Period Cramps

About the Symptom

Period cramps also known as menstrual cramps are a normal part of the regular menstrual cycle. Most women will have some pain and discomfort related to period bleeding that will resolve on its own in a few days. Heavier bleeding or severe pain that causes disturbance in day to day activities and missing school or work would be considered abnormal.

When to See a Doctor

Seek professional care if you experience any of the following symptoms

• Intermenstrual bleeding
• Abnormal menstruation
• Menstrual abnormality (duration or volume)
• Low back pain
• Pelvic pain
• Lower abdominal pain
• Abdominal pain

Possible Causes

Generally, Period cramps can be related to:

• Functional Dysmenorrhea

  Dysmenorrhea is the medical term for pain with menstruation. For most women this is mild and tolerable, but for some it can be severe and cause interference in living their life and doing normal activities. Primary or functional dysmenorrhea means the common menstrual cramps/pain that recur with each cycle and is not due to other diseases. This pain is from the natural cramping of the uterus as it sheds it lining, and typically gets better after the first few days. Secondary dysmenorrhea is due to some problem within the reproductive system. Functional dysmenorrhea is usually diagnosed only after other investigations (e.g. ultrasound) do not find any abnormalities responsible for the pain.

• Endometriosis

  A condition where endometrial cells (cells that line the womb) grow outside the uterus, typically near the ovaries or fallopian tubes. It is a common cause of pelvic pain, that can worsen with menstruation. The exact cause is unclear but there are several possible explanations, including the backward flow of menstrual blood into the abdominal cavity, immune system disorders, or transformation of normal abdominal cells. It is typically seen in reproductive aged women, and most often diagnosed in their 30's and 40's. It can cause infertility in some patients due to scarring of the fallopian tubes.

• Adenomyosis

  Adenomyosis is a condition of the uterus (womb) that can occur in women. It occurs when cells of the uterine lining (endometrium) migrate or grow into the muscle layer (myometrium). This can cause the uterus to enlarge, and make menstruation more painful and heavier than normal. While it is not dangerous on its own, it can be very uncomfortable for patients and can affect their enjoyment of life. The heavy bleeding can also make patients anemic and affect their medical health. The exact cause is not known but uterine adenomyosis is more common in women who are in their 30's and 40's and have had children.

• Migraine
• Cesarean Scar Syndrome
• Miscarriage
• Uterine Fibroids
• Tension Headache
• Premenstrual Syndrome (PMS)

• Uterine Malformation

Doctor's Diagnostic Questions

Your doctor may ask these questions to check for this symptom:

• Do you experience severe period cramps?
• How long have you had menstrual pain/cramps and painful periods this time?
• Have you experienced menstrual pain/cramps or painful periods before?
• How severe is your menstrual pain/cramps?
• How has your menstrual pain/cramps condition changed over time?

Find Similar Symptoms

References

• ACOG Patient FAQ

  https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods

• Dysmenorrhea and Endometriosis in the Adolescent

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/12/dysmenorrhea-and-endometriosis-in-the-adolescent

• Nagy H, Khan MAB. Dysmenorrhea. [Updated 2022 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan

  https://www.ncbi.nlm.nih.gov/books/NBK560834/

• French L. Dysmenorrhea. Am Fam Physician. 2005 Jan 15;71(2):285-91. PMID: 15686299.

  https://pubmed.ncbi.nlm.nih.gov/15686299/