What makes a period painful?

georgiebday
Jun 20
3 min read

Common, & not-so common causes of painful periods

Because if you didn't know, period pain - although being incredibly common, should not be (and is not) 'normal' -

In this post, I'm going to get into the different causes of painful periods, and what this means in terms of what is happening inside your body -

- because your body doesn't want to hurt you - pain is always there for a reason, a warning, a "helloooo, somethings really off here, do something about this", so this is how to tell what your body might be trying to say.

Prostaglandins
Hormonal Imbalance (oestrogen dominance / low progesterone)
Copper IUD
Lifestyle factors
Some medical conditions (fyi)
When to seek help

1. Prostaglandins

(Usually the primary culprit)

& often the main cause of painful, crampy bleeds that start on day 1 or just before.

These are inflammatory compounds released by the uterus to help it contract and shed its lining during menstruation. The more prostaglandins you release, the stronger the cramps.

High levels can also cause:

Nausea
Diarrhoea
Lower back pain

Some prostaglandins are more aggressive than others (PGE2, for example), and if your body produces a lot, period pain can be intense.

What helps:

Omega-3s (found in flaxseeds, chia, oily fish) help reduce prostaglandins
Magnesium (from leafy greens or supplements) can ease cramping
Anti-inflammatory herbs like ginger or turmeric
Light movement (walking, stretching) to improve blood flow
NSAIDs like ibuprofen (if needed) can block prostaglandin production short-term

2. Hormonal imbalances

Both oestrogen dominance or low progesterone can both contribute to painful bleeds.

Too much oestrogen (especially if not balanced by enough progesterone) can lead to a thicker uterine lining, which means heavier bleeds and stronger contractions to get it out.

This often pairs with PMS symptoms like mood swings, breast tenderness, and fatigue.

What helps:

Support your liver to metabolise oestrogen: cruciferous veg (broccoli, cauliflower), B vitamins
Avoid xenoestrogens in plastics, cosmetics, and processed foods
Prioritise fibre to help clear excess hormones via digestion
Cycle tracking + functional testing can help identify imbalance

3. Copper IUD

If pain is severe and persistent, check with your provider.

The copper intrauterine device can increase prostaglandin production and intensify cramps, especially in the first few months after insertion.

What helps:

Anti-inflammatory diet (omega-3s, turmeric, magnesium)
Track your symptoms - some people adjust over time, others don’t
If pain is constant, speak with your doctor about alternative contraceptives

4. Lifestyle factors that worsen inflammation

You may notice pain is worse in months when you're under more pressure, sick, or run down.

Poor sleep, stress, high-sugar diets, or a lack of anti-inflammatory nutrients can make your period more painful by raising your baseline inflammation.

What helps:

Prioritise sleep (especially in the luteal phase)
Cut back refined sugar, alcohol, and ultra-processed foods
Add whole foods that support hormone balance (fats, protein, fibre)
Gentle movement (like walking, Pilates, mobility) to reduce stagnation

Some medical conditions:

Worth getting checked if your period pain is debilitating or feels “deeper” than just cramps.

Endometriosis

A chronic condition where tissue similar to the uterine lining grows outside the uterus, causing inflammation, pain, and sometimes scarring. Pain may:

Begin earlier in the cycle
Last longer than the bleed
Radiate into the lower back, thighs, or rectum
Occur during sex, ovulation, or bowel movements

Adenomyosis

Adenomyosis is often underdiagnosed and usually confirmed via imaging.

This occurs when endometrial tissue grows into the muscular wall of the uterus. It can cause:

Heavy bleeding
Intense cramps
Pressure or bloating
Pain that worsens over time

Fibroids

More common in your 30s and 40s, but can show up earlier.

Fibroids are non-cancerous growths in or on the uterus. Depending on their size and location, they can lead to:

Heavy bleeding
Intense cramping
Pelvic pressure or pain

Cervical stenosis

Less common, but can cause severe cramping with light bleeding.

This is when the opening of the cervix is very narrow, which can slow menstrual flow and cause pressure and cramping as the uterus works harder to expel blood.