What are the differences between normal and severe menstrual cramps. How can you identify the underlying causes of intense period pain. What are effective relief strategies for managing severe menstrual discomfort.

Understanding Menstrual Cramps: Normal vs. Severe Pain

Menstrual cramps, also known as dysmenorrhea, are a common experience for many individuals during their menstrual cycle. These cramps can range from mild discomfort to severe pain that disrupts daily activities. To better understand the spectrum of menstrual pain, it’s crucial to differentiate between normal and severe cramps.

Characteristics of Normal Menstrual Cramps

Normal menstrual cramps typically present as:

• A throbbing or cramping pain in the lower abdomen
• Pressure or a continuous dull ache in the pelvic area
• Pain that may radiate to the lower back and inner thighs
• Discomfort that begins a day or two before menstruation
• Pain that peaks around 24 hours after the period starts
• Cramps lasting for two to three days

Identifying Severe Menstrual Cramps

Severe menstrual cramps, on the other hand, are characterized by:

• Pain that doesn’t improve with over-the-counter (OTC) pain medications
• Discomfort that significantly interferes with daily activities
• Cramps often accompanied by heavy bleeding or clotting
• Pain that begins earlier in the menstrual cycle
• Cramping that lasts longer than typical menstrual pain

Are severe menstrual cramps always a cause for concern? While occasional intense cramps may not necessarily indicate a serious problem, persistent severe pain warrants medical attention. It’s essential to consult a healthcare professional if you regularly experience debilitating menstrual cramps that disrupt your quality of life.

The Physiology Behind Menstrual Cramps

To comprehend why some individuals experience more severe menstrual pain than others, it’s important to understand the underlying physiological mechanisms at play.

The Role of Prostaglandins

During menstruation, the uterus contracts to shed its lining. These contractions are triggered by hormone-like substances called prostaglandins. Higher levels of prostaglandins are associated with more intense menstrual cramps. This explains why some individuals may be more prone to severe pain without any clear underlying medical condition.

Hormonal Fluctuations

Hormonal changes throughout the menstrual cycle can also influence the severity of cramps. Estrogen and progesterone levels fluctuate, affecting uterine contractions and sensitivity to pain. Some individuals may be more susceptible to these hormonal shifts, resulting in more intense cramping.

Underlying Causes of Severe Menstrual Cramps

While some people experience severe menstrual cramps without any clear cause, for others, intense pain may be a symptom of an underlying medical condition. Understanding these potential causes can help in seeking appropriate medical care and treatment.

Endometriosis: A Common Culprit

Endometriosis is a chronic, noncancerous condition where cells resembling the uterus lining grow outside the uterus. This condition can cause severe pelvic pain, especially during menstruation. Other symptoms of endometriosis include:

• Heavy periods
• Periods lasting longer than seven days
• Bleeding between periods
• Gastrointestinal pain
• Pain during intercourse
• Painful bowel movements
• Difficulty conceiving

Can endometriosis be effectively managed? While there is no cure for endometriosis, various treatment options are available to manage symptoms and improve quality of life. These may include pain medications, hormone therapy, and in some cases, surgical interventions.

Polycystic Ovary Syndrome (PCOS)

PCOS is a common hormonal disorder affecting approximately 1 in 10 women of childbearing age. While irregular periods are a hallmark of PCOS, some individuals may experience severe menstrual cramps when they do menstruate. Other symptoms of PCOS include:

• Heavy or prolonged periods
• Excessive facial and body hair
• Weight gain and difficulty losing weight
• Acne
• Thinning hair or hair loss
• Multiple skin tags
• Dark patches of skin, especially in skin creases

Uterine Fibroids

Fibroids are noncancerous growths that develop inside or outside of the uterus. They can range in size from as small as a seed to large masses that cause an enlarged uterus. While some individuals with fibroids may be asymptomatic, others may experience severe menstrual cramps. Additional symptoms of fibroids can include:

• Pelvic pressure
• Lower back pain
• Leg pain
• Heavy periods
• Periods lasting more than a week
• Constipation
• Frequent urination

Diagnosing the Cause of Severe Menstrual Cramps

If you’re experiencing persistent severe menstrual cramps, seeking medical attention is crucial for proper diagnosis and treatment. Healthcare professionals may use various methods to determine the underlying cause of your pain.

Medical History and Physical Examination

Your doctor will likely begin by taking a detailed medical history, including information about your menstrual cycle, the nature of your pain, and any other symptoms you may be experiencing. A physical examination, including a pelvic exam, may also be performed to check for any visible abnormalities.

Imaging Tests

Depending on your symptoms and initial examination, your healthcare provider may recommend imaging tests such as:

• Ultrasound: This non-invasive test uses sound waves to create images of your reproductive organs.
• MRI (Magnetic Resonance Imaging): This test provides detailed images of your pelvic area and can help identify conditions like endometriosis or fibroids.
• CT (Computed Tomography) scan: This imaging technique can help detect abnormalities in your pelvic region.

Laparoscopy

In some cases, a laparoscopy may be recommended. This minimally invasive surgical procedure allows the doctor to directly visualize your pelvic organs and can be particularly useful in diagnosing conditions like endometriosis.

Relief Strategies for Severe Menstrual Cramps

Managing severe menstrual cramps often requires a multi-faceted approach. While the specific treatment plan may vary depending on the underlying cause, several strategies can help alleviate pain and discomfort.

Over-the-Counter Pain Relievers

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help reduce pain and inflammation associated with menstrual cramps. These medications work by lowering prostaglandin levels, which are responsible for uterine contractions.

Heat Therapy

Applying heat to your lower abdomen can help relax the uterine muscles and alleviate pain. You can use a heating pad, hot water bottle, or take a warm bath to experience relief. Some individuals find that alternating between heat and cold therapy provides additional comfort.

Exercise and Stretching

Regular physical activity, particularly during your period, can help reduce the severity of menstrual cramps. Gentle exercises like walking, swimming, or yoga can improve blood circulation and release endorphins, which are natural pain relievers. Specific stretches targeting the lower back and pelvic area may also provide relief.

