Period pain is the most common gynecological condition, with studies showing its experienced by 45-95% of menstruators. Formally, period pain is known as dysmenorrhea— the greek word for difficult menstrual flow.

Although common, it isn’t necessarily normal. Strongly associated with depression and anxiety, period pain can negatively impact your daily activities and personal lives. Sleep is also affected in those with period pain, potentially leading to daytime fatigue and sleepiness. 

Primary Dysmenorrhea

There are two types of dysmenorrhea. Primary dysmenorrhea is pain without an underlying cause and might happen because of prostaglandin production, nutritional deficiencies, and some diet and lifestyle factors.

When you’re on your period, your uterine lining releases prostaglandins, causing the uterine muscles to contract. It’s thought that people who have dysmenorrhea produce too many prostaglandins. Ultimately, this causes contractions that reduce blood flow and cause oxygen deprivation in the uterus that often leads to a cramping pain sensation over the pubic bone.

Pain is typically bad just before and/or when your period begins. It can last between 8-72 hours and is most severe on the first or second days of your period— usually on the days with the heaviest flow. The pain might radiate to your back or thighs and may also cause other symptoms like nausea and vomiting, fatigue, light-headedness, or headaches.

Secondary Dysmenorrhea

Secondary dysmenorrhea is pain due to an underlying condition that can happen before, during, or after the period. Underlying conditions can include endometriosis, adenomyosis, fibroids and cysts, infections, and even IUDs. Secondary dysmenorrhea usually occurs in menstruators between 20 and 40 years old (likely due to a delay in diagnosis) and can worsen over time.

Risk Factors for Period Pain

• Age
• Smoking
• People who experience their period at an early age
• Long and heavy menstrual flow
• Higher BMI
• Alcohol use
• Family history of dysmenorrhea

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This is an excerpt from a post written by Dr. Alexsia Priolo, ND, a licensed Naturopathic Doctor in Toronto, Canada with a special interest in the menstrual cycle and fertility. Follow her on Instagram. Content curated and edited by Nayla Al-Mamlouk.