How To Know If Your Menstrual Cramps Are Abnormal, and What You Can Do To Make PMS Less Terrible

We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual and women's health issues that inevitably come with being a grown woman? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. This week’s topic: How to know whether your cramps are abnormal — and what you can do to ease menstrual pain.

Q: I know that everyone complains about hurting during their period but it seems like my cramps are much worse than most of my friends. Everything just hurts for days before and during, and it's driving me insane! Is there something wrong with me? Can I do anything to make this go away?

A: For most female-bodied folks, cramps are an unpleasant side effect of being born with a uterus. However, if your cramps are really — let’s just get this pun out of the way, shall we? — cramping your style, there may be something else going on. Here's how to know whether your cramps are normal, and if they are, what you can do to help ease the pain.

Potential Culprits for Extreme Uterine Cramping

If your cramps incapacitate you every month, there may be something more medically serious going on than normal PMS. Dysmenorrhea is what the doctors call painful menstrual cramps, and it’s no joke. If your cramps are beyond painful, ask your doctor about these three potential culprits.

Culprit #1: Uterine Fibroids

Uterine fibroids are noncancerous growths that set up shop inside your uterus. They are extremely common — around 75 percent of women experience them at some point in their lives. Most of the time, these wee growths are asymptomatic, so you don’t even know you have them. However, they can make your cramps more painful, in addition to making your period heavier and last longer. Uterine fibroids are picked up via ultrasound, so if you’re worried that you might have one, talk to your doctor so you can get looked at … inside. If it turns out you have symptomatic fibroids that are really messing with your lifestyle, there are a number of things you can do, including taking medication that alleviates pelvic pain, or opting for surgery to get those little buggers removed.

Culprit #2: Endometriosis

Endometriosis is a disorder wherein the lining of your uterus decides to take itself out on an adventure to see the wide world of your innards and grows outside your uterus. Since it maintains its identity as endometrial tissue, it thickens and bleeds with your menstrual cycle — but the blood has no place to go! The result? Irritated tissue that develops into scar tissue or adhesions. Basically, this road trippin’ tissue wreaks havoc on your pelvic area, which can cause severe pain. It can also mess with your fertility by obstructing the egg’s path — around one-third of women with endometriosis have trouble getting pregnant.

The bad news is that the only way you can know if you have endometriosis is if your doctor opens you up and takes a look-see. The good news is that, once you know you have it, you have options for managing your condition. Pain medication can help with your hurting symptoms. Hormone therapy can also help, since hormones control the waxing and waning of all endometrial tissue — even the wayward stuff partying where it’s not invited. If you’re experiencing severe symptoms, you can opt for surgery, more intense hormones that put your body effectively into early menopause, or even a hysterectomy. Unfortunately, endometriosis can come back, so it’s important to maintain whatever solution you choose and work with your doctor in the long term.

Culprit #3: Pelvic Inflammatory Disease

Pelvic inflammatory disease, or PID, is what the doctors call it when your reproductive organs get infected. This usually occurs from sexually transmitted bacteria like chlamydia or gonorrhea, although it can also happen from bacteria getting into you in other ways, such as through the unclean insertion of an IUD. While your PID may be asymptomatic, if you feel it, your pelvic area may hurt, penetrative sex may hurt, and you may experience not-great-smelling discharge and/or bleeding at weird times in your cycle.

If you have a PID for a while, it can result in scar tissue or pockets of infected fluid that grow all up in your reproductive space, which not only can cause you pelvic pain but can mess with fertility or result in an ectopic pregnancy, a dangerous situation in which a fertilized egg implants in your fallopian tube instead of in your much larger and more prepared uterus. Luckily, most PIDs are treatable with antibiotics, so if you think you may have one, talk to your doctor ASAP. The sooner you catch this culprit the better.

Home Solutions For Normal Menstrual Pain

Barring the above medical conditions, menstrual cramps often occur when your body makes too much of the hormone prostaglandin. While this is totally normal, it can just as totally suck. Luckily, if this is what’s happening to you, there are a number of things you can do to mitigate menstrual pain.


Muscles like warmth. Try taking a warm bath or snuggling up with a heating pad, hot water bottle, or my new best friend, a stick-on heat patch (you can buy them at your local pharmacy, they last for eight hours and are a lifesaver for a gal on the go).

