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What causes period pain and why you should care?

By Shagun Maheshwari


It starts with that familiar ache in your thigh. It moves up to your back, and it slowly makes its way to full blown out cramps.

Most of us with a uterus are familiar with the onset of cramps which serve as a reminder of our menstrual cycles. Pain due to menstruation is experienced by 45% - 95% of menstruators in certain age groups [1, 2]. For most menstruators, having pain during their cycle is so normalized that they wont even seek help or report it to their doctor [1, 2].

Given that menstrual pain can strongly affect quality of life, it is important to understand both the personal and societal implications of menstrual pain.

So why does having your period hurt?

Most of us are familiar with the biology behind periods. Every month the female reproductive system readies itself to house a fertilized egg. It does this by preparing a nutrient rich lining called the endometrium in the uterus. If the egg is not fertilized, this lining gets broken down and removed from the body.

But, what causes the pain? During one’s period, In order to enable shedding of the endometrium, the body produces a hormone called prostaglandin. Prostaglandin causes the muscles of the uterus to contract, and it allows the endometrium to shed. However, when levels of prostaglandin go up, the blood vessels supplying oxygen to the endometrium contract. This contraction causes cramps. These uterine cramps help the endometrium get squeezed out. High levels of prostaglandin leads to pain as reduced blood flow and lack of oxygen trigger pain receptors in the body.

Menstrual pain strongly affects the quality of life for those experiencing it by limiting their daily activities, causing disturbed sleep and mood swings. Many studies have shown that period pain can often lead to missing work or school at least once per cycle [3]. Menstrual pain is not only a problem to the person having their period, but also leads to broader societal losses in productivity.

Non steroidal anti inflammatory drugs (i.e. ibuprofen or aspirins) are common treatments to relieve primary dysmenorrhea. [4] These work by blocking the enzyme, responsible for production of prostaglandin. Ibuprofen can also lead to reduction in bleeding. If menstrual pain continues for more than two days it is recommended to consult with a doctor in order to ascertain whether there may be any underlying disorders.

Having said that, many women are afraid of taking painkillers every cycle as they fear side effects or getting too dependent on medication to handle their period pain. Lack of proper information and clarity on side effects of taking medication regularly during the menstrual cycle needs to be addressed. Given that so many people globally experience menstrual pains on a regular basis, care for menstruators in terms of improved policy as well as medical aids needs to be prioritized. Having severe pain every cycle cannot be the norm for menstruators.

There are also other causes that lead to painful periods. Sometimes period pain can be a sign of a more serious biological disorder like PCOS or endometriosis. To learn more about these conditions, stay tuned for our blog on period pain disorders!


[1] Bernardi, M., Lazzeri, L., Perelli, F., Reis, F. M., & Petraglia, F. (2017). Dysmenorrhea and related disorders. F1000Research, 6, 1645.

[2] Iacovides, S., Avidon, I., & Baker, F. C. (2015). What we know about primary dysmenorrhea today: a critical review. Human reproduction update, 21(6), 762–778.

[3] Zannoni, L., Giorgi, M., Spagnolo, E., Montanari, G., Villa, G., & Seracchioli, R. (2014). Dysmenorrhea, absenteeism from school, and symptoms suspicious for endometriosis in adolescents. Journal of pediatric and adolescent gynecology, 27(5), 258–265.

[4] Dawood, M. (2006). Primary dysmenorrhea: advances in pathogenesis and management. Obstetrics and gynecology, 108 2, 428-41 .

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