Why is menstruation so painful?Why are periods so painful?

Normal, healthy periods are not supposed to be painful, heavy, crampy, clotty, nor to be accompanied by bloating, diarrhea or moodiness. Sadly many women experience these things.

I suffered with awful periods for many years. Eventually when I took birth control pills, my periods became much worse, and I began to have all sorts of gynecological problems. I then learned about estrogen dominance AND having low progesterone in comparison to my estrogen levels. I used bio-identical progesterone cream, I had to use more than what many other women may usually be told to use, and I improved my periods a lot. I also changed my diet. I read research papers and read textbooks. I learned more and more about addressing my issues. My crazy periods/menstruation was telling me about my hormone health. Had my hormone health been balanced, I would have had painless, and non-heavy periods instead!

There are hormone-like chemicals known as prostaglandins. In layman’s terms, there are ‘good’ and ‘bad’ ones. In truth, nothing in the body is good or bad, but for the purposes of explanation, using good/bad is convenient. The bad ones promote swelling, pain and discomfort. The good ones do the opposite, they relieve inflammation and pain. What we eat determines which ones we have, to a large degree. Once I began to eat more oily fish, take fish oils, and made my diet better, my periods improved from this as well. Omega 3s help to promote good prostaglandins. Read this if you’d like more information:

The Omega-6/Omega-3 Connection to Painful Periods

I was also a vegetarian for over 20 years, and unlike the hype goes, the “balanced vegetarian diet” didn’t do me many favours. I was slowly becoming very deficient. The severe deficiencies created played a large role in me developing hypothyroidism. Once I began to eat offal/organ meats, meats that are usually consumed, veg and good fats, my health definitely began to improve too. Getting treatment for my hypothyroidism also made a huge impact on my periods.

I think it was epiphanous when I finally learned that painful periods, heavy periods, bloating, cramping etc. were NOT normal and that I most certainly could fix these issues. I’ve never taken another chemical birth control/contraceptive, I think they are toxic. I’ve learned so much, and met so many women who have become ill since using them. Some are a little ill, some are severely affected. Since using bio-identical progesterone cream, changing my diet, getting treatment for hypothyroidism, making sure ALL my vitamins and minerals were optimal so the levels were all at the UPPER END of the ranges given, and of course, making sure that my iron and ferritin were optimal, big changes occurred.

I wrote the steps I followed in this answer:

Bronwyn Miller's answer to What is the best treatment for heavy periods due to infertility?

19 Replies to “Why is menstruation so painful?Why are periods so painful?”

  1. After a girl achieves puberty, she starts getting her periods, commences menstruation. It is equivalent of commencement of production of semen in boys who may get night emissions after achieving puberty. The start of periods is an indication that a girl can bear a child.

    It is necessary to understand what a period means. The inner lining of every woman’s womb develops in order to support conception. It thickens a bit and also accumulates some fluids in order to be able to give nutrition to a baby, if conceived. But when the conception does not take place, slowly, this lining gets separated and gets discarded after about a cycle of 28 days. This process also involves fluid discharge including blood.

    This is, in very short and simple, the physiology of periods. It is very common for a girl, particularly a young teenager, to feel discomfort and some spasmodic pain while this separation of inner lining takes place. In some, it leads to cramps. In some others, it leads to a feeling of being bloated. You ought o remember that a period is a time when every girl/woman goes through an actual upheaval in her hormonal levels. Hence, the discomfort and some amount of pain.

    If someone experiences a lot of pain or a lot of bleeding, then she ought to visit a gynac for an examination. Most of the problems are easily treatable with tablets. And most importantly, young girls must remember that getting an exam done is very natural and doctors are extremely careful during the process. There is no need to feel any hesitation to go to a gynac.

  2. While there is an answer here explaining why periods cause discomfort, there is not an answer that aptly explains that painful periods can be an indication of problems.

    Sure, there is an answer about some medication that distracts the pain signals but…

    Even still today too many doctors live by that religiously based notion that God made periods painful as punishment for Eve’s sin and so ignore women's complaints as women just being the weaker sex…

    The weaker sex that can tolerate the pain of pushing a baby that is larger than the hole down there out of that hole. So… about that pain

    It can be a host of things:

    • Infection – yeah so I had a yeast infection literally for years by the time a gynecologist listened to me because no they do not all have cottage cheese like discharge
    • You can get a urinary tract or bladder infection during your cycle and they will think the blood in your urine is from your cycle
    • Cysts
    • Endometriosis
    • Improperly implanted IUD
    • STDs can cause painful periods
    • Tilted uterus or other malformed reproductive organs
    • Hormone imbalance – which by the way can be because you are on the wrong kind of birth control

    Push your doctor for answers and better yet, consult a pelvic pain specialist

  3. we suffer back pain lot bcoz of the following phase that occur in our ovaries and uterus..

