Overview

The process of your uterus shedding its lining every month is called menstruation. Some discomfort during your period is common, but intense or crippling pain that interferes with your life is not.

Having painful periods is a condition called dysmenorrhea. It’s the most commonly reported menstrual disorder. More than half of menstruating women report pain for at least one or two days every month.

Painful periods can be classified into two types:

  • Primary dysmenorrhea usually starts soon after the first period. It’s often caused by prostaglandins, which occur naturally in the body.
  • Secondary dysmenorrhea typically occurs later in life and often stems from a reproductive disorder.

No matter which one you’re experiencing, there are ways to address and alleviate the pain.

What causes pain during your period?

A variety of painful symptoms may accompany menstrual periods. Sometimes symptoms can occur shortly before your period actually starts. They typically taper off during the first few days of your period.

Prostaglandins

Cramps are caused by prostaglandins. These hormone-like lipids make the uterus contract, and these contractions help the uterus expel its lining.

Prostaglandins are also involved in the inflammation and pain responses. They reside in and are released from the uterine lining.

Once released, they increase the force of the contractions during the first couple days of your period. The higher the level of prostaglandins, the more severe the cramping is.

Very high levels can also cause nausea and diarrhea. As the uterine lining is shed, the levels of prostaglandins are your body is lowered. This is why cramps typically subside after the first couple of days of your period.

Other possible causes of menstrual cramps include:

Pain relievers like ibuprofen (Advil) can help relieve cramps. But if the pain isn’t lessened at all with an over-the-counter pain reliever, talk with your doctor about whether hormonal treatment is an option.

Estrogen and progesterone

Estrogen and progesterone are hormones that help regulate the menstrual cycle. They can also affect chemicals in the brain that are associated with headaches. Right before your period starts, there are lowered levels of estrogen in the body, which can trigger headaches.

As soon as you feel a headache coming on, it’s best to treat it early. The sooner treatment starts, the more likely you’ll get relief. Make sure you’re drinking enough water. If possible, lie down in a dark and quiet room.

You might also try placing a cold cloth on your head or do some deep breathing for relaxation. Over-the-counter medications like ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen (Aleve) might also provide relief.

Fluctuating hormone levels can also cause breast pain and tenderness, which can be very uncomfortable for some women. Estrogen enlarges the breast ducts, and progesterone makes the milk glands swell. This results in breast tenderness.

The breasts might also feel “heavy.” Many times, NSAIDs can be effective in easing premenstrual breast tenderness or pain. If the pain is severe, prescription hormonal treatment might be an option for you.

Finding relief

While some pain or discomfort with your period is normal, severe or debilitating pain — or pain that interferes with your life or daily activities — is not normal. But treatment is out there.

Here are some ways to help reduce pain associated with your period:

  • Try home remedies like heating pads, massage, or light exercise to help ease menstrual cramps.
  • For breast swelling and tenderness, some lifestyle changes, such as diet, can help minimize your symptoms.
  • If headaches related to hormone levels are an issue during your period, here are some ways to find relief and prevent them from occurring.

The takeaway

You don’t have to simply accept painful periods. No matter what the origin, there are treatments for your pain.

If home remedies, complementary therapies, and lifestyle changes aren’t enough to mitigate menstrual pain, talk with your doctor. They can help you get relief.

Start tracking your pain, and bring your log to your appointment. A pain log can confirm your symptoms are indeed tied to your periods and provide some validation. It will also help your doctor understand what’s going on.

Be sure to note in your log:

  • when the symptom occurred
  • type of symptom
  • the severity and duration of the symptom

You can print out a log or make your own.

Sometimes more intensive treatment might be necessary, like birth control pills or other medications to help with hormone fluctuations. Your doctor might want to run tests to rule out any other condition that might be causing your symptoms, too.