Dietary Modifications

Certain dietary changes may help alleviate menstrual pain:

• Increase intake of omega-3 fatty acids, found in fish, flaxseeds, and walnuts
• Consume more fruits, vegetables, and whole grains
• Reduce intake of caffeine, alcohol, and salty foods
• Stay hydrated by drinking plenty of water

Herbal Remedies and Supplements

Some individuals find relief from menstrual cramps through herbal remedies and supplements. These may include:

• Ginger: Known for its anti-inflammatory properties
• Cinnamon: May help reduce menstrual bleeding and pain
• Magnesium: Can help relax uterine muscles
• Vitamin E: May help reduce pain intensity

It’s important to consult with a healthcare provider before starting any new supplements, as they may interact with other medications or have side effects.

Medical Treatments for Severe Menstrual Cramps

When lifestyle changes and over-the-counter remedies are insufficient, medical treatments may be necessary to manage severe menstrual cramps, especially if they are caused by underlying conditions.

Hormonal Birth Control

Hormonal contraceptives, such as birth control pills, patches, or intrauterine devices (IUDs), can help regulate menstrual cycles and reduce the severity of cramps. These methods work by thinning the uterine lining and lowering prostaglandin levels.

Prescription Pain Medications

In cases of severe pain, your doctor may prescribe stronger pain medications. These might include prescription-strength NSAIDs or, in some cases, opioid pain relievers for short-term use.

Hormonal Treatments

For conditions like endometriosis or PCOS, hormonal treatments may be recommended. These can include:

• Gonadotropin-releasing hormone (GnRH) agonists
• Danazol
• Progestin-only therapies

These treatments aim to suppress ovulation and reduce estrogen levels, which can help alleviate pain and other symptoms.

Surgical Interventions

In some cases, surgical procedures may be necessary to treat the underlying cause of severe menstrual cramps:

• Laparoscopic surgery for endometriosis
• Myomectomy or hysterectomy for uterine fibroids
• Endometrial ablation for heavy menstrual bleeding

The choice of surgical intervention depends on the specific condition, its severity, and the individual’s reproductive goals.

When to Seek Medical Attention for Menstrual Cramps

While some level of discomfort during menstruation is normal, certain signs indicate the need for medical evaluation. It’s important to consult a healthcare provider if you experience:

• Severe pain that interferes with daily activities
• Cramps that worsen over time or with age
• Pain that lasts longer than the first few days of your period
• Heavy menstrual bleeding or large blood clots
• Severe pain accompanied by fever or nausea
• Sudden changes in your menstrual pattern
• Pain during intercourse
• Difficulty getting pregnant

Early intervention can lead to better management of symptoms and prevent potential complications associated with underlying conditions.

The Impact of Severe Menstrual Cramps on Quality of Life

Severe menstrual cramps can have a significant impact on an individual’s quality of life, affecting various aspects of daily functioning and well-being.

Physical Limitations

Intense pain can limit physical activities, making it difficult to perform routine tasks at work, school, or home. Some individuals may need to take time off or limit their engagements during their menstrual period.

Emotional and Psychological Effects

Chronic pain associated with severe menstrual cramps can lead to:

• Increased stress and anxiety
• Mood swings
• Feelings of frustration or helplessness
• Depression in some cases

Social and Relationship Impacts

Severe menstrual pain may affect social interactions and relationships. Individuals might feel compelled to cancel plans or avoid social engagements due to pain or discomfort.

Productivity and Economic Consequences

Missed work days or reduced productivity due to severe menstrual cramps can have economic implications. Studies have shown that menstrual disorders, including severe cramps, contribute to significant work absenteeism and presenteeism (reduced productivity while at work).

How can individuals cope with the impact of severe menstrual cramps on their quality of life? Developing a comprehensive management plan with a healthcare provider is crucial. This may include pain management strategies, lifestyle adjustments, and addressing any underlying conditions. Additionally, seeking support from friends, family, or support groups can help in dealing with the emotional and psychological aspects of chronic menstrual pain.

Myth-Busting: Common Misconceptions About Menstrual Cramps

There are several misconceptions surrounding menstrual cramps that can lead to misunderstanding and inadequate treatment. Let’s address some of these myths:

Myth: Severe Menstrual Pain is Normal

While some discomfort during menstruation is common, severe pain that disrupts daily life is not normal. Persistent intense pain should be evaluated by a healthcare professional.

Myth: Only Teenagers Experience Bad Cramps

Severe menstrual cramps can affect individuals of any age. In fact, some conditions that cause intense cramping, like endometriosis, may develop or worsen with age.

Myth: Having Children Cures Menstrual Cramps

While some individuals may experience changes in menstrual pain after childbirth, having children does not guarantee relief from severe cramps, especially if they are caused by underlying conditions.

Myth: Exercise Makes Cramps Worse

Contrary to this belief, moderate exercise can often help alleviate menstrual cramps by improving blood circulation and releasing endorphins.

Myth: Menstrual Pain is All in Your Head

Menstrual cramps are a real physiological phenomenon caused by uterine contractions and hormonal changes. Severe pain should be taken seriously and not dismissed as imaginary or exaggerated.

Dispelling these myths is crucial for promoting better understanding and encouraging individuals to seek appropriate care for severe menstrual cramps. Education and open dialogue about menstrual health can help reduce stigma and ensure that those experiencing intense pain receive the support and treatment they need.

Normal vs. Severe Pain, Causes, Relief Tips

Severe Menstrual Cramps: Normal vs. Severe Pain, Causes, Relief Tips

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Medically reviewed by Deborah Weatherspoon, Ph. D., MSN — By Adrienne Santos-Longhurst — Updated on February 28, 2023

If you have severe menstrual cramps that disrupt your daily life, regular exercise, heating pads, and some supplements could make a difference. For severe pain, a healthcare professional may be able to recommend strategies for lasting relief.

Menstrual cramps can range from a mild nuisance lasting a day or two to several days of unbearable pain that interferes with everyday activities. They’re one of the most common causes of pelvic pain and many experience them just before and during their period.

The pain is caused by uterine contractions that happen just before or during the onset of your period. But what makes the pain more severe for some people?

Read on to learn more about the potential causes of severe cramps and how to manage the pain.

Menstrual cramps feel like a throbbing or cramping pain in your lower abdomen. You may also feel pressure or a continuous dull ache in the area. The pain may radiate to your lower back and inner thighs.

Cramps usually begin a day or two before your period, peaking around 24 hours after your period starts. They typically last for two to three days.

Menstrual cramps can be accompanied by other symptoms, including:

• nausea
• fatigue
• loose stools
• headache
• dizziness

Typical menstrual cramps are painful, but they usually respond well to over-the-counter (OTC) pain relievers, including ibuprofen.

