Women's Health Painful Menstrual Cramps: Fibroids or Something Worse? By UPMC Magee-Womens Hospital, February 10, 2015 Are those awful cramps that hit you every month normal — or a sign of something more serious? Painful menstrual cramps, or dysmenorrhea, are a common problem and one of the leading reasons for women missing work or school. Although they can only last a few days during your menstrual period, cramps can certainly put a damper on enjoying your usual activities. But if your cramps are getting worse — or can’t be controlled with a hot pad and over-the-counter painkillers — it may be time to see a doctor to rule out the potential causes. Causes of Painful Menstrual Cramps Fibroids are growths, or tumors, that form inside the wall of the uterus. They can be as small as an apple seed or as big as a grapefruit. Usually benign, these growths can cause pain and heavy bleeding. Fibroids can be treated with hormone therapy, such as birth control, uterine fibroid embolization, and sometimes surgery. Endometriosis is a condition that occurs when the endometrial tissue lining the uterus grows outside of the uterus. During menstruation, this tissue breaks down and bleeds in response to hormonal changes. Scar tissue, or adhesions, can form inside the pelvis where the bleeding occurs, causing organs to stick together and resulting in severe abdominal pain. Birth control pills or other hormones can slow the growth of tissue. In severe cases, surgery may be needed. Pelvic inflammatory disease (PID) is a serious infection of the female reproductive organs that can develop from an untreated sexually transmitted disease (STD), such as chlamydia and gonorrhea. It occurs when bacteria moves into the uterus and upper genital tract. Untreated PID can lead to permanent damage and infertility, as well as ectopic pregnancies. Diagnosed early, it can be treated with antibiotics. Ovarian cysts are fluid- or tissue-filled sacs that form in or on the ovaries. Most are harmless and can go away on their own. Many small cysts may have no symptoms, but some may cause a dull or sharp ache in the abdomen during certain activities. Larger cysts may twist, causing pain. Some cysts can bleed or rupture, requiring immediate medical attention. An IUD, or intrauterine device, inserted into the uterus can prevent pregnancy for up to 10 years. A copper IUD continually releases copper, which immobilizes sperm and prevents egg implantation. But it can trigger heavier and more painful periods, especially in the first few cycles after insertion. RELATED: Fibroid Treatment Options If your periods cause significant pain or interfere with your quality of life, consult with your doctor. To learn about uterine fibroids, please contact the Magee Fibroid Treatment Center at 412-641-4435.