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Painful Periods Symptoms

More than half of all women of childbearing age report pain with their menstrual periods for at least one to two days of their cycle [1,2]. It is important and necessary for the uterus to contract during a menstrual period, to ensure that all of the unneeded lining is completely shed and pushed out. This cramping may cause discomfort but should not be painful.

The contracting of the uterine muscles is caused by a substance called prostaglandin. It is secreted by the built-up lining, and when there is enough prostaglandin, the uterus contracts and the period begins. In some cases, this mild, normal cramping becomes painful due to an overproduction of prostaglandin.

The contracting can also become painful due to one of several disorders of the female reproductive tract. It's also possible to have both high prostaglandin and some abnormality of the organs at the same time.

The condition of having painful periods is also called painful menstruation, menstrual cramps, or dysmenorrhea.

Characteristics

Characteristics of painful periods may vary, but will likely include the following details.

Duration

A normal menstrual period lasts from about three to five days, and the cramping should cease after about the second day.

Who is most often affected?

Women who are most likely to experience painful periods include:

  • Younger women: They are more likely to have prostaglandin-related pain, which often improves with age and/or after giving birth.
  • Older women: They are more likely to have pain related to disorders of, or abnormal growths on, the uterus and other pelvic organs.

Is it serious?

The pain associated with this symptom can vary in severity depending on the cause.

  • Not serious: Mild cramping that is relieved with over-the-counter medications such as ibuprofen is most likely not serious.
  • Moderately serious: Cramping that is painful enough to interfere with school, work, and normal relationships can be treated by a gynecologist. This specialist can rule out any serious causes and offer treatment that can ease the symptoms.
  • Serious: Severe pain along with heavy bleeding— especially if it occurs for more than just one to two days per month, or even throughout the month — should be treated by a gynecologist as soon as possible. Menstrual pain this severe almost never resolves on its own, but there are medications and surgical procedures that can help.

Painful Periods Causes

Many conditions can cause the symptom of painful periods. We've listed several different causes here, in approximate order from most to least common [2,3].

High prostaglandin levels

Prostaglandins are hormone-like substances that are made in the lining of the uterus. They increase as the lining builds up and decrease as it is shed. It is the prostaglandins that cause the cramping. If they are overproduced, the cramping can become severe [4].

Abnormal tissue buildup

In some cases, the same tissue that builds up on the inner surface of the uterus each month also builds up where it shouldn't. This menstrual tissue may grow on the outer surfaces of the uterus, ovaries, fallopian tubes, and bladder (called endometriosis). This tissue also produces prostaglandins, and it also contracts and bleeds. This can cause severe pain throughout the menstrual cycle.

Benign growths

Abnormal growths within, or on the inner (such as fibroids) or outer surface of, the muscular walls of the uterus may lead to pain. These can even make the normal contracting of the uterus to expel the lining very painful.

  • Benign growths: These can occur on the inner, outer, or middle muscle walls of the uterus, again making normal contractions very painful. However, it is also possible to have benign growths that are otherwise painless.
  • Overgrown tissue: Discussed prior, the menstrual tissue that normally lines the uterus may grow into the muscle walls of the uterus (called adenomyosis), making the normal contractions very painful.

Rare and unusual causes

It is possible for tumors of the pelvic organs to cause severe menstrual cramping and bleeding. Your doctor can diagnose these and begin a plan of treatment.

We've listed some specific conditions that can cause painful periods, along with how to identify each of them:

4 Possible Conditions

The list below shows results from the use of our quiz by Buoy users who experienced painful periods. This list does not constitute medical advice and may not accurately represent what you have.

  1. 1.Menstrual Cramps

    Dysmenorrhea is a term describing pain associated with menstruation (or when one gets a period). It's very common, happening to about 50% of women. Primary dysmenorrhea means that the pain is directly caused by a menstrual period, which is different than "secondary" dysmenorrhea, where a disorder is causing the pain.

    2-3 days before a period. Peaks in the mid-20s and declines in frequency afterwards.

    Rarity:
    Common
    Top Symptoms:
    abdominal pain (stomach ache), abdominal cramps (stomach cramps), painful periods, lower back pain, abdominal pain that shoots to the back
    Symptoms that always occur with menstrual cramps:
    abdominal pain (stomach ache)
    Symptoms that never occur with menstrual cramps:
    being severely ill, disapearance of periods for over a year
    Urgency:
    Self-treatment
  2. 2.Endometriosis

    Endometriosis is a disorder in which the tissue that normally lines the uterine walls grows outside the uterus.

    Recovery is dependent on severity of disease and treatment approach.

    Rarity:
    Uncommon
    Top Symptoms:
    vaginal discharge, abdominal pain (stomach ache), vaginal bleeding, pelvis pain, painful periods
    Urgency:
    Primary care doctor

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  3. 3.Uterine Fibroids

    Uterine fibroids are noncancerous tumors in the uterus. They are common in women of childbearing age.

    Treatment ranges from medication to surgical removal of the fibroid.

    Rarity:
    Common
    Top Symptoms:
    vaginal bleeding, pelvis pain, abdominal cramps (stomach cramps), painful periods, irregular period
    Urgency:
    Primary care doctor
  4. 4.Mature Cystic Teratoma of the Ovary

    The ovary is an important part of the female reproductive system. An ovarian cyst is a fluid-filled sac in the ovarian tissue. It is not a cancerous growth but because it is in such a small organ it can cause pressure and pain.

