Menstrual cramps are an inevitable part of womanhood. Every woman who menstruates experiences period pain to some extent. But for some, it is more than just a discomfort. Severe menstrual cramps can disrupt daily life. If you are one of them and think it is normal, it may be a problem! Period pain is not believed to be normal if it stops you from doing your daily activities. In this case, it should be evaluated by a gynecologist as it could be a sign of any underlying condition such as endometriosis or polycystic ovary syndrome (PCOS). Let’s find out the likely causes of severe menstrual cramps.

What causes severe menstrual cramps?

Here are 9 common reasons why you may suffer severe menstrual cramps:

1. Primary dysmenorrhea

Primary dysmenorrhea refers to common menstrual cramps that are not caused by other medical conditions. These cramps typically start one to two days before menstruation and can last between 2 and 4 days. You may feel pain ranging from mild to severe in your back, thighs, or lower abdomen. The pain results from uterine contractions triggered by a chemical imbalance in the body.

2. Endometriosis

Endometriosis is a chronic condition in which tissue similar to the uterine lining grows outside the uterus. While this abnormal growth is noncancerous, it can cause significant pain, not just during menstruation but also at other times in the menstrual cycle. Apart from severe menstrual cramps, you may also experience heavy periods, gastrointestinal pain, pain during intercourse, painful bowel movements, and periods that last longer than 7 days, according to Current obstetrics and gynecology reports.

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3. Uterine fibroids

Fibroids are non-cancerous growths that develop inside or outside of the uterus. Symptoms range from heavy bleeding, prolonged menstrual periods, back pain, leg pain, and constipation to severe cramps. However, the symptoms may vary, depending on the size and location of the fibroids. For some, fibroids might be asymptomatic, they can be debilitating for others. Your doctor may advise treatment to regulate hormones and reduce symptoms. In severe cases, surgical options might be considered.

4. Pelvic inflammatory disease (PID)

PID is an infection of the female reproductive organs often caused by sexually transmitted infections (STIs), such as chlamydia and gonorrhea. A study published by the Journal of the American Academy of PAs found that it can result in chronic pelvic pain, including severe menstrual cramps. Those who have this infection may also experience painful intercourse, fever, spotting between periods, a burning sensation while urinating, and bleeding during sex.

5. Adenomyosis

Adenomyosis occurs when the endometrial tissue grows into the muscular wall of the uterus. This can cause the uterus to grow to two to three times its normal size and become tender, leading to heavy bleeding and painful period cramps. Since it does not always show symptoms, if you experience severe menstrual cramps, consult with your gynecologist to diagnose the cause.

6. Intrauterine device (IUD)

An IUD, particularly a copper IUD, can cause more intense menstrual cramps, especially during the first few months after insertion, reveals a study published by the British Medical Association. The device might increase the production of prostaglandins or cause an inflammatory response in the uterus. Your doctor may recommend pain relievers to control period pain. However, if cramps persist, switching to a different form of contraception might be an option.

7. Cervical stenosis

Cervical stenosis, also known as closed cervix, is a condition where the cervix is abnormally narrow or completely closed, which can impede menstrual flow. This causes a buildup of blood in the uterus, leading to increased pressure and pain. You can either be born with this condition or develop it later in your life. Symptoms of this condition include painful periods, reduced bleeding, and spotting between periods.

8. Polycystic ovary syndrome (PCOS)

PCOS is a hormonal disorder that causes enlarged ovaries with small cysts on the outer edges. It affects approximately 1 in 10 women of childbearing age, according to the Office on Women’s Health. Women with this condition may notice symptoms such as irregular menstrual cycles, which can be accompanied by severe cramps, acne, weight gain, thinning hair, and hair growth on the face, chin, and parts of other parts of the body, according to a study published in Indian Journal of Dermatology Venereology and Leprology. You may be advised to take hormonal birth control pills to regulate periods and reduce cramps.

9. Ovarian cysts

Ovarian cysts are fluid-filled sacs that can develop on or in the ovaries. It can lead to symptoms such as heavy periods, sharp or dull pain in the lower abdomen, bloating, and discomfort during intercourse. While many cysts are harmless and resolve on their own, some can cause significant pain and discomfort, especially if they rupture or become large. In cases of large or painful cysts, surgical removal may be necessary.

Tips to manage severe menstrual cramps

Here are 5 tips that can help you reduce the intensity of menstrual cramps and pain:

1. Heating pad

Applying heat to the lower abdomen can relax uterine muscle contractions and improve blood flow, reducing the severity of cramps. You can use a heating pad or hot water bottle and place it on your lower abdomen for 15-20 minutes. You may also consider taking a warm bath for instant relief.

2. Over-the-counter pain relievers

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can not completely control menstrual cramps and pain. But they can definitely help reduce the severity of abdominal and back pain.

3. Regular workouts

Physical activity increases blood circulation and releases endorphins (natural painkillers) that improve mood and alleviate pain. Avoid doing any intense workouts. Instead, try walking, jogging, and stretching exercises to eliminate pain.

4. Stay hydrated

Staying well-hydrated is very crucial when it comes to reducing period cramps. It helps reduce bloating and discomfort, you may suffer during the menstrual cycle. Aim to drink at least 8 glasses a day. You can also drink chamomile or ginger tea to provide soothing effects.

5. Manages stress levels

Stress can exacerbate menstrual cramps. So incorporate relaxation techniques such as deep breathing to promote relaxation and reduce tension in the body.

Apart from these tips, avoid consuming foods high in sugar, salt, and saturated fats. Moreover, increase your consumption of magnesium-rich foods such as green leafy vegetables and omega-3 fatty acids (like fish) to reduce inflammation and cramps.