Understanding your menstrual cycle can be puzzling. Periods can fluctuate in timing, flow and even the level of discomfort they bring. Factors such as age, stress levels, diet and exercise can also all influence the nature of your period. All of this complexity can make it challenging to determine when period pain signals a slight change in your usual period or something more serious. The presence of pain during a period, while common, can at times be something that requires further investigation. How do you know when you’re experiencing usual period pain versus something else?
What Makes Periods Painful?
Unfortunately, it’s common for many women to experience menstrual cramps as part of their cycle. This happens when the uterus contracts to shed its lining (the endometrium) and results in cramps that can range in intensity from mild to debilitating. In addition, prostaglandins (hormone-like substances) can play a role in this process, causing further discomfort.
In general, a painful period may also be caused by one of the following:
- Uterine Fibroids
These are non-cancerous growths within the uterus wall that can sometimes cause heavy bleeding and significant pain. Uterine fibroids are very common and usually go unnoticed. However, every once in a while, their presence can make period pains significantly worse. - Adenomyosis
Adenomyosis is a condition that causes endometrial tissue in the lining of the uterus to grow into the muscular wall of the uterus. It enlarges the uterus, and may lead to very heavy menstrual bleeding, pain and prolonged periods. - Endometriosis
In a normal cycle, the uterine lining thickens and then sheds. With endometriosis, similar tissue grows outside the uterus. The shedding of this tissue each month results in pain, inflammation and scar tissue formation, explaining endometriosis’s link to debilitating pain.
Is My Period Pain Typical?
It’s helpful to understand what is normal for your body and what could indicate a deeper issue. Menstrual cramps often start a day or two before your period and can be mild or severe. They typically last 24-72 hours and are centered in the lower abdomen or back. Sometimes nausea, headaches, dizziness and a general feeling of being unwell accompany periods.
The following are signs and symptoms that your period pain may be caused by endometriosis
- When the pain occurs: Endometriosis-related pain is not always confined to your period; it can strike anytime within your cycle. If you notice cramping-type pains that occur outside the window of your immediate period, it might be a sign of endometriosis.
- Level of pain: If your period pain prevents you from functioning normally or lingers after your period ends, endometriosis might be the culprit. Although pain is an unfortunate part of many periods, a high level of pain should not be considered normal. If this occurs, speak to your doctor.
- Severity and length of pain: Endometriosis pain tends to be notably worse than menstrual cramps and can last longer than normal period pain.
- Other symptoms: When endometriosis is present, it can cause other symptoms, such as painful bowel movements, painful sex and at times, lower back pain.
- Family history: If there is a history of endometriosis within your family, your risk of having endometriosis is slightly higher. Consider this when assessing your symptoms.
- Painkiller resistance: Endometriosis pain may not respond well to over-the-counter pain relief. By contrast, period pain is usually helped with regular pain relief.
When To See Your Doctor
Make an appointment to see your doctor if the pain you are experiencing seriously impacts your quality of life or the symptoms mentioned above are present. Your doctor will take a medical history and conduct a physical examination to get a better understanding of your pain. If required, diagnostic tests, such as an ultrasound scan or laparoscopy, may be used to provide an accurate diagnosis.
Outlook
Knowing the difference between usual cramps and endometriosis is essential for getting the right treatment. While period pain is common, do not ignore it, particularly if the pain seems excessive or unusual. If the cause of the period pain is, in fact, endometriosis, this is a manageable condition that can be dealt with by appropriate care and guidance, so be sure to consult your doctor.
