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If every month you find yourself shaking your fist at your uterus and dropping a few f-bombs as you reach for more Midol, we’re with you. Periods can be a real pain — literally. But why do periods hurt anyway?

As you know, your uterus makes it rain Carrie-style every month by shedding its lining when you don’t get pregnant. This is the fun little process known as menstruation.

Shedding part of your uterus shouldn’t exactly feel like a walk in the park, but period pain can sometimes feel unbearable for a reason beyond PMS.

Allow us to introduce you to the key culprits behind period pain. We’ve got the details on what exactly causes your period to hurt, and how to help the pain calm TF down.

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Painful periods actually have a proper name. In fact, it’s a condition called dysmenorrhea.

According to the American College of Obstetricians and Gynecologists, dysmenorrhea is the most common period issue. More than one half of women who menstruate report pain for a minimum of 1 to 2 days every month.

Painful periods can be broken down into two categories:

  • Primary dysmenorrhea: This type typically begins right after the first period. It’s usually thanks to lipids (fat-like molecules in your bloodstream, cells, and tissue) called prostaglandins. Think of prostaglandins as lipids that act like hormones.
  • Secondary dysmenorrhea: This type normally happens later in life and usually comes from a reproductive disorder. It often progressively worsens.

While pain and soreness are par for the course with periods, extreme or even crippling pain that messes with your life is not normal.

All the PMS feels

When Aunt Flo is on her way or already here to visit, there are a ton of side effects related to pain and discomfort, many of which are totally normal. The most common PMS pain symptoms include:

  • cramping
  • tender ta-tas
  • diarrhea and constipation
  • bloating and gas
  • headaches
  • backaches
  • clumsiness
  • a lower tolerance for sound or light

Prostaglandins act like hormones by getting your uterus contracting and shedding its lining which, you guessed it, causes cramping.

These guys also participate in the pain responses and inflammation of it all. They hang out in the uterine lining and get released when the lining is released.

After they free-fall with the lining, they kick the contractions up a few notches, usually during the first couple days of your period.

Un-fun math equation: The higher level of prostaglandins = even sh*ttier cramping.

If the levels are super high, they may also cause diarrhea and nausea.

Other possibilities behind killer cramps include conditions like:

  • Endometriosis: A condition where tissue — like the tissue found on the uterus lining — grows outside the uterine wall.
  • Fibroids: They’re abnormal growths that can pop up in or on your uterus.
  • Pelvic inflammatory disease (PID): This is an infection of the female reproductive organs.
  • Cervical stenosis: This is when the cervical canal or spinal nerve narrows.
  • Ovarian cysts: These happen when sacs or pockets grow in or on your ovaries.
  • IUD pain: This involves discomfort or cramps after an IUD has been inserted or removed.
  • Pregnancy: When cramps happen between 1 and 4 weeks after a missed period, it could be a sign that you’re pregnant.

Estrogen and progesterone are hormones that tag team regulating menstrual cycles.

Unfortch, they are also known to affect chemicals in the brain that are linked to headaches. Just before your period begins, there are reduced levels of estrogen in your body, which can trigger those annoying headaches (ugh).

Shifting hormone levels can also cause dreaded boob pain. What happens is, estrogen widens breast ducts while progesterone makes the milk glands swell. This intense combo results in breast aches. You may be familiar with the “heavy” feeling that this tenderness can bring.

You do not have to take period pain lying down (unless you think a nap will help!). Whether your pain is mild or unbearable, there are period pain remedies to help you out:

  • Try using a heating pad or weighted blanket for cramps.
  • Diet changes like limiting caffeine and alcohol may help reduce period pain.
  • Getting your body moving with exercise or yoga may also help.
  • Over-the-counter (OTC) meds like handy dandy ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen (Aleve) may be hella helpful.
  • If your boobs hurt, a breast massage might help, too.
  • If your head’s killing you, try applying a cold compress to your head, like a cold washcloth.
  • Drink plenty of H20, too.

If your pain is more intense than the relief OTC meds or a heating pad can provide and it interferes with your life (i.e., missing school or leaving school early, missing work, etc.), it’s a good idea to talk with your doctor.

You could have an underlying condition causing your period pain. There might be a different treatment option available that may help.

If you decide to chat with your doc about your period pain, it’s helpful to bring a diary or journal of your symptoms to your appointment. Logging your symptoms can help your doctor understand your pain and confirm if it’s tied to your period so that they can find the best treatment.

Make a note of things like:

  • length/heaviness of bleeding (i.e., how many pads/tampons you use)
  • days per month of pain
  • severity of pain
  • pain that relates to your periods or not
  • pain on days without bleeding
  • urinary or bowel symptoms (burning w/ peeing, diarrhea, constipation, pain w/ bowel movement)
  • nausea, vomiting
  • the location of your pain
  • what makes your pain worse (i.e., intercourse? movement?)
  • what makes your pain better

Your doctor may decide to run some tests to determine if something like hormonal treatment, birth control pills, or other meds may help with the hormone fluctuations causing your intense pain.

Period pain sucks, but it’s typically normal.

Hormones like estrogen and progesterone and the lipid known as prostaglandins play huge roles in creating those nasty cramps and headaches.

Sometimes other conditions like fibroids, PID, ovarian cysts, and endometriosis may be to blame for this pain.

If your period pain is so intense that home remedies and OTC treatments don’t work for you, make an appointment to talk with your doctor. Bring along a log of your symptoms so that your doc can find the best treatment plan for you.