How Much Menstrual Pain Is Normal? 5 Signs Your Period Cramps Require Medical Attention

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A 2016 Quartz article in which a doctor claims that period cramps can be as painful as heart attacks recently made the rounds on the internet, eliciting some strong reactions from Twitter. Many women said they already could have told us that — which I found rather alarming. How has our society let so many people suffer from that much pain on a monthly basis? And is that really just period cramps, or is there something else going on there?

Many of us learn growing up to expect some discomfort around our periods. But the problem is, we're not taught how much. Those with conditions like endometriosis or fibroids that cause severe pelvic pain often don't help because they and their doctors believe the pain is normal. But it's not. It's important to acknowledge how common severe menstrual pain is, but we shouldn't normalize it in the process.

There are two types of period pain: primary dysmenorrhea, which stands on its own, and secondary dysmenorrhea, which is linked to an underlying condition, Dr. Nita Landry, OB/GYN and co-host of The Doctors, tells Bustle. Because menstrual pain is so normalized, many people with secondary dysmenorrhea believe they actually have primary dysmenorrhea and don't get the treatment they need soon enough. It's important to catch these issues early so that symptoms don't escalate.

Many people experience primary dysmenorrhea, on the other hand, due to the volume of blood in the uterus, the contractions that push it out, or decreased blood supply to the womb, Dr. Sophia Yen, CEO of Pandia Health, tells Bustle. "While it can be normal to have period cramps — discomfort — your periods shouldn’t be debilitating," Astroglide's resident ob-gyn Dr. Angela Jones tells Bustle. What exactly is the difference between regular discomfort and debilitating pain, though? Here are some signs, according to doctors, that your menstrual pain requires medical attention.

1Painkillers Aren't Enough

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Nobody should ever have to live in pain, period (heh). So, if you're experiencing pain, the first step is to try over-the-counter solutions like Motrin, Advil, or Aleve, says Dr. Angela. If these don't work, that's a sign that something more is going on — or that, at the very least, that you require a stronger treatment for pain management.

2It Interferes With Your Life

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Normal period cramps don't make it difficult to go to work or school, says Dr. Angela. If you find it more difficult to function on your period, talk to a doctor about potential underlying conditions. But again, it doesn't really matter if it's a sign of something else or not; you still deserve help managing it.

3It Doesn't Go Away After You Stop Bleeding

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"Severe pain that does not disappear after your period" is the hallmark of abnormal menstrual pain, says Dr. Nita. "It can be indicative of a larger problem and should never be chalked up as ‘normal’ or just a ‘bad period.'"

4You've Got Other Symptoms

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The symptoms will vary based on which condition you're dealing with, but if there are other health issues you're facing, they could be connected. For instance, those with polycystic ovary syndrome, which is also characterized by an excess of male hormones, irregular periods, and growths on the ovaries, can also experience severe menstrual pain, OB/GYN Aimee Eyvazzadeh, M.D. tells Bustle.

5You Can't Tolerate It

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Ultimately, whether or not your pain requires medical attention comes down to whether or not it's acceptable to you. "The difference between pain and discomfort is that pain is something that you can’t tolerate where as discomfort is something you can tolerate," says Yen.

No matter where your menstrual cramps stem from, they absolutely are preventable. Dr. Nita recommends a heating pad, hot water bottle, warm bath or shower, non-steroidal anti-inflammatory drug, exercise, or sex for temporary relief. In the longer term, going on hormonal birth control can help keep cramps at bay. If these don't work (or even if they do but you have a sense something's off), it's best to see your doctor.