Top 7 Causes of Period Cramping and Pain

More than half of people who have a menstrual cycle experience pain from their period (dysmenorrhea) for one or more days each month when they are ovulating. Even though period pain can cause headaches or general discomfort, the pain is typically due to menstrual cramps.

Menstrual cramping happens when your uterus contracts to shed the uterine lining. This can result in pain in your stomach, groin, lower back or upper thighs. Previously, we talked about when it might make sense to see a doctor for menstrual cramps. In this article, we discuss what might be causing your period pain and provide ways you can try to stop it.


What causes period pain?

If you experience consistent painful periods, it’s normal to wonder why. Perhaps you are the only woman in your family who gets severe cramps. Or maybe your periods recently became painful or didn’t start to be painful until your twenties. Whatever your situation, a doctor can help you understand why you get painful cramps each month. A list of common reasons for painful periods are:


Known as premenstrual syndrome, PMS affects about 90 percent of people with menstrual cycles. PMS usually starts a few days before your period starts and can continue into the first or second day of menstruation. Doctors believe PMS is caused by dropping estrogen and progesterone levels before the start of the period cycle. PMS has several symptoms including irritability, fatigue, and menstrual cramping.


A more severe form of PMS is called Premenstrual dysphoric disorder and affects about 5 percent of people with menstrual cycles. Medical professionals believe PMDD has a correlation with people with depression or high levels of stress. Similar to PMS, symptoms of PMDD are more intense, typically including more painful cramps.


Endometrium, also referred to as the “uterine lining”, grows inside the uterus. But if someone has endometriosis, the endometrium can grow outside the uterus, typically in other parts of your reproductive organs such as the ovaries or fallopian tubes. As the body attempts to shed uterine tissue during a period, the endometrium growing outside the uterus has nowhere to go and can become trapped in the body. This sometimes causes painful cramps, irritation, inflammation and heavy bleeding. Fortunately, in most cases, endometriosis can be managed with medicines and surgical procedures.


Developed in the uterine lining, uterine fibroids are benign growths. They can be so small that it’s impossible to see them with the naked eye, or big enough to change the shape of your uterus. Usually, they appear during childbearing years and but often decrease in size or go away completely post-menopause.

Particular factors can increase one’s risk of getting uterine fibroids, including: age, having a family history of fibroids, being overweight or being of African descent.

Because fibroids grow in the uterine lining, they can cause painful period cramps and heavy periods.

Ovarian cysts

Generally formed during ovulation, ovarian cysts develop in the ovaries. A cyst is typically a harmless sac of fluid that forms in or on your body. Many people develop at least a single small cyst every month that fades away on its own. However, some people with menstrual cycles get multiple or large ovarian cysts which may cause pain or other complications. In cases like these, medical treatment may be required to manage the cyst(s). Ovarian cysts may also be the result of polycystic ovary syndrome or PCOS. This is a condition where a hormone imbalance causes many small, harmless cysts to grow in the person’s ovaries. This may cause painful periods, insulin resistance, difficulty getting pregnant and other health conditions. Symptoms of PCOS often include period irregularities, excess hair on the face or body, weight gain or difficulty losing weight, thinning hair on the head, and acne. Medical professionals may prescribe treatments that help manage PCOS symptoms.


Adenomyosis is a benign condition that can cause severe cramps but is a treatable condition. It occurs when the endometrium grows into the muscle wall of the uterus. While endometrium can affect the entire uterus muscle, it usually only  affects a single area. Medical professionals aren’t sure exactly what causes adenomyosis, but it’s six times more common in women who’ve undergone uterine surgery or who’ve had children.

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is when the uterus and ovaries become infected. Bacteria from a sexually transmitted infection (STI) can cause an infection and progress to the reproductive organs. PID can also form after a surgical procedure. While many people with menstrual cycles experience no symptoms of PID, it may result in painful cramps.

How to stop period cramps

If you’re suffering from painful menstrual related cramps, check out our article on ways to naturally relieve cramping and cramp pain.

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