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Why Some Periods Hurt More Than Others
Interviewer: We're talking with women's expert Kirtly Parker Jones. She's the expert on all things women. Here is the scenario, Dr. Jones, it is that time of the month, and I know menstrual cramps are normal. I know that. But for whatever reason, it just feels more painful this time compared to any other time. Or so it seems like. I know I won't die from menstrual cramps, but it feels pretty darn close. Am I normal?
Dr. Jones: Okay. First of all, let's talk about how common period cramps are, and that is about 16% to 90% of women have cramps. So that's a big range, depending on which study you do. Of those people, about 2% to 29% have severe dysmenorrhea, meaning severe pain, enough that it disrupts their lives.
Well, why would one period be different than the other? Well, it could be the amount of exercise you had. It could have been how much sleep you had. It could have been your pain tolerance. Maybe your hormones were a little bit different. Maybe you made two eggs that month, so you made a little more estrogen that month. So not all months are exactly the same with respect to cramps. So what happens with the really bad ones? Well, you're not going to die, but there are people . . .
Interviewer: That's the good news.
The Role of Prostaglandins in Menstrual Pain
Dr. Jones: . . . particularly, and you're such a young voice. I'm going to assume that you're a young person. Young people can have a number of symptoms that go along with period cramps, which can make it even worse. So the hormone that makes the uterus cramp, that pushes out that dead uterus lining so that it's all cleaned out, so you can start again, is called prostaglandins.
And it's vital to the health of the uterus that you make it, but it makes not only the blood vessels constrict, so the lining will come out, but it also makes the uterus cramp. But prostaglandins can also cause diarrhea, and they can cause fainting. And when you're dizzy and you're feeling nauseated and throwing up, then everything hurts more. So sometimes it's enough that people actually throw up and pass out. Sometimes, they don't.
When to See Your Doctor About Menstrual Cramps
Now, if you told me that your periods were getting heavier and heavier or not heavier but more and more painful, I would begin to think that as each period got worse, there was something going on. So a woman who said, "I just had one of the worst periods of my life." I'd think, "Fine." If you said, "My periods are getting worse and worse," I'd think of two conditions:
- One are fibroids in the uterus. So the uterus is kind of trying to contract around a little muscle ball.
- And the other one is endometriosis. A condition where little bits of uterine glands are growing around the pelvis, and that causes pain, too.
So, for women who are having really bad periods but they're getting worse and worse and worse, (a) we have very good therapy for periods, but (b) we may need to do a little investigation. If it's just the worst period of your life and it's only this one, it's probably not going to be so bad next time. And the good news is you're probably normal.
updated: June 6, 2025
originally published: February 3, 2017
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