ThermaCare Menstrual Cramp Relief Heat Wraps, $10, Amazon


As you may know from the phrase "runner’s high," exercise releases beta-endorphins, aka home-made opioids, which make you feel fantastic and feel no pain so you can run FOREVER, or so the athletes tell me. Exercise also helps your body burn prostaglandins, so it can help with any overproduction of those chemicals your body may be engaged in.


Over the counter anti-inflammatory drugs like ibuprofen and aspirin (and all their cheaper generic versions) can not only kick that muscle hurt you’re feeling (remember that your uterus is a muscle), but can also decrease overproduction of prostaglandin.


I mean changing your diet, not eating less. Some research indicates that certain foods can help mitigate menstrual pain. Tips include foods high in calcium and antioxidants, fewer processed foods (lay off on that wonder bread), less caffeine, alcohol, and tobacco — which we know are all poison anyway — and more water.


Western medicine rarely pays enough attention to herbal remedies, which unfortunately means that there are few “scientific” studies proving the efficacy of herbs in the literature. However, if you go to your local herbalist, he or she will most likely have a slew of options for you to try that have been in use for thousands of years on uteruses (uteri?) worldwide. Common herbal remedies for menstrual pain include Black Cohosh, Turmeric, the oddly named Chaste Tree/Berry, and the similarly tongue-in-cheek Cramp Bark. Just tell your doctor if you’re taking any of these, since some of them can interact dangerously with other medications.


As with herbs, Western medical research hasn’t done the best job of assessing the utility of acupuncture. However, the literature does indicate that acupuncture can mitigate menstrual pain, and more importantly, women have been using acupuncture therapy for just this purpose for hundreds of years … so hop on that bandwagon to freedom from pelvic pain!


While you might not be in the sexiest of moods when you’re being pummeled from the inside out, research shows that orgasming can help relieve cramps. That’s because orgasming results in muscle spasms that relieve tension. So the next time your uterus starts planning the next Great American Succession, holler at your lover! You have the best excuse for a booty call: the doctor basically ordered it. And if you’re not comfortable calling up a cutie when you’re on your moon, you can always get yourself off.


If you live in a state that allows it, consider medical marijuana. Cannabis reduces your brain’s awareness that it’s experiencing pain (don’t panic, this is what most pain meds do), so you don’t feel it as much. It also may actually relax your muscles, making the cramps go away. If you decide to seek medical marijuana, you’ll be in good company — way back in the 1890s, Queen Victoria hit the herb to vanquish her cramps.

Remember: The Pain Does Not Make The Woman

There’s a whole lot of talk going around about the strength of women — about how much more pain we can take than men, as evidenced by discussion upon discussion of childbirth versus getting kicked in the balls, resulting in weird experiments like this. If this sort of talk makes you feel badass and powerful, that is fantastic, because you are these things. However, if you are experiencing painful periods, that pain isn’t necessarily something you have to endure, and it doesn’t make you the strong woman you are.

By way of explaining that last statement, let me tell you a very personal story: I had mind-meltingly horrific menstrual pain from the moment I started bleeding at age 12. From talking to my female-bodied family members and friends, I knew my pain was significantly higher than average. I tried some solutions here and there when I was in school (pain meds, oral contraceptives), but at some point in my early 20s, it became clear that I probably had endometriosis, which as we all now know requires minimal surgery to actually diagnose. I sat on this knowledge for YEARS, without consciously knowing why I was waiting. And then one day, I had a revelation: some part of me liked being the strongest, most pain-enduring woman I knew. The pain had become an integral part of the way I defined my personal womanhood, even as it hindered me from being able to work, play, and effectively live my life.

Since that understanding, I have completed the surgery and gotten an IUD to help manage my endometriosis. My cramps still really suck, but I don’t have to battle my body for between a quarter and a half of my waking life, and I still feel like the badass human with a uterus I know myself to be.

The Bottom Line

If you are experiencing severe menstrual pain, talk to your doctor! If you aren't sure where your pain falls on the normal to problem spectrum but know it's hindering your life, TALK TO YOUR DOCTOR! Because realtalk for a minute ladies: there's no reason whatsoever to be in any more pain than you need to be.

Be kind to your body and make it feel better! It won’t make you any less of a powerful woman. I promise — it's just the opposite.

Images: Lotus Carroll/Flickr; Giphy