    To understand why the back or pelvic hurts during a period, we need to understand the menstrual cycle and the changing levels of hormones. The menstrual cycle is made of a few main phases.

    • The first phase, which is menstruation, begins on the first day of your period. During menstruation hormones, oestrogen and progesterone, are relatively low.

    • In the second phase, also known as the follicular phase, FSH (or follicle-stimulating hormone) is released, which causes immature eggs to develop. These follicles cause a lot of oestrogen to be produced, and the lining of the uterus thickens, for a possible egg to be embedded.
    • The third phase in ovulation, and is when a mature egg is released from the ovary. It is triggered by an abrupt rise in LH (or luteinising hormone). At ovulation, the cervix moves higher and its opening widens. The release of the egg and the movement of the cervix is why some women experience cramps or aches at ovulation, and why some women experience ovulation spotting. After ovulation, the egg enters the fallopian tube and moves along the uterus.
    • The fourth phase, also known as the luteal phase is when oestrogen production drops and progesterone increases. This further thickens the uterine lining to allow for a fertilized egg to embed. If fertilization doesn’t occur, the egg breaks down, and progesterone levels drop, which disintegrates the uterine lining, in preparation for a period. This drop in progesterone is why some women experience mood swings, bloating, tender breasts or tiredness.

    During the period, the broken-down lining of the uterus flows down through the cervix and out of the vagina. When you have a period, the uterus swells and expands and can become almost double the size and weight (pictured below).

    Understanding the anatomy of the pelvis can help us understand why the back and pelvis can hurt during a period and during this time when the uterus is so enlarged. Here are some explanations:

    • Firstly, the uterus is suspended in the pelvis to the sacrum (pictured below), which is the triangular bit of bone between your lower back and your tailbone. You can feel the top part of your sacrum, where the dimples in your lower back are. These ligaments are called the uterosacral ligaments. When the uterus swells, this puts pressure on the uterosacral ligaments, which can then create a dragging feeling, heaviness or pain on the sacrum and tailbone.

    • Secondly, to push the uterine lining out through the vagina during menstruation, the uterus muscle contracts, and if it contracts sharply, it can make you feel strong cramps. Hormone-like substances called prostaglandins trigger these contractions, and prostaglandins are also involved in pain and inflammation processes. If a woman has high amounts of prostaglandins, she can have more severe menstrual cramps.
    • If a woman has endometriosis, cells that resemble the lining of the uterus exist on other places within her pelvis, such as on her bladder, bowel, or vaginal walls. These cells can be triggered with a period and cause more pain and inflammation, which is why women with endometriosis tend to have more severe period pain.
    • Sometimes the uterus isn’t aligned neutrally within the pelvis, and this can contribute to pain that may be one-sided or to pain in the lower abdomen. The uterus may be tilted to the side or it may be tilted forwards. Visceral mobilization to re-position the uterus well inside the pelvis by a trained women’s health physiotherapist can help bring back alignment to the uterus and surrounding tissues.
    • Often the pelvic floor muscles can cramp because of the contracting uterus and vagina. This can also contribute to an increased perception of period pain, because not only is the uterus contracting, but the pelvic floor and pelvic wall muscles go along for the ride. Over time, these muscles can become stuck in a tight position from overworking for many months or years. Because these muscles also attach to the pelvis, tailbone and lower back they can add to your lower back or pelvic pain. Pelvic floor release techniques by a trained women’s health physiotherapist can release these tight muscles, which can in turn reduce the overall pain during periods.
  4. Major Reasons of painful periods:

    During your menstrual period, your uterus contracts to help expel its lining. Hormone-like substances (prostaglandins) involved in pain and inflammation trigger the uterine muscle contractions. Higher levels of prostaglandins are associated with more-severe menstrual cramps.

    Severe contractions may constrict the blood vessels feeding the uterus. The resulting pain can be compared to the chest pain that occurs when blocked blood vessels starve portions of the heart of food and oxygen.

