Every menstruating person experiences their own period individually. The term period problems is used to describe various types of discomfort or pain that can occur during menstruation. While some people have no symptoms at all, others suffer from severe menstrual pain every month. That is why we are going to look at what types of period problems exist, what is normal and why we actually have them.

Primary period pain is mostly mild

Menstrual cramps are divided into primary and secondary period pain. Primary period pain is milder and can be relieved naturally with (simple) home remedies and a healthy diet. Although the pain is unpleasant, it is bearable and usually harmless. The causes of primary period pain are not disease related and are very individual. Reasons for menstrual pain can be, for example, the early onset of the first period, low body weight, a long menstrual cycle or even genetic predisposition. Ask the menstruating people in your family how they experience or have experienced their period. Maybe your experiences with menstrual problems are similar? The good news is: Statistically speaking, the pain decreases with age.

Secondary period pain is caused by a disease

Secondary period pain, on the other hand, is caused by an underlying gynecological or organic disease. These can be, for example, endometriosis, polyps, cancer or inflammation of the reproductive organs. Endometriosis is the most common cause of secondary period pain. In some cases, the symptoms are so severe that those affected cannot go about their normal daily lives for several days a month. To relieve secondary period pain, the focus is on the treatment of the underlying disease. It is best to speak directly to your gynecologist if you suffer from severe menstrual pain. 

Why do we experience period pains?

You may ask yourself: Where does menstrual pain come from? During your period, the uterus contracts cramp-like, causing contractions of the uterine muscles. The muscle movements are caused by hormones, for example prostaglandin. Depending on the strength of the contractions, these can cause pain. But why does the uterus contract at all? Every month during the menstrual cycle, new uterus lining forms to prepare for the fertilized egg. If fertilization does not occur, the lining of the uterus is not needed and is rejected along with the unfertilized egg. This consumes a great deal of energy from the body. The muscles of the uterus contract in waves, which can lead to cramping pain. The rhythmic muscle movements also cause the blood circulation within the uterus to be interrupted by the cramps. This can cause a lack of oxygen, which is the reason for additional period pain (ischemic pain). 

Which period problems are there?

Menstrual problems are very unique and can occur in up to 150 different forms. The complaints can range from an unpleasant feeling in the back to diarrhea and severe abdominal cramps. Dizziness, nausea, a feeling of tension in the breasts or tiredness are also typical. Headaches and abdominal cramps are among the most common complaints during menstruation. Besides physical pain, mood swings can also occur.

Menstrual cramps: What is normal?

The symptoms usually appear a few hours before the start of your period and last for a day or two. All menstruating people can be affected by menstrual cramps. Up to a certain point, period pain is normal, especially at the beginning of your period. But it is difficult to say exactly to what (pain) degree period pain is normal. As long as the monthly menstrual pain is bearable and simple home remedies help, everything is probably okay. However, if the symptoms during your period (severely) restrict your everyday life and your own performance, you should make an appointment with your trusted gynaecologist. This is because diseases, such as endometriosis, can be the cause of the severe pain. Painful or difficult periods with symptoms are medically called dysmenorrhea.

INFO-BOX: How can I track my period pain?

You might be wondering whether your menstrual symptoms are (still) normal? Often it helps to talk to other menstruating people about your period problems in order to get a better feeling of how others experience their periods. Here are a few questions that can help you to classify your pain:

  • On a pain scale from 1 to 10: Where would I rank my period pain?
  • Can I ease my complaints with simple home remedies or do only painkillers help?
  • What kind of menstrual problems do I experience?
  • Do I suffer from the same complaints every month?
  • Does my period interrupt my everyday life? Do I have to cancel dates or appointments because of the pain?
  • Do the symptoms have a negative effect on my well-being or my productivity?

Sometimes it helps to ask yourself these questions every month anew and to create a small period journal over time. This way you will get a good picture of your symptoms, recognize patterns and develop a feeling for which symptoms and pain are ‘normal’ for you. Take your notes with you to your next appointment with your gynecologist and get medical advice on it.

Period pain: When should you see your doctor?

In case of severe menstrual problems that restrict your everyday life, a medical examination is important! Suddenly occurring menstrual pain or changes in the duration or intensity of your periods should always be professionally examined. It is better to have another check-up to make sure that everything is fine and to get the necessary medical support to treat your menstrual problems, if necessary.

How are you experiencing your period?

How are you feeling during your period? Are you more of carefree period person or do you suffer from all kinds of menstrual cramps? What are your most common complaints? And has it always been like this or has your period changed over the years? Tell us about your symptoms and how you feel during your period.

Illustration by Magdalena Otterstedt / Kopfüber Design for Vulvani