Severe cramps, however, tend to begin earlier in the menstrual cycle and last longer than typical cramps do.

signs of severe cramps

Not sure if your cramps are typical or severe? Generally, severe menstrual cramps:

• don’t improve when you take OTC pain medication
• interfere with your daily activities
• are often accompanied by heavy bleeding or clotting

During your period, your uterus contracts to help shed its lining. These contractions are triggered by hormone-like substances called prostaglandins. Higher levels of prostaglandins are associated with more severe menstrual cramps.

Some people tend to have more severe menstrual cramps without any clear cause. For others, severe menstrual cramps may be a symptom of an underlying medical condition.

Endometriosis

Endometriosis is a chronic, noncancerous condition where cells that resemble the uterus lining, called endometrial cells, grow outside the uterus.

Pelvic pain is the most common symptom. Others include:

• heavy periods
• periods that last longer than seven days
• bleeding between periods
• gastrointestinal pain
• pain with intercourse
• painful bowel movements
• trouble getting pregnant

Polycystic ovary syndrome (PCOS)

PCOS is a common hormone disorder affecting approximately 1 in 10 women of childbearing age. Higher levels of androgens, which are male hormones, and irregular periods are common symptoms.

Other symptoms of PCOS include:

• heavy periods
• prolonged periods
• excessive facial and body hair
• weight gain and trouble losing weight
• acne
• thinning hair or hair loss
• multiple skin tags
• dark patches of skin, especially in the creases of the neck and groin

Fibroids

Fibroids are noncancerous growths that develop inside or outside of the uterus. They range in size from as small as a seed to large masses that can cause an enlarged uterus. You can have one or more fibroids, often without symptoms.

When fibroids do causes symptoms, the symptoms vary depending on the number of fibroids, their size, and location.

In addition to severe mensural cramps, fibroids can also cause:

• pelvic pressure
• lower back pain
• leg pain
• heavy periods
• periods that last more than a week
• constipation
• frequent urination
• difficulty emptying the bladder

Pelvic inflammatory disease (PID)

PID is a bacterial infection of the female reproductive organs. It’s usually caused by sexually transmitted infections (STIs), such as chlamydia and gonorrhea. Other infections that aren’t sexually transmitted can also cause it.

Pelvic pain is the most common symptom of PID. Other symptoms include:

• painful intercourse
• bleeding during or after sex
• foul-smelling vaginal discharge
• burning sensation when urinating
• fever
• spotting between periods

Cervical stenosis

Cervical stenosis, which is also called a closed cervix, happens when the opening of your cervix is narrow or completely closed. You can be born with a cervical stenosis or develop it later.

A closed cervix can prevent menstrual blood from exiting your body, making your periods very light or irregular. It can also lead to fertility issues.

Adenomyosis

Adenomyosis is a thickening of the uterus. It occurs when the endometrial tissue that lines your uterus grows into the muscles of your uterus.

The tissue continues to function as it usually would throughout your cycle — thickening, breaking down, and exiting your body. This causes your uterus to grow two to three times its normal size.

Adenomyosis doesn’t always cause symptoms. When it does, you may notice severe menstrual cramps that get increasingly worse, as well as heavy or prolonged menstrual bleeding.

Intrauterine device (IUD)

An IUD is a small birth control device that’s inserted into your uterus. There are different types of IUDs available, some containing hormones while others are hormone-free.

They’re safe for most people, but they can occasionally cause side effects, including:

• severe menstrual cramps
• irregular periods
• heavy menstrual bleeding

There’s also a small risk of the IUD perforating your uterus during insertion or bacteria entering your uterus during insertion, causing PID. Expulsion is another rare possibility, which is when the IUD moves out of place. All of these can cause severe pelvic pain.

If you have very painful menstrual cramps or cramps that last longer than two or three days, make an appointment with your healthcare provider.

They’ll likely start by reviewing your medical history and performing a physical exam, including a pelvic exam. They may also give you a Pap test.

Depending on your other symptoms, they may recommend additional tests, including:

• an ultrasound to check the size and thickness of your uterus as well as detect fibroids or cysts
• a CT scan, which can provide a detailed view of your reproductive organs
• gynecologic laparoscopy, a minimally invasive surgical procedure, to confirm a diagnosis of endometriosis

Severe menstrual cramps are typically hard to treat on your own, but these tips may help while you work with your healthcare provider to narrow down an underlying cause:

• Get regular exercise. Results of a 2015 study showed that doing 30 minutes of aerobic exercise three times a week significantly reduced the severity of menstrual cramps over the course of 8 weeks.
• Use a heating pad. There’s evidence that heat may be as effective as ibuprofen for relieving menstrual cramps. Place a heating pad on your lower abdomen for relief.
• Manage your stress. Work and general life stress has been linked to menstrual cramps. Breathing exercises, yoga, and spending time doing things that you enjoy can help keep your stress down.
• Soak in a hot bath. Soaking in a hot bath soothes your lower abdomen and back. It’s also relaxing and a great way to relieve stress.
• Take supplements. Certain supplements may help reduce the severity of menstrual cramps. These include omega-3 fatty acids, magnesium, and vitamins B-1 and B-6.
• OTC pain medication. OTC pain relievers, such as ibuprofen and acetaminophen, often aren’t enough to completely eliminate severe menstrual cramps. If you take them a day before you usually start to experience cramps, they may be more effective.

You don’t have to power through severe menstrual cramps. If your pain interferes with your ability to go on about your day or lasts longer than two or three days, talk to your healthcare provider. They can help you get to the bottom of what’s causing your severe cramps and recommend a plan to keep the pain under control.

