they can also cause excess acid in the stomach resulting in a burning pain. Over a long time, there is a real risk of having stomach ulcers. They can also cause obesity with attendant problems like diabetes and hypertension.Dr. Rachna Pande