January 14 2021 | Written by Pri Dogra (She/Her)
In health class I learned that sometimes periods can cause cramps. ‘No big deal,’ I thought before my first period. Cramps when running aren’t that bad and they disappear quickly.
Boy, was I wrong. I now have a very strong love-hate (and maybe ‘hate’ again) relationship with my period. Over the years, I have learned to appreciate it as a signal that my body and hormones are working as they should be. On the other hand, it’s extremely difficult to see past the pain. I’m talking bed-ridden, have-to-leave-work, vomiting, curled-up-on-the-floor, can’t-sleep-at-all, used-to-take-T3 kind of pain. THESE must be more like the cramps they meant in health class…sound familiar?
I’ve noticed a few things about my cramps: the first full day is always the worst, the pain comes in waves, and I experience different kinds of pain depending on what day it is in my cycle. If you are in my boat even the slightest bit, read on to explore the basics of period pain and to understand what’s really going on.
What Are Cramps?
Each cramp is a uterine contraction. In the body, there are hormone-like chemicals called prostaglandins. Prostaglandins are responsible for inflammation, pain, blood flow, forming blood clots and inducing labour. During menstruation, it is these prostaglandins that trigger the uterus to contract. According to the Cleveland Clinic, the uterus may contract so strongly that it presses “against nearby blood vessels, cutting off the supply of oxygen to muscle tissue.” When the oxygen supply is paused, the pain shines through, explaining why my pain comes in waves.
As I’m sure many of you know, cramps can occur before menstruation too. Unfortunately, during menstruation the pain is not necessarily localized. It can radiate from the lower belly to the thighs, lower back, and even hips. ‘Normal’ cramps should respond to standard remedies like heat and painkillers or anti-inflammatories like Tylenol or Advil. Everyone’s ‘normal’ threshold for pain is different, but if your period rules your life, that’s a different conversation. The Mayo Clinic says cramps can range from “merely annoying” to debilitating. Based on the poll answers which I will reveal later, many of our followers seem to better relate to the latter.
Types of Cramps
Menstrual cramps fit into two categories: primary dysmenorrhea and secondary dysmenorrhea.
Simply put, “dysmenorrhea” is medical jargon for painful periods. Primary dysmenorrhea is characterized by recurrent menstrual cramps for no other reason than a period. Pain might start before the actual period, typically lasting from 12 to 72 hours. This type of dysmenorrhea is often accompanied by nausea, vomiting, fatigue, and diarrhea (those damn prostaglandins…).
Secondary dysmenorrhea is pain from a condition or infection that affects the reproductive organs. This type of pain generally lasts longer and begins sooner. Nausea, vomiting, fatigue and diarrhea aren’t as frequent.
Specific Causes of Cramps
While very painful periods are common, they’re not normal. Certain underlying conditions can cause or contribute to excruciating pain:
Endometriosis: as mentioned in our previous blog, research states that “endometriosis is when tissue that somewhat resembles the lining of the womb (endometrium) is found outside the womb.” This, along with possible swelling and scarring, can cause immense pain.
Polycystic Ovarian Syndrome (PCOS): when a female has higher-than-average levels of androgens (male sex hormones) and cysts have formed in the ovaries, although not everyone with PCOS presents with cysts. PCOS may cause heavier and more painful periods. More info on this can be found here.
Uterine fibroids: noncancerous growths in or on the wall of the uterus. These can contribute to excess pain of the pelvis, back, abdomen, and legs.
Pelvic Inflammatory Disease (PID): bacteria in the uterus that causes an infection and spreads to other reproductive organs. Scarring in the fallopian tubes may lead to more painful cycles, particularly painful ovulation.
Adenomyosis: when the uterine lining grows into the muscle of the uterus. As a result, the uterus is enlarged which can cause extra pain and bleeding.
Cervical stenosis: when a narrowed cervix “[impedes] menstrual flow, causing a painful increase of pressure within the uterus.”
These are only some of the reasons that might explain abnormal pain. It is extremely important to do your own research and advocate for your own health.
What do cramps feel like?
I have three younger brothers. While they may see me routinely removed from my life once a month, they will never truly understand the pain. Personally, I would describe my cramps as boiling water being spilled internally. We decided to take it to the people (you) and find out how they would describe their pain. Here some of my favourite (most relatable) responses:
“Like my uterus is mad and is tearing down baby shower decorations I didn’t ask for.”
“Stabbing with electric shocks.”
“A 1000lb weight on my uterus.”
“Hell on earth. Like my insides are being torn out slowly.”
“Like my uterus is trying to chew its way out of my body.”
What can we learn from this?
I can tell all of you fellow sufferers that you’re definitely not alone, and that it is crucial to listen to your body. Menstrual cycles are vital indicators of overall health, which is why it’s so important to identify what’s causing the pain. If your regular OTC meds aren’t cutting it or you feel like you have to hit pause on everything, it’s time to check in with your doctor or gynecologist.