Bad period cramps are usually caused by your uterus squeezing strongly to shed its lining, which is driven by chemicals called prostaglandins; higher levels of these chemicals mean stronger, more painful cramps. Very severe or worsening cramps can also be a sign of an underlying condition like endometriosis, fibroids, pelvic inflammatory disease, or other issues with the uterus or ovaries, especially if the pain interferes with daily life or is new or different for you.
Common reasons it hurts so much
- Primary dysmenorrhea (typical period cramps) happens when prostaglandins make the uterine muscle contract hard and reduce blood flow, which can cause intense pain in the lower belly, back, or thighs, especially in the first 1–3 days. Some people simply make more prostaglandins than others, so their “normal” cramps are much worse.
- Secondary causes include endometriosis, fibroids, adenomyosis, pelvic inflammatory disease, or ovarian cysts, all of which can make cramps sharper, longer-lasting, or more disabling than typical period pain.
When to seek urgent help
See a doctor or urgent care right away (or emergency care if needed) if:
- The pain is so bad you can’t stand, walk, or function, or it suddenly becomes the worst pain you’ve ever had.
- You have fever, vomiting, pain on one side, very heavy bleeding (soaking a pad or tampon every hour for several hours), dizziness, or fainting, which can signal infection, heavy blood loss, or an ovarian problem.
Things you can try now
These are general tips, not a diagnosis or a substitute for a clinician, but they help many people:
- Over‑the‑counter pain relievers like ibuprofen or naproxen, taken with food, can lower prostaglandins and ease cramps; they work best if started as soon as cramps begin or slightly before your period, as long as you have no medical reason to avoid them.
- Heat (heating pad, hot water bottle, warm bath) on your lower abdomen or back, gentle stretching, walking, and staying hydrated can relax the muscles and reduce pain.
- If cramps are severe every month, birth control methods that thin the uterine lining (like hormonal pills, patch, ring, IUD, or injection) can significantly reduce cramping for many people, but need to be discussed with a clinician.
Next steps for you
- If your cramps are new, suddenly much worse, or disrupting school, work, or sleep, make an appointment with a doctor, nurse practitioner, or gynecologist to rule out conditions like endometriosis or fibroids and to discuss stronger or preventive treatments.
- Keep a simple “period and pain” log (when your period starts/ends, pain level 0–10, where it hurts, other symptoms, and what helps) and bring it to your visit; this helps clinicians find patterns and choose better treatments.
If you tell more about your age, how long this has been happening, how heavy your bleeding is, and whether you’re sexually active, a more tailored explanation and next‑step plan can be offered.