Last medically reviewed on May 10, 2019

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Adenomyosis. (2017).
  my.clevelandclinic.org/health/diseases/14167-adenomyosis
• Dehnavi ZM, et al. (2018). The effect of aerobic exercise on primary dysmenorrhea: A clinical trial study. DOI:
  10.4103/jehp.jehp_79_17
• Dysmenorrhea. (2014).
  my.clevelandclinic.org/health/diseases/4148-dysmenorrhea
• Intrauterine device (IUD). (2017).
  hhs.gov/opa/pregnancy-prevention/birth-control-methods/iud/index.html
• Ju H, et al. (2014). The prevalence and risk factors of dysmenorrhea. DOI:
  10.1093/epirev/mxt009
• Mayo Clinic Staff. (2018). Uterine fibroids.
  mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288
• Osayande AS, et al. (2014). Diagnosis and initial management of dysmenorrhea.
  aafp.org/afp/2014/0301/p341.html
• Parasar P, et al. (2017). Endometriosis: Epidemiology, diagnosis and clinical management.
  ncbi.nlm.nih.gov/pmc/articles/PMC5737931/
• Pelvic inflammatory disease (PID) – CDC fact sheet. (2015).
  cdc.gov/std/pid/stdfact-pid.htm
• Polycystic ovary syndrome. (2019).
  womenshealth.gov/a-z-topics/polycystic-ovary-syndrome
• Rigi N, et al. (2012). Comparing the analgesic effect of heat patch containing iron chip and ibuprofen for primary dysmenorrhea: a randomized controlled trial. DOI:
  10.1186/1472-6874-12-25

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Feb 28, 2023

Written By

Adrienne Santos-Longhurst

Edited By

Phil Riches

May 10, 2019

Written By

Adrienne Santos-Longhurst

Edited By

Phil Riches

Medically Reviewed By

Deborah Weatherspoon, Ph.D., MSN

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Medically reviewed by Deborah Weatherspoon, Ph.D., MSN — By Adrienne Santos-Longhurst — Updated on February 28, 2023

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Medically reviewed by Deborah Weatherspoon, Ph. D., MSN — By Adrienne Santos-Longhurst — Updated on February 28, 2023

If you have severe menstrual cramps that disrupt your daily life, regular exercise, heating pads, and some supplements could make a difference. For severe pain, a healthcare professional may be able to recommend strategies for lasting relief.

Menstrual cramps can range from a mild nuisance lasting a day or two to several days of unbearable pain that interferes with everyday activities. They’re one of the most common causes of pelvic pain and many experience them just before and during their period.

The pain is caused by uterine contractions that happen just before or during the onset of your period. But what makes the pain more severe for some people?

Read on to learn more about the potential causes of severe cramps and how to manage the pain.

Menstrual cramps feel like a throbbing or cramping pain in your lower abdomen. You may also feel pressure or a continuous dull ache in the area. The pain may radiate to your lower back and inner thighs.

Cramps usually begin a day or two before your period, peaking around 24 hours after your period starts. They typically last for two to three days.

Menstrual cramps can be accompanied by other symptoms, including:

• nausea
• fatigue
• loose stools
• headache
• dizziness

Typical menstrual cramps are painful, but they usually respond well to over-the-counter (OTC) pain relievers, including ibuprofen.

Severe cramps, however, tend to begin earlier in the menstrual cycle and last longer than typical cramps do.

signs of severe cramps

Not sure if your cramps are typical or severe? Generally, severe menstrual cramps:

• don’t improve when you take OTC pain medication
• interfere with your daily activities
• are often accompanied by heavy bleeding or clotting

During your period, your uterus contracts to help shed its lining. These contractions are triggered by hormone-like substances called prostaglandins. Higher levels of prostaglandins are associated with more severe menstrual cramps.

Some people tend to have more severe menstrual cramps without any clear cause. For others, severe menstrual cramps may be a symptom of an underlying medical condition.

Endometriosis

Endometriosis is a chronic, noncancerous condition where cells that resemble the uterus lining, called endometrial cells, grow outside the uterus.

Pelvic pain is the most common symptom. Others include:

• heavy periods
• periods that last longer than seven days
• bleeding between periods
• gastrointestinal pain
• pain with intercourse
• painful bowel movements
• trouble getting pregnant

Polycystic ovary syndrome (PCOS)

PCOS is a common hormone disorder affecting approximately 1 in 10 women of childbearing age. Higher levels of androgens, which are male hormones, and irregular periods are common symptoms.

Other symptoms of PCOS include:

• heavy periods
• prolonged periods
• excessive facial and body hair
• weight gain and trouble losing weight
• acne
• thinning hair or hair loss
• multiple skin tags
• dark patches of skin, especially in the creases of the neck and groin

Fibroids

Fibroids are noncancerous growths that develop inside or outside of the uterus. They range in size from as small as a seed to large masses that can cause an enlarged uterus. You can have one or more fibroids, often without symptoms.

When fibroids do causes symptoms, the symptoms vary depending on the number of fibroids, their size, and location.

In addition to severe mensural cramps, fibroids can also cause:

• pelvic pressure
• lower back pain
• leg pain
• heavy periods
• periods that last more than a week
• constipation
• frequent urination
• difficulty emptying the bladder

Pelvic inflammatory disease (PID)

PID is a bacterial infection of the female reproductive organs. It’s usually caused by sexually transmitted infections (STIs), such as chlamydia and gonorrhea. Other infections that aren’t sexually transmitted can also cause it.

Pelvic pain is the most common symptom of PID. Other symptoms include:

• painful intercourse
• bleeding during or after sex
• foul-smelling vaginal discharge
• burning sensation when urinating
• fever
• spotting between periods

Cervical stenosis

Cervical stenosis, which is also called a closed cervix, happens when the opening of your cervix is narrow or completely closed. You can be born with a cervical stenosis or develop it later.

A closed cervix can prevent menstrual blood from exiting your body, making your periods very light or irregular. It can also lead to fertility issues.

Adenomyosis

Adenomyosis is a thickening of the uterus. It occurs when the endometrial tissue that lines your uterus grows into the muscles of your uterus.

The tissue continues to function as it usually would throughout your cycle — thickening, breaking down, and exiting your body. This causes your uterus to grow two to three times its normal size.

Adenomyosis doesn’t always cause symptoms. When it does, you may notice severe menstrual cramps that get increasingly worse, as well as heavy or prolonged menstrual bleeding.

Intrauterine device (IUD)

An IUD is a small birth control device that’s inserted into your uterus. There are different types of IUDs available, some containing hormones while others are hormone-free.

They’re safe for most people, but they can occasionally cause side effects, including:

• severe menstrual cramps
• irregular periods
• heavy menstrual bleeding

There’s also a small risk of the IUD perforating your uterus during insertion or bacteria entering your uterus during insertion, causing PID. Expulsion is another rare possibility, which is when the IUD moves out of place. All of these can cause severe pelvic pain.

If you have very painful menstrual cramps or cramps that last longer than two or three days, make an appointment with your healthcare provider.

