There's no other way to put it: Period cramps suck. If you're part of the population who menstruates, you're probably familiar with the wonders of period pain—the sharp spasms that feel like you just got punched in the gut, to steady, underlying aches that feel like someone is using a cheese grater on your insides.
"Every woman experiences cramps differently," says Dr. Sherry, an OBGYN and author of she-ology: The Definitive Guide to Women’s Intimate Health. Period. "If you are having heavy periods with large blood clots, you will probably experience more intense cramping. Some women may have light bleeding but still have severe cramps. Blood flow and volume doesn’t always correlate how significant the cramping will be."
Period cramps are often categorized as mild, moderate, and severe. Dr. Sherry says that your personal pain tolerance will also play a factor in determining on how uncomfortable cramps will be for you. A day or two before your flow starts, it's possible to feel mild to severe cramps in your lower back and legs, which can sometimes cause numbness in your legs along with nausea or vomiting.
Whatever kind of cramps you might experience, know that feeling some pain is totally normal, and nothing that a heating pad or ibuprofen can't solve. But, if you notice a change in the pain threshold of your cramps, it could be your body signaling another health issue.
So, what are your cramps trying to tell you? We asked Dr. Sherry to break it down.
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You Have Agonizing Cramps & a Heavy Flow
Dr. Sherry says that the cramps that have you permanently curled up, clutching a pillow on the couch could be your body passing a blood clot. "The size of the clot can determine the severity of the cramping," she explains. "In general, the larger the clot, the more painful the cramping."
According to Dr. Sherry, if your period becomes irregular and heavy due to clots, there could be a larger veiled issue. Some common causes of excessive clots range from a change in physical and psychological factors such as stress, weight loss, excessive exercising, and pregnancy, to STIs, thyroid and hormone disorders, uterine fibroids and polyps, and polycystic ovarian syndrome.
You Have Constant, Mild Cramping
Low-grade consistent pain that's bearable, but uncomfortable could be representative of a few different issues. "This type of cramping could possibly not respond to typical treatments and be a sign of a ruptured cyst, a bladder infection, sexually transmitted infections, pregnancy or endometriosis," explains Dr. Sherry.
Your Camps Don't Respond to Typical Treatments
If your cramps seem to be immune to period pain remedies like ibuprofen, nonsteroidal anti-inflammatory medications, acupuncture, biofeedback, or the birth control pill, Dr. Sherry says that endometriosis shouldn't be ruled out. "I would be concerned endometriosis was the cause of the pain, which doesn’t always respond to traditional treatments," she says. If this situation sounds familiar, make an appointment with your doctor to err on the safe side so that the potential condition doesn't go untreated.
You Get Sharp Pains on One Side
The right hook you might suddenly feel could simply be that your uterus is leans over to one side. "The uterus anatomically can normally lean to the left or the right in a woman’s pelvis," Dr. Sherry explains. "If this is the case, period pain will be more noticeable on one side or the other." Alternatively, some women experience a pain on one side during ovulation when the egg is released from one of the ovaries.
You Get Period Migraines, Too
If you get a killer headache before or during your flow, it could be signaling the change in hormones that takes place when your body prepares to menstruate. "Hormonal changes trigger many unpleasant symptoms, headaches are one of those symptoms," says Dr. Sherry. "The changes of estrogen and progesterone during the menstrual cycle can worsen headaches, especially migraines."