Most people experience mild pain and discomfort during their period. But for some, the pain and cramping are so severe that it impacts their ability to function normally. Limited research suggests that period pain can be as painful as a heart attack.

Menstruation or periods are the monthly vaginal bleeding that occurs as a person’s body sheds the lining of the uterus.

Cells in the lining of the uterus release chemicals called prostaglandins that cause the blood vessels and muscles of the uterus to contract and shed its lining.

Prostaglandins are also responsible for the cramping pain that comes before or during a period, with pain intensity proportionate to the amount of prostaglandins released.

This article explores whether period cramps could be as painful as heart attacks and what conditions cause them.

A person holding a hot water bottle against their abdomen. Anecdotal evidence suggests period cramps may be as painful as a heart attack.Share on Pinterest
Design by Medical News Today; photography by Magida El-Kassis/Stocksy

The medical term for period pain or the pain associated with menstruation is dysmenorrhea. It often begins a few hours before menstruation and persists for 2 to 3 days, with the pain strongest during the first 24 to 36 hours.

The pain a person may feel can vary from dull and constant to intense spasms. Its intensity can also vary with each period and from person to person.

Dysmenorrhea affects 45 to 95% of people who menstruate, and half describe the pain as moderate or severe.

What does the research say?

A 2018 article in Quartz quoted John Guillebaud, a University College London reproductive health professor, as saying that patients described menstrual cramping pain as “almost as bad as having a heart attack.”

There are limited studies that describe or qualify dysmenorrhea pain. However, numerous studies show how it impacts a woman’s quality of life.

About 3 to 33% of menstruating females report very severe pain that renders them incapacitated for 1 to 3 days, causing them to miss school or work.

More than one-quarter of females take work absences or reduce their working hours for at least 1 day per 6 months for period pain.

It can also have a negative effect on multiple aspects of a person’s life, including their friendships, family relationships, school or work performance, and social and recreational activities.

There are two types of dysmenorrhea. Primary dysmenorrhea is the presence of painful menstruation not caused by pelvic disorders.

Secondary dysmenorrhea involves menstrual pain due to an underlying medical condition or structural abnormality within or outside the uterus. Below are the most common conditions that cause painful periods.

Endometriosis

Endometriosis involves the growth of tissues that resemble the lining of the uterus (endometrium) to grow outside the uterus. Its most common symptoms are pelvic pain and infertility.

It can cause severe, life-impacting pain during:

  • periods
  • bowel movements
  • urination
  • sexual intercourse

Fibroids

Uterine fibroids are a common type of benign tumor. They may occur in or around the womb, and their most common symptoms include:

Adenomyosis

Adenomyosis occurs when the inner lining of the uterus breaks through and grows into the muscular wall of the uterus.

Dysmenorrhea and heavy menstrual bleeding are common symptoms.

Endometrial polyps

Endometrial polyps, or uterine polyps, refer to overgrowths of a person’s endometrial glands and tissues within their uterus.

It is the contributing factor to 50% of abnormal uterine bleeding cases and 35% of infertility.

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is the inflammation of the upper genital tract. In 85% of cases, PID is secondary to sexually transmitted diseases like gonorrhea and chlamydia.

Symptoms include:

Use of contraceptive devices

Using intrauterine devices (IUDs) for contraception may also cause period pain, especially during the first few months of insertion.

Several things that may ease painful cramps include:

Pain relievers are the first line of treatment for managing dysmenorrhea. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen work by blocking prostaglandin production, reducing period pain.

Birth control methods that contain estrogen and progestin, such as patches, vaginal rings, and pills, can also treat painful periods.

It is essential to talk with a healthcare professional or an obstetrician-gynecologist (OB-GYN) if a person experiences very painful periods during their menstrual cycle.

They may recommend a pelvic exam to find out the cause of the pain and provide medications to relieve it.

Painful periods, or dysmenorrhea, is a common menstrual condition. The type and intensity of pain can vary from person to person and even in one’s menstrual cycle.

Most period pain is mild, while other people’s pain may be severe enough to interfere with everyday activities.

It can also be caused by conditions such as endometriosis, fibroids, adenomyosis, and pelvic inflammatory disease.

Treatment for dysmenorrhea includes pain relievers, oral contraceptives, lifestyle changes, and home remedies.

Individuals with period pain interfering with their daily life should seek medical attention. A doctor can assess the condition and recommend treatments to help reduce the pain.