They’ll likely start by reviewing your medical history and performing a physical exam, including a pelvic exam. They may also give you a Pap test.

Depending on your other symptoms, they may recommend additional tests, including:

• an ultrasound to check the size and thickness of your uterus as well as detect fibroids or cysts
• a CT scan, which can provide a detailed view of your reproductive organs
• gynecologic laparoscopy, a minimally invasive surgical procedure, to confirm a diagnosis of endometriosis

Severe menstrual cramps are typically hard to treat on your own, but these tips may help while you work with your healthcare provider to narrow down an underlying cause:

• Get regular exercise. Results of a 2015 study showed that doing 30 minutes of aerobic exercise three times a week significantly reduced the severity of menstrual cramps over the course of 8 weeks.
• Use a heating pad. There’s evidence that heat may be as effective as ibuprofen for relieving menstrual cramps. Place a heating pad on your lower abdomen for relief.
• Manage your stress. Work and general life stress has been linked to menstrual cramps. Breathing exercises, yoga, and spending time doing things that you enjoy can help keep your stress down.
• Soak in a hot bath. Soaking in a hot bath soothes your lower abdomen and back. It’s also relaxing and a great way to relieve stress.
• Take supplements. Certain supplements may help reduce the severity of menstrual cramps. These include omega-3 fatty acids, magnesium, and vitamins B-1 and B-6.
• OTC pain medication. OTC pain relievers, such as ibuprofen and acetaminophen, often aren’t enough to completely eliminate severe menstrual cramps. If you take them a day before you usually start to experience cramps, they may be more effective.

You don’t have to power through severe menstrual cramps. If your pain interferes with your ability to go on about your day or lasts longer than two or three days, talk to your healthcare provider. They can help you get to the bottom of what’s causing your severe cramps and recommend a plan to keep the pain under control.

Last medically reviewed on May 10, 2019

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Adenomyosis. (2017).
  my.clevelandclinic.org/health/diseases/14167-adenomyosis
• Dehnavi ZM, et al. (2018). The effect of aerobic exercise on primary dysmenorrhea: A clinical trial study. DOI:
  10.4103/jehp.jehp_79_17
• Dysmenorrhea. (2014).
  my.clevelandclinic.org/health/diseases/4148-dysmenorrhea
• Intrauterine device (IUD). (2017).
  hhs.gov/opa/pregnancy-prevention/birth-control-methods/iud/index.html
• Ju H, et al. (2014). The prevalence and risk factors of dysmenorrhea. DOI:
  10.1093/epirev/mxt009
• Mayo Clinic Staff. (2018). Uterine fibroids.
  mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288
• Osayande AS, et al. (2014). Diagnosis and initial management of dysmenorrhea.
  aafp.org/afp/2014/0301/p341.html
• Parasar P, et al. (2017). Endometriosis: Epidemiology, diagnosis and clinical management.
  ncbi.nlm.nih.gov/pmc/articles/PMC5737931/
• Pelvic inflammatory disease (PID) – CDC fact sheet. (2015).
  cdc.gov/std/pid/stdfact-pid.htm
• Polycystic ovary syndrome. (2019).
  womenshealth.gov/a-z-topics/polycystic-ovary-syndrome
• Rigi N, et al. (2012). Comparing the analgesic effect of heat patch containing iron chip and ibuprofen for primary dysmenorrhea: a randomized controlled trial. DOI:
  10.1186/1472-6874-12-25

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

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Feb 28, 2023

Written By

Adrienne Santos-Longhurst

Edited By

Phil Riches

May 10, 2019

Written By

Adrienne Santos-Longhurst

Edited By

Phil Riches

Medically Reviewed By

Deborah Weatherspoon, Ph.D., MSN

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Medically reviewed by Deborah Weatherspoon, Ph.D., MSN — By Adrienne Santos-Longhurst — Updated on February 28, 2023

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all causes and how to deal with them

Contents

• 1 Causes of menstrual pain and cramps: how to eliminate them
  • 1.1 Causes of menstrual pain and cramps
    • 1.1.1 Hormonal changes
    • 1.1.2 Incorrect posture and posture
    • 1.1.3 Circulatory disorders
    • 1.1.4 Medical problems
  • 1.2 The impact of menstrual pain on a woman’s life
  • 1.3 Categories of pain
  • 1.4 How to tell if it’s menstrual pain
  • 1.5 Need to see a doctor for menstrual cramps and cramps
  • 1.6 Medicines for menstrual cramps and cramps
  • 1.7 Non-drug treatments for pain and cramps
    90 005 1.7.1 Heat therapy
    • 1.7 .2 Meditation and relaxation
    • 1. 7.3 Massage
    • 1.7.4 Exercise
    • 1.7.5 Diet
  • 1.8 Pain relief techniques at home
    • 1.8.1 Heat and massage
    • 1.8.2 Topical products
    • 1.8.3 Nutritional support
    • 1.8.4 Fitness and yoga
    • 1.8.5 Preventive measures
  • 1.9 Methods for alleviating pain at work
  • 1.10 Prevention of menstrual pain and cramps
  • 1.11 Related videos:
  • 1.12 Q&A:
    • • 1.12.0.1 What are the main causes of menstrual pain and cramps?
      • 1.12.0.2 What methods help reduce or get rid of menstrual cramps and cramps?
      • 1.12.0.3 How to eat right during menstruation to avoid pain and cramps?
      • 1.12.0.4 Can pain and cramps during menstruation affect the psychological state?
      • 1.12.0.5 What types of medicines can be taken for menstrual cramps and cramps?
      • 1.12.0.6 What are effective relaxation techniques that help relieve pain and cramps during menstruation?

Find out why menstrual cramps and cramps occur, how to deal with them and overcome dysfunction. Read our useful article and get the necessary tips and tricks.

Every month in a woman’s life there is an unpleasant symptom – menstrual cramps and cramps. The feeling of discomfort in the lower abdomen is accompanied by painful cramps, which can reduce the quality of life and affect daily activities. This symptom determines the mood for the rest of the week, and not every woman can quickly and easily cope with them.

Such pains can be the first signal about the presence of certain disorders in the body. However, it is not always possible to independently determine what exactly causes pain. It is important to understand what methods can help reduce pain and what actions can be taken to improve the quality of life when menstrual cramps appear.

