Woman lying on a bad with her hand on her stomach

Period Pain: five reasons you may have it bad

Do you get severe period pain every month? Here are five reasons it could be happening.

Most women experience period pains every month but for 10% of women, that pain is so severe it puts their lives on hold – period pain is thought to be the biggest cause of absences from school, college or work for women under 30.1

Find out what could be causing your painful periods and how to tackle them.

What is period pain?

Those monthly tummy cramps are caused by contractions of the womb wall, ranging from feelings of dull pain to intense spasms.2 The contractions are stimulated by hormone-like substances called prostaglandins. A 2006 study, published in medical journal The BMJ, reported that women experiencing the most pain have more prostaglandins, and levels are highest during the first two days of menstruation.3,4 You’re more likely to experience severe cramping if you started your periods before the age of 11 years, have never been pregnant, are overweight, or you smoke or drink alcohol.5 Painful cramps can also occur during the perimenopause, the transition leading up to menopause, due to an increased release of prostaglandins.6

Handpicked content: What you should know about the menopause

What else can trigger severe period pains?

Some women just have painful periods, with no underlying conditions. But for others, the pain during menstruation could be linked to certain medical conditions, including:

1. Endometriosis

Scientists still aren’t sure why it happens but in women with endometriosis, the lining of the womb appears in parts of the body where it shouldn’t; around the bladder, on ovaries or inside the bowel, for example.

In endometriosis, the normal monthly hormonal changes trigger the breakdown of this womb lining into scar tissue, causing intense pain before, during and/or after the period.7,8

2. Polycystic ovary syndrome (PCOS)

PCOS is caused by high levels of insulin, which triggers a hormonal imbalance. This causes symptoms like irregular periods, hair growth and the formation of polycystic ovaries – when your ovaries become enlarged and contain lots of fluid-filled sacs.9 A study published in Clinical Medicine & Research in 2004 found that PCOS may cause more painful periods. This is because your periods become so irregular that when they do happen, there’s a much heavier blood flow that leads to more intense cramping.10

3. Ovarian cysts

An ovarian cyst is a fluid-filled sac, found inside the ovary. These cysts are usually harmless, but a 1990 study by researchers at the University of Illinois found that they can cause period pain.11,12

4. Fibroids

These are growths in and around the womb. Women with fibroids tend to experience heavy, painful periods.13 Scientists aren’t sure why some women develop fibroids, but they might be linked to oestrogen as the growths tend to shrink after the menopause when oestrogen levels are low.14

5. Pelvic inflammatory disease (PID)

PID is an infection of the womb, fallopian tubes and ovaries. It’s usually caused by a bacterial infection, and symptoms include heavy and painful periods.15

If you think you may have one of these conditions, talk to your GP to make sure you get the right treatment.

Simple ways to help period pain

Try these tips to help relieve the pain of menstrual cramps:

  • Consider taking thiamine (vitamin B1) – a 2001 review by the National Women’s Hospital in Auckland showed both nutrients could help fight period pain.16
  • Do some exercise – in 2017, Iranian researchers found that aerobic exercise could ease period pain by boosting circulation and relieving mental stress17
  • Wallow in a warm bath or place a hot water bottle against your tummy – the heat relaxes the muscles of the uterus, reducing the pain18
Advice is for information only and should not replace medical care. Please check with your GP before trying any remedies.
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1. WebMD. Menstrual Pain. Available from: https://www.webmd.com/women/guide/menstrual-pain#1
2. NHS Choices. Period pain. Available from: https://www.nhs.uk/conditions/period-pain/
3. As Source 1
4. Proctor M and Farquhar C. Diagnosis and management of dysmenorrhoea. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459624/
5. As Source 1
6. The Centre for Menstrual Cycle and Ovulation Research. Perimenopause. Available from: http://www.cemcor.ubc.ca/resources/life-phases/perimenopause
7. Endometriosis UK. Endometriosis Facts and Figures. Available from: https://www.endometriosis-uk.org/endometriosis-facts-and-figures
8. WebMD. What is Endometriosis? Available from: https://www.webmd.com/women/endometriosis/ss/slideshow-endometriosis-overview
9. NHS Choices. Polycystic ovary syndrome. Available from: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/#what-causes-pcos
10. Sheehan MT. Polycystic Ovarian Syndrome: Diagnosis and Management. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069067/
11. WebMD. Ovarian Pain: Possible Causes, Diagnosis and Treatments. Available from: https://www.webmd.com/women/guide/ovarian-pain-causes-diagnosis-treatments#2
12. Dawood MY. Dysmenorrhea. Available from: https://www.ncbi.nlm.nih.gov/pubmed/2178834
13. NHS Choices. Fibroids. Available from: https://www.nhs.uk/conditions/fibroids/
14. As Source 13
15. NHS Choices. Pelvic inflammatory disease. Available from: https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/
16. Procto ML, Murphy PA. Herbal and dietary therapies for primary and secondary dysemnorrhoea. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11687013
17. Dehnavi ZM, Jafarnejad F, Kamali Z. The Effect of aerobic exercise on primary dysmenorrhea: A clinical trial study. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5791467/
18. ScienceDirect. Dysmenorrhea. Available from: https://www.sciencedirect.com/topics/medicine-and-dentistry/dysmenorrhea

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