    Menstrual cramps may also be caused by:

    • Endometriosis. In this painful condition, the tissue that lines your uterus becomes implanted outside your uterus, most commonly on your fallopian tubes, ovaries or the tissue lining your pelvis.
    • Uterine fibroids. These noncancerous growths in the wall of the uterus may be the cause of pain.
    • Adenomyosis. In this condition, the tissue that lines your uterus begins to grow into the muscular walls of the uterus.
    • Pelvic inflammatory disease (PID). This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.
    • Cervical stenosis. In some women, the opening of the cervix may be so small that it impedes menstrual flow, causing a painful increase of pressure within the uterus.

    Read: Solution for period cramps

    Risk factors

    You may be at greater risk of menstrual cramps if:

    • You're younger than age 30
    • You started puberty early, at age 11 or younger
    • You have heavy bleeding during periods (menorrhagia)
    • You have irregular menstrual bleeding (metrorrhagia)
    • You've never given birth
    • You have a family history of dysmenorrhea
    • You're a smoker


    Menstrual cramps don't cause any other medical complications, but they can interfere with school, work and social activities.

    Certain conditions associated with menstrual cramps may have complications, though. For example, endometriosis can cause fertility problems. Pelvic inflammatory disease can scar your fallopian tubes, increasing the risk of a fertilized egg implanting outside of your uterus (ectopic pregnancy).

    Read: Solution for period cramps

  5. No one except your doctor can tell you why are your periods painful.

    If you want to find out the reason why is that the case, visit a gynecologist and talk to him/her about it. He/she will probably do an ultrasound to see is everything okay with your uterus, ovaries, cervix, fallopian tubes and bladder. If necessary, they might suggest a vaginal ultrasound just in case.

    There are many reasons that a period can be painful – endometriosis, fibroids, PID (pelvic inflammatory disease) or some anomalies. If everything is ok after your examination, it is usually diagnosed as primary dysmenorrhea (presence of the pain without an underlying cause).

    Bottom line – go to the doctor.

  6. Painful menstrual periods are periods in which a woman has crampy lower abdominal pain, sharp or aching pain that comes and goes, or possibly back pain.Some pain during your period is normal, but a large amount of pain is not. The medical term for painful menstrual periods is dysmenorrhea.Many women have painful periods. Sometimes, the pain makes it hard to do normal household, job, or school-related activities for a few days during each menstrual cycle. Painful menstruation is the leading cause of lost time from school and work among women in their teens and 20s.

    • Painful menstrual periods fall into two groups, depending on the cause:
    • Primary dysmenorrhea
    • Secondary dysmenorrhea

    Primary dysmenorrhea is menstrual pain that occurs around the time that menstrual periods first begin in otherwise healthy young women. In most cases, this pain not related to a specific problem with the uterus or other pelvic organs. Increased activity of the hormone prostaglandin, which is produced in the uterus, is thought to play a role in this condition.

    There may not be an identifiable cause of your painful menstrual periods. Certain women are at a higher risk for having painful menstrual periods. Risk factors include:

    • being under age 20
    • having a family history of painful periods
    • smoking
    • having heavy bleeding with periods
    • having irregular periods
    • never having had a baby
    • having experienced early puberty, which is puberty before the age of 11.

    Your health care provider may prescribe birth control pills to relieve menstrual pain. If you do not need them for birth control, you can stop using the pills after 6 to 12 months. Many women continue to have symptom relief even after stopping the medication.

    Ela woman app is one such app which allows to track cycle days and provide best prediction for ovulation. I used it personally and found it useful in taking away my daily stress

  7. Good question, interesting problem (yes, we internists have a particular way of looking at people who have unusual issues this way, it is how our minds work). The logical answer to this question is that something is going on outside the ovary, as this is not a commonly seen problem. My guess is that there is endometrial tissue outside its usual location – ie endometriosis – that swells in response to circulating estrogen during your cycle. This tissue is very vascular, and as blood is very irritating to the peritoneum (the nerve filled sac that surrounds the abdomen/pelvis), scars form in the area (adhesions) that attach areas that usually aren’t attached. This is why different positions change the pain you have – likely one of these adhesions pulls on the peritoneum. It is possible that some of the endometrial tissue could attach part of the bowel to other parts, causing a little entrapment but not enough to cause a full blockage (you would get quite sick if this happened).

    This is just a guess; the only way you can know for a fact if this is the case is by undergoing a laparoscopy (a surgeon looks into the abdomen with a tube from the outside). All the imaging in the world will not show the adhesions, unfortunately. Once found, these adhesions can be surgically cauterized (cut or burnt to release them). However, this is often like the old hydra story – sometimes, just the act of the surgery can cause more adhesions.