This article will discuss the various causes of menstrual cramps and cramps, as well as the methods that will help to cope with this unpleasant symptom. There are many ways to relieve pain, such as drug therapy, traditional methods, lifestyle changes and diets. Our task is to provide maximum useful information and make it possible to make the right decision in the fight against menstrual pain and cramps.

Causes of menstrual pain and cramps

Hormonal changes

One of the main causes of menstrual pain is the hormonal changes that occur in a woman’s body during menstruation. The levels of the hormones estrogen and progesterone change, which can lead to uterine contractions and, as a result, pain. In the same period, the level of the hormone prostaglandins also increases, which leads to uterine spasm and pain.

Incorrect posture and posture

Leakage and accumulation of fluid in the pelvic area can occur due to incorrect posture and posture. This can negatively affect the work of the uterus, causing cramps and pain during menstruation.

Circulatory disorders

Circulatory disorders can cause blood to accumulate in the pelvic area, which can contribute to pain and spasms. A sedentary lifestyle and lack of physical activity can also cause circulatory disorders.

Medical problems

Menstrual cramps and cramps can also be due to medical problems such as endometriosis, fibroids, pelvic inflammatory disease. In case of severe and prolonged pain, it is necessary to consult a doctor for examination and identification of possible causes.

The impact of menstrual pain on a woman’s life

Menstrual pain can have a significant impact on a woman’s life, especially if it is frequent or intense. Pain during menstruation can lead to changes in mood and behavior, sleep and work disturbances, lack of desire to exercise, and restrictions in social activity.

Restrictions in social activity may mean not participating in social activities, meetings with friends, or school activities. This can lead to feelings of isolation and loneliness, as well as psychological conditions such as anxiety and depression.

There is also the possibility that severe menstrual cramps can lead to decreased performance at work. Women who suffer from menstrual pain may need to take a few days off or not make full use of their days off, which can negatively impact career performance.

Finally, menstrual cramps can impair a woman’s overall quality of life, especially if they become chronic.

Categories of pain

Menstrual pain can be of different types and intensity. They may be acute, blunt, penetrating, localized, or widespread. Pain can also have a different origin and duration.

• Functional pain is the most common type of menstrual pain. They occur as a result of contraction of the muscle fibers of the uterus during menstruation. They are usually located in the lower abdomen and can be mild to moderate in intensity.
• Abnormal pains are pains that occur in various diseases of the female organs, such as endometriosis, uterine fibroids, inflammatory diseases, etc. They may be more intense and widespread than functional pain and may require specialist advice.
• Neuropathic pain is pain that is associated with the presence of various nerve disorders or diseases. They can have their own character and can be localized in different parts of the body, including the abdominal cavity.
• Precyclical pain is pain that occurs a few days before the onset of menstruation and is associated with changes in the level of hormones in the body. They can be of varying intensity and nature and often disappear after the onset of menstruation.

How to tell if it’s menstrual pain

Menstrual cramps and cramps can mimic other conditions, so it’s important to know how to tell if it’s menstrual pain. One of the key signs is the time of onset of pain – it usually begins 1-2 days before the onset of menstruation and continues for the first two days after the onset.

Another sign is the nature of the pain. Menstrual pain is often described as a dull, aching pain located in the lower abdomen or lower back. This pain may be accompanied by cramps and a short-term improvement in well-being after the removal of menstrual blood.

• Pain during urination and painful urination may be signs of other diseases;
• Absence of menstruation for more than 6 months or unusual pattern of menstrual bleeding may also be a sign of other diseases and require medical attention;
• If the pain causes the urge to vomit, then gastrointestinal diseases and gynecological diseases should be excluded;
• Pain that does not disappear after taking painkillers also requires examination by a gynecologist to rule out other diseases.

Need to see a doctor for menstrual cramps and cramps

Menstrual pain can be quite severe, but if it becomes unbearable, you should not postpone the visit to the doctor. After all, there are a number of diseases that can lead to such sensations and require mandatory consultation with a specialist.

One of the main causes of excessive pain is endometriosis, in which tissue normally shed during menstruation grows inside the uterus. To find out if you suffer from this disease, you will have to go through an examination and understand if you need surgery.

Another important reason to see a doctor is uterine cramps. Such symptoms can occur with various diseases: fibroids, endometriosis and others. If you feel that your pain is much higher than normal, and they are accompanied by sharp cramps, consult your doctor. The specialist will be able to suggest certain medical procedures or treatments to improve your condition.

• Never self-medicate if your pain and spasms are too severe.
• Consult your doctor before taking any medication.
• Even if your condition has already improved due to the measures taken, do not forget to schedule an appointment with a specialist for an earlier time.

Medicines for menstrual pain and cramps

Aspirin is one of the most commonly used medicines for pain and cramps. It is an analgesic and can lower prostaglandin levels, which causes painful contractions during menstruation.

Ibuprofen is another effective remedy for pain and cramps during menstruation. It is also an analgesic and can help reduce inflammation and prostaglandin levels in the body.

Naproxen sodium – also used to reduce general pain and relieve severe abdominal cramps that may be accompanied by menstrual bleeding and dysmenorrhea.

Paracetamol is a safe option available without a prescription. Even though it is not an anti-inflammatory, it is effective in reducing pain during menstruation and reducing fever.

Diazepam is a relaxant commonly used to reduce anxiety, stress and anxiety. This drug can be taken during menstruation to relieve menstrual cramps and cramps in the body.

Narcotic analgesics should only be considered as a last resort when other agents fail. These medicines are used only on prescription due to the high degree of addiction and other side effects.

It is forbidden to take unfamiliar medicines without first consulting a doctor.

Non-drug treatments for pain and spasms

Heat therapy

Heat can be an effective way to relieve pain and reduce spasms. Simple methods, such as applying a heating pad to the abdomen or lower back, can reduce discomfort and pain.

Meditation and Relaxation

Many women report pain relief from regular meditation. Taking deep breaths and stopping your thoughts for a while can help you relax and reduce tension.

Massage

A gentle massage of the abdomen and lower back can help relax muscles and reduce discomfort. Contact a professional massage therapist, or massage yourself using soft and circular hand movements.

Exercise

• Light aerobic exercise, such as walking, can reduce pain and cramps.
• Yoga can help you manage pain and improve your mood.
• Stretching and strengthening exercises may also be helpful.

But don’t forget that intense exercise is not desirable during your period, so choose light to moderate options.

