Period pain – the medical term is dysmenorrhea – is one of the most common problems that menstruating women experience. It typically refers to menstrual cramps – the crampy, lower abdominal discomfort and pain that can come and go during your period. It can be sharp pain, or just an all-over achy sensation.

An estimated 9 out of 10 women will have period pain during their reproductive lifespan. For some, the pain is mild and bearable. For other women, they have severe period pain that can be very debilitating and interfere with school and work. Period pain is actually the leading cause of missed school days and work days for women in their teens and 20s.

Period pain is common during your teen years; it usually starts within 4 to 5 years of your first period. For many women, the pain decreases as they age, and by the time women hit their 30s, their period pain is usually mild and not so bothersome. Unfortunately, some women continue to have moderate to severe period pain until they hit menopause.

What Causes Period Pain?

Period pain falls into two categories – primary dysmenorrhea and secondary dysmenorrhea.

Primary Dysmenorrhea refers to menstrual cramps and other period pain and discomfort, like backaches, that occur in healthy young women in their adolescence. This type of period pain isn’t related to a specific problem with the ovaries, uterus, or other reproductive organs.

Primary menstrual pain is related to the increased activity of prostaglandins (chemicals that are formed by the uterine ling during a normal menstrual cycle). Prostaglandins cause contractions in the uterus, which reduce blood blow and oxygen to the uterus and give you discomfort and pain. Some women have higher levels of prostaglandins than others, and these women will often experience more intense uterine contractions during their periods – which is why their period pains can be so severe and painful.

Roughly 90 percent of all menstruating women will experience primary dysmenorrhea in their lifetime. It generally is worst in their adolescent, but decreases in severity as you age. Symptoms also improve after you have your first child.

Secondary Dysmenorrhea is period pain that’s caused by a secondary medical condition, such as endometriosis (when the lining of the uterus grows in other areas of the body), fibroids, ovarian cysts, a narrow cervix, pelvic inflammatory disease(a bacterial infection that starts in your womb and spreads to your other reproductive organs), a sexually transmitted infection, and intrauterine devices (IUD) made from copper.

Secondary period pain can often start earlier in your menstrual cycle – possibly before your period even begins – and it often lasts longer than primary dysmenorrhea. In other words, it can make you miserable and feeling achy and crampy for weeks.If you have secondary dysmenorrhea, your period pains can be accompanied with loose stools or diarrhea, an upset stomach, nausea and/or vomiting, headache, fatigue, and flu-like symptoms.

Women with secondary dysmenorrhea often have very heavy periods. And because of the vast amount of blood that women are losing, many can develop anemia and end up being very fatigued as a result.

Roughly 10 percent of all women will have period pains that temporarily disable them and interfere with their every day life.

When to Call the Doctor about Period Pain

Because period pain can be a normal part of being a girl and having menstruation, you don’t necessarily need to contact the doctor. Home treatments often will work to give you some relief until your period is over.

However, it is a very good idea to contact your gynecologist or healthcare provider in the following situations:

• You are experiencing severe cramps that last more than 2 to 3 days.

• You’re over 25, and you suddenly develop menstrual cramps and pain. (And you don’t have a history of having such painful periods.)

• Your bleeding excessively; You are going through more than one pad (or more than one tampon) each hour.

• There are any signs of infection around the time of your period – such as having a fever, experiencing chills, and body aches.

• You think you might be pregnant, and you’re having painful menstrual cramps.

• Your period pain is different than it was in the past, or it is much worse than any other menstrual pain you’ve experienced.

How to Ease Period Pains – At Home Remedies

If your period pains are mild or moderate, you can treat your discomfort by taking over-the-counter pain relievers – such as Ibuprofen (Advil), Naproxen (Aleve), and Acetaminophen (Tylenol).

Non-steroidal anti-inflammatory drugs (NSAIDs), such as Advil and Aleve, are often most effective at giving you relief, since they decrease prostaglandin production. Less prostaglandins often means less cramping and fewer contractions.

NSAIDs can be hard on your stomach, so you may want to take them with food. You should talk to your healthcare provider before taking NSAIDs if you have a history of kidney problems or stomach issues – like ulcers or reflux.

If you want to go the more natural route to help your period pain, it may help if you use a heating pad or heating patch to your stomach and pelvic area. Heat therapy helps dilate the blood vessels of the muscles, which increases the flow of oxygen and basically works against what prostaglandins are doing.

Exercise may also be beneficial and easing painful periods. There are a number of research studies that suggest that exercise does reduce menstrual symptoms, including period pain in some women. Even if exercise doesn’t help you a whole lot, it sure is good for you!

Medical Treatments for Period Pain

When at-home treatments don’t help treat your period pain, you should go to the doctor or healthcare provider to get professional help.

Physicians can prescribe birth control pills and hormonal birth control to help treat painful periods. Hormonal birth control methods – whether it’s the pill, the patch, a hormone injection, or hormone-releasing IUD – work to relieve period pain by thinning the uterine lining (which forms prostaglandins) and therefore decreases uterine contractions.

For women who are trying to get pregnant, or those who do not want to use birth control to relieve their symptoms, their healthcare provider may prescribe pain relievers that require a prescription to help ease women’s menstrual pain.

Traditionally, doctors would offer women who have excessively heavy periods (and severe period pain, as a result) a hysterectomy to offer them relief. However, a hysterectomy is a major medical operation that removes the women. The recovery time can be six to eight weeks, and some women would rather not have a hysterectomy.

Instead of a hysterectomy, some women will opt for a surgical procedure called endometrial ablation – in which the lining of the uterus is removed. Ablation will help about 80 percent of women with painful periods.

If surgical procedures are not for you, you may want to ask your doctor about using a TENS (Transcutaneous electrical nerve stimulation) device. TENS is a form of alternative medicine that has been found more effective than placebos in helping relieve period pains. TENS treatment involves using electrode patches, which you apply to the skin near your abdomen. You wear a small battery pack on a belt, which passes electric current to the electrodes patch on your skin. It is believed that this causes the release of endorphins (the feel-good chemicals, or body’s natural pain relievers). As a result, this electrical current may decrease your pain.