Why are my periods so painful?

Period pain is common but severe pain is not something you simply have to accept as part of having periods.

Some pain is caused by the normal contractions of the uterus during menstruation.
When pain is severe, worsening or occurs at other times in the cycle it may sometimes indicate an underlying condition such as endometriosis or adenomyosis.

Understanding the pattern of your pain can help determine whether further assessment is needed.

Why do periods cause pain?

During a period the uterus contracts to help shed its lining. Chemicals called prostaglandins are involved in these contractions and can contribute to cramping and pain.

This type of period pain is known as primary dysmenorrhoea and commonly occurs around the beginning of a period.

When is period pain more concerning?

Pain that is severe, worsening or significantly affecting work, study, exercise or relationships deserves further attention.

Pain between periods, pain during or after sex or changes in the usual pattern of your period pain can also suggest that something other than ordinary menstrual cramping may be involved.

Could endometriosis be causing my pain?

Endometriosis occurs when tissue similar to the lining of the uterus grows elsewhere in the body, commonly within the pelvis.

It can cause painful periods, pelvic pain, pain during sex and pain with bowel movements or urination. Some women with endometriosis also experience heavy bleeding, bloating or difficulty becoming pregnant.

What other conditions can cause painful periods?

Adenomyosis can cause heavy and painful periods when tissue similar to the uterine lining grows within the muscular wall of the uterus.

Fibroids, pelvic inflammatory disease and other pelvic conditions can also cause pain. The cause is not always obvious from symptoms alone.

When to see a doctor

If period pain is severe, getting worse or interfering with your normal activities it is important to have it assessed.

Your doctor can consider your symptoms and medical history and may recommend an examination, ultrasound or other investigations depending on what is found.

Key points

Some period pain is caused by normal contractions of the uterus.
Severe or worsening pain should not simply be accepted as normal.
Endometriosis and adenomyosis are important causes of significant period pain.
Pain between periods or during sex may need further investigation.
Assessment can help identify the cause and guide appropriate treatment.

Medically reviewed by Dr Susana Rodriguez, menopause clinician at ClaraSana Women’s Health, Perth.

Our content is based on up-to-date Australian guidelines & may differ from information on other sites.

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