    Sometimes, these issues can be relieved by oral contraceptives, or by a shot of monthly progesterone (ie depo-provera).

    Of course, all of this is pure conjecture, based on the little information described. You should speak to your doctor about this, and he/she can ask more questions, review your history, physically examine you, and hopefully come up with a diagnostic and therapeutic game plan for you.

    Good luck, let me know what happens (helps to know if I am right or wrong)

  8. From the age of 12-13, most girls start a normal process called monthly. Someone is a little earlier or someone is late for some time in this case. Monthly means there is another change between girls. Before the start of the menstruation, all the girls understand through some signs that it will be monthly.

    Most menstrual periods during menstruation and menstrual periods, abdominal pain, excessive abdominal pain, and sometimes pain in the legs.

    Why is the pain during the menstrual period

    Ovary is if

    If there is an irregular menstrual cycle

    If you have Uterine Fibroids

    If you have been for a long period of time

    If the mother is more likely to be a girl

    Who is more prone to pain during the menstrual period:

    If there is an irregular menstrual cycle

    Maybe those of men who started earlier

    Some of the family may be especially mothers

    People who have to bleed during menstrual periods

    What are the problems of menstrual time

    Mood becomes very irritable

    The disorder arises in food

    The body hurts

    The head hurts

    If someone has migraine pain, this time the pain of a migraine is high

    Do it

    If you have excess pain in the abdomen, you can give a belt with a hot water bag

    Do not take a bath in hot water

    Eat right to eat

    Be clear

    If the pain is too high, then you will definitely take medicines according to the doctor's advice.

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  9. To expel the lining of the uterus, your uterus needs to squeeze hard to expel it from the body, that alone hurts. Also there are ligaments that attach the uterus to your back, which means it can hurt there too.

    Sometimes a very painful period can mean the lining of your uterus has got places it’s not supposed to be, this is called endometriosis. Heavy or painful periods are always worth a trip to the doctor, hopefully they won’t dismiss it as normal, but they probably won’t dive into invasive tests at the first visit. Changes to your period are also worth a visit.

    For years exercise was recommended, but that has been disproved. A lot of people find heat to be helpful. There are some over the counter drugs, always follow the instructions.

  10. Painful menstrual periods are periods in which a woman has crampy lower abdominal pain, which can be sharp or aching and come and go. Back pain may also be present. Some pain during your period is normal, but a large amount of pain is not. Sometimes, the pain makes it hard to do normal household, job, or school-related activities for a few days during each menstrual cycle. The medical term for painful menstrual periods is dysmenorrhea.

    Livia is a Perfect drug free solution for this types of period pain. Using two electrodes that transmit electric pulses to your lower abdominal area, Livia blocks the cramps. It’s simple, and has no side effects. Livia’s pulses address the pain immediately. Using technology based on gate control theory, Livia transmits a very specific pulse that keeps the nerves “busy”. Busy nerves means that the nerve gate is closed, pain signals can’t pass through and are not felt. There is no waiting and no adjustments are needed. 9 out of 10 women suffer from menstrual pains. 2 out of 10 consider them unbearable. At least half had tried a variety of solutions. Livia is relevant for women of all ages that suffer from menstrual pains. It doesn’t restrict your movement at any way, it’s designed to be clipped on and forgotten about.

    Is it safe to use? – This question may come to your mind. The answer is “Yes”, Livia Kit is completely safe to use. They strive to meet the most stringent International standards & completed the CE-Mark approval and are near completion with the FDA approval process.

  11. I will try to answer your question rather than unrelated peripheral issues.

    Obviously, the proximate cause is contraction of the uterine muscles (the same as in labor. But what causes the contractions? PROSTAGLANDIN.

    This is a hormone produced as a result of absorption of blood and breakdown products from the endometrium (lining of the uterus) that are absorbed into the bloodstream. Prostaglandin causes the uterine muscles to contract.

    The most effective treatment is a prostaglandin inhibiter such as Aleve (OTC) or a prescription, preferably started before the cramps get bad.

  12. Menstruation is a monthly process of removal of the uterus lining that carries unfertilized eggs, through the cervix opening and then finally out through the vaginal canal. It is a pivotal event in a woman’s life and is a clear indication of the fact she has hit puberty and is now fertile. It is a 5 day cycle of vaginal bleeding and some of its symptoms include abdominal cramps. Now, Dr. Chetana V. from Aster CMI says the intensity of these cramps may vary from individual to individual.

