While painful period cramps are a total drag for many of us, we can pretty much expect how bad they'll be most months. But there are a few things to watch out for if your cramps are so bad that you need to call in sick to work on a regular basis, or your cramps are much worse than usual all of a sudden. If your period cramps are suddenly different from what you’re used to, or they’re accompanied by other symptoms, they could point to an issue that needs your doctor’s attention.
Cramps can be painful, and some discomfort each month is totally normal. According to the Mayo Clinic, period cramps are caused by contractions in the uterus as it sheds its lining. Some of us have higher levels of the contraction-causing hormones called prostaglandins, so we wind up with more painful periods.
But some months are more painful than others, and it's important to know what that could mean. Any changes to your monthly menstrual cycle are good to keep track of, and if you’re suddenly in a lot of pain, or a lot more pain than usual, don’t ignore it — especially if you’re suddenly bleeding more heavily than usual as well.
Dr. Adeeti Gupta, M.D., founder of Walk In GYN Care in Manhattan, tells Bustle via email that "Sudden new onset cramps [...] need to be investigated to rule out conditions such as ovarian cysts, pelvic tumors, rapidly growing fibroids, rapidly growing endometriosis, [or a] change in IUD position if you have an IUD." Dr. Gupta also says that sudden, severe cramps can also mean you have a gastrointestinal issue like Irritable Bowel Syndrome (IBS) or diverticulitis.
Women’s Health also reports that severe cramps on one side of your abdomen can be a sign of an ovarian torsion. Ovarian torsions happen when an ovary becomes twisted around the ligaments that surround it, and sometimes the fallopian tube also becomes twisted. This twisting can cause the blood supply to be cut off from these organs. Ovarian torsions are painful and intense, and are considered a medical emergency. It’s possible to lose an ovary if it’s left untreated. And while this sounds scary, ovarian torsions are also highly uncommon, according to HealthLine, and they tend to be caused by other underlying conditions affecting the ovary, like ovarian cysts or masses.
A good way to gauge if your cramps might be pointing to an underlying health problem is to notice if they're suddenly more intense, or if they're different from what you usually experience during your period. If your cramps aren't being helped by over-the-counter medications like ibuprofen, or if the pain is lingering well past the point where you’re bleeding has stopped — meaning that your period is over, but the pain isn’t resolving — make an appointment to see your doctor. According to VeryWell Family, between five and 20% of people with a menstrual cycle experience cramps so bad that they interfere with daily life. But severe cramping is still cause for concern.
Remember that typical period cramps, while sometimes painful, should be pretty easy to treat. If your pain isn’t responding to your usual medications or a heating pad, or if the pain is unusual and more severe than you’re used to, it’s a good idea to check in with your gynecologist "to see what changed," Dr. Gupta says. Your doctor can examine you to rule out any potential underlying conditions that could affect your health and fertility moving forward.