Diet

Some women report that certain foods can cause pain and cramps during menstruation. Try cutting out foods like coffee, alcohol, chocolate, animal fats, carbohydrates, and junk food. Instead, increase your intake of vegetables, fruits, green leaves, and other fiber-rich foods.

Home Pain Relief Techniques

Heat and Massage

Heat is the ideal way to reduce menstrual pain: a hot chestnut bag, thermal spring water, or a heating pad on your stomach will help relax your muscles and reduce cramps. If you like, you can combine this with gentle abdominal massage, which also helps improve blood circulation and reduce pain.

Topical remedies

Topical remedies can be a good way to relieve pain: Use arnica or capsaicin based ointments to reduce pain and reduce inflammation. You can also try an anti-inflammatory and pain-relieving ointment containing ibuprofen or paracetamol.

Nutritional support

Some foods that can help you manage period pain: Include more foods rich in iron, vitamins and minerals in your diet. Focus on foods containing omega-3 fatty acids, vitamin E, magnesium and calcium. Remember to drink enough water to prevent dehydration.

Fitness and yoga

Exercise and yoga can help reduce menstrual pain: moderate exercise can reduce overall pain, while stretching and breathing exercises can help relieve menstrual cramps. Avoid physical activity that can stress your belly, but move regularly and remember to take rest breaks.

Preventive measures

Some methods can help prevent pain before and during your period: Incorporate more fruits and vegetables into your diet by visiting a dietitian or nutritionist, choosing the right tampons and pads, and don’t forget your period calendar to prepare ahead of time and meet all your commitments ahead of time.

Techniques for alleviating pain at work

When working physically, it is advisable to wear comfortable and not too tight clothing that does not impede movement, so as not to increase pain.

If possible, take a break to relax and de-stress. During the break, light stretching exercises can be done to improve blood circulation.

You can apply heating pads or cold compresses to the affected area to relieve pain, relieve spasms, and improve blood circulation.

If you are working at a computer, position your keyboard, monitor, and mouse comfortably to reduce hand and neck strain. It is worth taking the correct posture to reduce the load on the back.

It must be understood that it is important not only to alleviate pain at work, but also to reduce stress and tension, as they can exacerbate pain. Therefore, it is worth finding time for psychological and emotional relaxation, for example, yoga classes or meditation.

Prevention of menstrual pain and cramps

To avoid pain and cramps associated with the menstrual cycle, it is necessary to follow a number of recommendations and features of self-care during this period.

• Enough physical activity – a sedentary lifestyle can exacerbate pain.
• Get regular sleep and rest to help reduce stress and fatigue.
• A balanced diet that includes fruits, vegetables, herbs and protein products, as well as the rejection of bad habits – alcohol and smoking.
• Moderate consumption of caffeine and sugar, which can cause worsening pain and cramps.
• Regular personal hygiene and body care, which includes daily showering, changing sanitary napkins, etc.

However, if the pain does not make it possible to lead a normal life, it is necessary to consult a doctor for examination and identification of possible pathology.

Related videos:

Q&A:

What are the main causes of menstrual pain and cramps?

The main causes of pain and cramps during menstruation can be associated with increased levels of prostaglandins in the body, weakened pelvic muscles, endometriosis, hormonal imbalance and other factors.

What methods help reduce or get rid of menstrual cramps and cramps?

Methods that can help relieve or relieve menstrual cramps and cramps include heat, massage, regular exercise, medications containing aspirin or ibuprofen, acupuncture, yoga, and other forms of relaxation.

How to eat right during menstruation to avoid pain and cramps?

Proper nutrition during menstruation includes increased intake of vitamins and minerals such as vitamin D, calcium, magnesium and iron, avoidance of spicy and fatty foods, drinking more water and fruits, and limiting caffeine and alcohol.

Can pain and cramps during menstruation affect the psychological state?

Yes, pain and cramps during menstruation can have a negative impact on the psychological state, causing confusion, irritability, fatigue and depression. It is important to take care of your mental health and seek help when needed.

What types of medicines can be taken for menstrual cramps and cramps?

Medicines containing aspirin or ibuprofen, analgesics, muscle relaxants, hormones, and others can be used for menstrual cramps and cramps. However, before using any drugs, you should consult your doctor and follow the instructions for use.

What are effective relaxation techniques that can help relieve pain and cramps during menstruation?

Effective relaxation techniques that help relieve menstrual pain and cramps include deep breathing, meditation, yoga, acupuncture, massage, hot compresses, warm baths, and other therapies. Everyone can find their own relaxation method that is right for them.

why the stomach hurts, how to relieve cramps

contents

• How do pains in the lower abdomen appear during menstruation?
• Causes of menstrual pain
• How to reduce the pain during menstruation?
• When should a woman see a doctor?

Pain during menstruation is considered a common menstrual disorder: its prevalence reaches 80%. Painful periods have a negative impact on a woman’s life: they complicate family and personal relationships, disrupt daily activities, and are a common cause of disability. In addition to the pain itself, a woman develops a fear of waiting for menstruation, which can lead to nervous exhaustion ¹ . Let’s find out why the stomach hurts during menstruation and how you can relieve the pain.

How do pains in the lower abdomen appear during menstruation?

Scientifically, painful periods are called “dysmenorrhea”. The pain is usually dull, but can be cramping, pulling, burning. Women complain of pain without a clear location – “the lower abdomen hurts.” Painful sensations can spread to the back, along the inner surfaces of the thighs, give into the rectum ¹ .

In addition to pain, there are accompanying symptoms. All associated symptoms in dysmenorrhea can be divided into 4 groups ² :

• emotional-mental – irritability, loss or increase in appetite, decreased mood, drowsiness, insomnia, odor intolerance, taste perversion;
• vegetative – nausea, belching, hiccups, feeling cold or hot, sweating, fever, dry mouth, frequent urination. Also, a woman’s stomach may swell, there are false urges to defecate;
• vegetative-vascular – fainting, headache, dizziness, palpitations, pain in the heart, coldness, numbness of the arms and legs, swelling of the eyelids, face;
• metabolic-endocrine – vomiting, feeling of “cotton” legs, general severe weakness, itching of the skin, pain in the joints.

Sometimes the listed complaints bother a woman more than spasms. In some women, pain and psychosomatic reactions during menstruation are so pronounced that they lead to complete disability lasting from several hours to several days ³ .