    The reason for this difference in menstrual cramps is due to the higher level of prostaglandins, that is a chemical responsible for uterus and bowel contraction both during menstruation and pregnancy. Every woman releases prostaglandins in different amounts during both these situation and the amount released is directly proportional to the intensity of the pain experienced by her. And this is basically why menstruation is considered to be so painful, though some women might not feel it all, while others might experience severe inconvenience and pain, all at once.

  13. The menopause is a time when the hormones that regulate your menstrual cycle, in particular, o-estrogen, begin to fluctuate. Naturally, this causes changes to your menstrual cycle, your periods become irregular and eventually stop. Alongside this, you may also experience period pain. However, it is also possible to experience period pain even when you are not having a period. Although it is not known exactly why this is, it is thought to be a result of conflicting messages being sent by your hormones. Eventually, as your hormones settle again, these symptoms should disperse.

    It is important to remember that period pain may also be an indication of a more serious health condition, such as endometriosis or ovarian cysts, so if you are concerned

    Try Secy to get rid from menstrual pain

  14. During your period, your body makes chemicals called "prostaglandins." These chemicals cause the uterus to contract or tighten. It's the same kind of contraction that happens during labor and childbirth. Contractions during a period are normal. But, they can be painful. The medical name for painful periods is "dysmenorrhea."

    Some medical conditions can make the pain during your period worse. The most common one is called "endometriosis." In this condition, tissues that should grow only in the uterus grow outside the uterus.

    Women with painful periods have cramping in the lower belly. The cramps can be mild or bad. You might also have pain in your back or thighs. Pain often starts with your period or right before your period.

    Some women also have:



    ●Extreme tiredness


    ●Bloating (a feeling of fullness in the belly)

    Wish it helps.

  15. To push the blood through, the uterus tenses and relaxes. These are called uterine contractions.

    If the uterus contracts too strongly, it can press on nearby blood vessels, cutting off blood supply (and hence Oxygen) to the nearby muscles. This causes the pain.

    The pain usually occurs in the abdomen and radiates to the lower back and even thighs.

    P.S. Taking a long, hot bath helps 🙂

  16. Thats like asking why the sun needs to be hot! Jokes apart, period pain is different for every woman. It changes from cycle to cycle and also as you age. For some (very lucky) women there is no pain during the period. So the answer to your question is that periods don’t have to be painful, they just are.

  17. Basic biology. Your period is the sloughing off of the endometrium, the lining of your uterus. This should happen every month.

    From the first day of your period to the first day of your next period is commonly known as a cycle. Around day 15 of your cycle, you ovulate, if you don't get pregnant your lining of your uterus strips off the walls of your uterus and exits the body around the 28th to 30th day. It looks like just blood, but it's more than that. It is material that would nourish the implanted fetus, the first stage of what might become a baby.

    You may have noticed “clots” passing. Thoses aren’t clots. They are pieces of your uterine walls, coming away with the endometrium. That’s why it hurts. In effect you are “giving birth” to the lining of your uterus, cramps are felt.

    Some women don't get much cramping. Some do. When I was young, I had mild cramps. But in my 30′s I developed endometriosis. My lining became brittle and broke off in larger pieces, causing much more cramping, clots and pain. It was caused by a hormonal imbalance. End of biology lesson.

  18. Explained quickly, and also simple, we can say that menstruation or period consists of the detachment and expulsion of the endometrium outside the body of the woman. If fertilization does not occur, each month the inner layer of the uterus shuts off, and the egg is expelled in the form of blood through the vagina.

    Menstruation causes pain because prostaglandins, the chemicals found on the walls of the uterus, increase until menstruation occurs and are responsible for uterine contractions.

    These substances are released during menstruation with the aim of promoting the detachment of the endometrium, and among other aspects tend to increase the sensitivity to pain in women. That is why menstruation hurts, and for this reason you tends to get pain in the uterus and the area of the lower abdomen.


  19. Late in the monthly cycle, before menstruation, progesterone secretion by the ovaries falls sharply. When it does, this induces spasmodic constriction of the arteries than supply the uterine wall. The uterine wall is mostly muscle, and muscle hurts when it’s deprived of a blood flow. Therefore each spasm of the uterine arteries can cause pain, felt more intensely in some women than in others. It is these arterial spasms, however, that also cause the internal lining of the uterus (endometrium) to disintegrate and fall away, thus bring on menstruation.

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