Why Do Periods Hurt?
Overview
The process of your uterus sheds its lining every month is called menstruation. Some discomfort during your period is common, but intense or crippling pain that interferes with your life is not.
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Having painful periods is a condition called dysmenorrhea. It’s the most commonly reported menstrual disorder: More than half of menstruating women report pain for at least one or two days every month.
Painful periods can be classified into two types:
- Primary dysmenorrhea usually starts soon after the first period. It’s often caused by prostaglandins, which naturally occur in the body.
- Secondary dysmenorrhea typically occurs later in life and often stems from a reproductive disorder.
No matter which one you’re experiencing, there are ways to address and alleviate the pain.
Symptoms
Symptoms of menstrual cramps include:
- Throbbing or cramping pain in your lower abdomen that can be intense
- Pain that starts 1 to 3 days before your period, peaks 24 hours after the onset of your period and subsides in 2 to 3 days
- Dull, continuous ache
- Pain that radiates to your lower back and thighs
Some women also have:
- Nausea
- Loose stools
- Headache
- Dizziness
When to see a doctor
See your doctor if:
- Menstrual cramps disrupt your life every month
- Your symptoms progressively worsen
- You just started having severe menstrual cramps after age 25
A variety of painful symptoms may accompany menstrual periods. Sometimes symptoms can occur shortly before your period actually starts. They typically taper off during the first few days of your period.
Prostaglandins
Cramps are caused by the hormone-like lipids called prostaglandins that make your uterus contract to help get rid of its lining.
Prostaglandins are also involved in inflammation and pain responses. They reside in the uterine lining and are also released from this lining.
Once released, they increase the force of the contractions during the first couple of days of your period. The higher the level of prostaglandins, the more severe the cramping is.
Very high levels can also cause nausea and diarrhea. As the lining is shed, the levels of prostaglandins in your body are lowered. This is why cramps typically subside after the first couple of days of your period.
Other possible causes of menstrual cramps include:
- endometriosis
- fibroids
- pelvic inflammatory disease
- cervical stenosis
Pain relievers like ibuprofen (Advil) can help relieve cramps. But if the pain isn’t lessened at all with an over-the-counter pain reliever, talk with your doctor about whether hormonal treatment is an option.
Risk factors
You might be at risk of menstrual cramps if:
- You're younger than age 30
- You started puberty early, at age 11 or younger
- You bleed heavily during periods (menorrhagia)
- You have irregular menstrual bleeding (metrorrhagia)
- You have a family history of menstrual cramps (dysmenorrhea)
- You smoke
Complications
Menstrual cramps don't cause other medical complications, but they can interfere with school, work, and social activities.
Certain conditions associated with menstrual cramps can have complications, though. For example, endometriosis can cause fertility problems. Pelvic inflammatory disease can scar your fallopian tubes, increasing the risk of a fertilized egg implanting outside of your uterus (ectopic pregnancy).