    Ovarian cysts are not cancerous, and a majority go away by themselves. However, consult a physician to prevent any rare complications.

    Rarity:
    Ultra rare
    Top Symptoms:
    abdominal pain (stomach ache), pelvis pain, painful periods, painful sex, spontaneous back pain
    Urgency:
    Primary care doctor

Painful Periods Treatments, Relief and Prevention

If your pain is persistent or interfering with daily life, or you experience heavy bleeding that is abnormal (lasting more than several days or beyond your normal menstrual cycle), you should consult your physician or gynecologist sooner than later. However, there are several methods of managing painful periods at home that you may find to be effective.

At-home treatments

There are several methods you can try at home to help alleviate period pain.

  • Heat: A heating pad applied to the lower abdomen is sometimes helpful.
  • Pain medication: Take nonsteroidal anti-inflammatory drugs, such as ibuprofen, for the first one to two days of cramping.
  • Supplements: B supplements may be helpful for muscle cramps, but it is likely more beneficial to make sure that your diet is nutrient-rich via fruits, vegetables, and lean proteins in the first place [5].
  • Improve habits: Make positive changes in diet, exercise, sleep, and stress management in order to improve overall health. If you are overweight, you may consider a weight loss program, since excess body fat often interferes with normal functioning of hormones.

Medical treatments

You should consult your physician to discuss the following.

  • For heavy or painful bleeding: Cramping painful enough to interfere with activities of daily living should be investigated by your physician, especially if there is heavy bleeding along with it.
  • Medication or procedures: Your physician may find that you are in need of additional or alternate medication to address other conditions or procedures if you have any growths.
  • Alternative treatments: Acupuncture can be helpful to some women for severe menstrual cramps.

Seek immediate treatment in the emergency room or call 911 for the following

If you experience very heavy vaginal bleeding that does not stop within just a few minutes you should go to the emergency room.

FAQs About Painful Periods

Here are some frequently asked questions about painful periods.

Do birth control pills help menstrual cramps?

Yes, unless there is also some other disorder of the reproductive tract such as fibroids or any sort of tumor. Birth control pills prevent ovulation and therefore lower the production of prostaglandins. It is the prostaglandins, created in the built-up lining of the uterus, which cause the cramping each month [6,7].

Are severe menstrual cramps a sign of cancer?

Only in very rare cases. Severe menstrual cramps are not uncommon and have many other possible causes. If there is also abnormal bleeding, there may be more cause for concern. A gynecologist can perform tests and get a definitive answer one way or the other.

Is abnormal vaginal discharge part of having menstrual cramps?

No. If the dischargebecomes irritating and/or foul-smelling, that is a symptom of some other condition such as a yeast infection or a sexually transmitted disease. This kind of discharge should always be investigated by a gynecologist, who can order tests to determine the cause and then begin the appropriate treatment.

Do severe menstrual cramps cause pain in the digestive tract?

Some women report mild nausea with severe cramps, but otherwise, menstrual cramps do not affect the stomach, intestines, or rectum. If there is pain, cramping, or an abnormal discharge that seems to involve any of these parts of the body, it should be investigated separately by a physician who can arrange for the proper tests and treatment.

Does fibromyalgia make menstrual cramps worse?

In many cases, yes. Some women report that their menstrual pain is worse with fibromyalgia, and their fibromyalgia is worse during their menstrual periods [8,9]. Fibromyalgia is believed to be an autoimmune disease that causes increased sensitivity of the nerves. When both fibromyalgia and menstrual pain are present, both a fibromyalgia specialist and a gynecologist should be seen.

Questions Your Doctor May Ask About Painful Periods

  • Q.Are you sexually active?
  • Q.Have you given birth to any children?
  • Q.Do your symptoms occur or worsen before or during your period?
  • Q.Have you ever had any surgeries?

If you've answered yes to one or more of these questions, try our painful periods symptom checker to find out more.

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Painful Periods Symptom Checker Statistics

  • People who have experienced painful periods have also experienced:

    • 14% Bloody Vaginal Discharge
    • 11% Vaginal Bleeding
    • 3% Vaginal Discharge
  • People who have experienced painful periods were most often matched with:

    • 42% Endometriosis
    • 42% Uterine Fibroids
    • 14% Menstrual Cramps
  • Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

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References

  1. Harlow SD, Park M. A longitudinal study of risk factors for the occurrence, duration and severity of menstrual cramps in a cohort of college women. An International Journal of Obstetrics and Gynaecology. 1996. Obgyn Link
  2. Dysmenorrhea: Painful periods. The American College of Obstetricians and Gynecologists. Published January 2015. ACOG Link
  3. Fibroid-like conditions: Adenomyosis and endometrial polyps. Brigham and Women's Hospital. Brigham and Women's Hospital Link
  4. Period pain. NHS. Updated October 21, 2017. NHS Link
  5. Leg cramps and the nutrition connection. University of Wisconsin Hospitals. Published October 9, 2018. UWH Link
  6. Treating menstrual cramps with hormone therapy. University of Colorado: Colorado Women's Health. Colorado Women's Health Link
  7. Treatments for painful periods. UW Medicine. UW Medicine Link
  8. Fibromyalgia. Office on Women's Health. Updated October 18, 2018. WomensHealthGov Link
  9. Chen CX, Draucker CB, Carpenter JS. What women say about their dysmenorrhea: A qualitative thematic analysis. BMC Women's Health. 2018;18:47. NCBI Link