Depending on the severity of abdominal cramps, concomitant symptoms, disability, dysmenorrhea is mild, moderate and severe ³ :

• mild – the stomach hurts during menstruation only on the 1st day. At the same time, there are no accompanying symptoms, the daily activity of a woman is not disturbed;
• moderate – menstrual cramps are felt in the first 2-3 days of menstruation, other complaints may be present, but women, as a rule, do not refuse to study and work;
• severe – the stomach hurts a lot, there are a variety of accompanying symptoms. The pain lasts from 2 to 7 days and causes disability.

Causes of menstrual pain

Dysmenorrhea is usually divided into primary and secondary, and their causes differ ³ . In primary dysmenorrhea in women, as a rule, there are no pathological changes in the genital organs. With secondary dysmenorrhea, the appearance of cramps in the lower abdomen during menstruation is associated with various (most often gynecological) diseases.

Primary dysmenorrhea usually appears in adolescence 1–3 years after the onset of menstruation. In the first years of the disease, pain during menstruation is usually tolerable, short-term and does not affect performance. Over time, there may be an increase in spasms, an increase in their duration, the appearance of new symptoms accompanying pain ² .

The mechanism of development of pain during menstruation is associated with the following reasons ² .

• Excess prostaglandins. Prostaglandins are biologically active substances. The body produces them to regulate sleep, body temperature, inflammation and pain response. During menstruation, the lining of the uterus (endometrium) is shed and prostaglandins are released from it. Normally, they provide uterine contractions and the removal of the “old” endometrium to the outside. In women with dysmenorrhea, prostaglandins are produced in excess. The strength of uterine contractions increases, intrauterine pressure increases, spasm of the uterine vessels occurs – all this leads to the development of pain. The more prostaglandins are formed, the more the stomach hurts.
• Lack of progesterone. Hormones control the production of prostaglandins. It increases with the participation of estrogens and decreases with the action of progesterone. If estrogens are produced in excess and their ratio with progesterone is disturbed or progesterone is formed in insufficient quantities, then menstruation becomes painful.
• Hypersensitivity to pain. Women with painful periods have been found to have a low pain threshold. This is associated with a weakening of the analgesic system. Increased pain sensitivity can be inherited. However, the prolonged existence of pain in itself leads to overexcitation of nerve cells and an increase in pain sensitivity.

Abdominal cramps during menstruation may appear or increase under the influence of external factors. These include ³ :

• smoking;
• obesity or underweight;
• stress;
• exposure to extreme temperatures;
• injuries and infections;
• excessive exercise.

Also, the risk of menstrual pain increases in girls who have previously heard a negative opinion about menstruation from adult women (mothers, sisters).

In secondary dysmenorrhea, pain is a symptom of some pelvic disease, including ³ :

• endometriosis. With this disease, a tissue similar to the endometrium appears outside the inner uterine layer: it grows into the muscular layer of the uterus and even into neighboring organs. Pain with endometriosis is severe, it can hurt not only during menstruation, but also in the intermenstrual period. Soreness is explained by inflammation, tissue damage, accumulation of blood in endometrioid foci, adhesions;
• uterine fibroids. The pain appears when the myomatous node makes it difficult for the outflow of blood during menstruation. A large volume of menstrual blood, as it were, is “born”, overcoming resistance;
• inflammatory diseases of the pelvic organs. Chronic inflammatory process of the pelvic organs can reduce the production of progesterone, increase the formation of prostaglandins. Due to the long existence of the inflammatory focus, pain sensitivity increases;
• malformations of the uterus and vagina. This is a rare cause, but causes very severe pain. Due to a congenital anomaly, the outflow of blood to the outside is impossible or significantly difficult. With the onset of menstruation in a girl, blood accumulates in the internal genital organs and the pain increases. Correction requires surgical treatment.

How to reduce pain during menstruation?

Primary dysmenorrhea is treated with pharmacotherapy ^2,3,4 :

• non-steroidal anti-inflammatory drugs;
• antispasmodics;
• combined oral contraceptives;
• preparations of gestagens;
• vitamin E, B6, magnesium preparations;
• calcium antagonists.

There are non-drug therapies that can reduce period cramps. They can be used as a supplement or alternative to medical treatment ⁴ :

• physical exercise to stretch and relax muscles;
• applying a heat source (eg heating pad) to the abdomen;
• behavioral psychotherapy;
• acupuncture and acupressure.

Dysmenorrhea may occur in women who use intrauterine contraception (spiral). It has been proven that when using a spiral, the concentration of prostaglandins in the endometrium during the adaptation period increases and causes an increase in the contractile activity of the uterus. Therefore, women with painful periods should not use this method of contraception ² .

Treatment of secondary dysmenorrhea depends on the nature of the underlying disease. To find the cause of pain during menstruation, a specialist after questioning, examining, taking a smear may recommend additional studies: complete blood count, urine, blood biochemistry, examination by functional diagnostic tests, consultations of related specialists, ultrasound of the genitals, abdominal organs, hysteroscopy, laparoscopy ³ .

In the treatment of secondary dysmenorrhea, the most important factor is the elimination of its cause. For treatment, pharmacotherapy, physiotherapy, surgical operations are used ^2.3 .

In infectious and inflammatory processes in the genital tract, local remedies are used in complex therapy, for example, Depantol® suppositories. This is a combination drug that has a regenerating, antiseptic, metabolic effect. Depantol® contains ⁵ :

• chlorhexidine – antiseptic active against bacteria, fungi, protozoa;
• dexpanthenol is a stimulator of tissue repair, it normalizes cellular metabolism, accelerates mitosis and increases the strength of collagen fibers.

Depantol® does not interfere with the functional activity of beneficial vaginal microflora – lactobacilli. Candles remain active in the presence of blood, pus ⁵ .

When should a woman see a doctor?

Dysmenorrhea is not just pain during menstruation, but also a risk factor for other chronic pain (in the abdomen, pelvis, limbs), sleep disorders, poor mental health, and a trigger for some gynecological diseases. This is why period cramps should not be endured, they should be treated by a specialist ⁴ .

Pain during menstruation may be symptoms of a serious gynecological disease if ^2.3 :

• stomach pain worse with each successive menses;
• spasms are constantly present, and in the period of menstruation and before them intensify;
• soreness towards the end or after the menstruation and is accompanied by a rise in temperature;
• painful periods associated with pain during intercourse;
• menstruation became painful after 30 years.