Learn more about possible underlying causes of severe menstrual pain.

No one looks forward to menstrual cramps. For many women, they are a regular part of life that they manage on their own.

Some women take ibuprofen or apply a heating pad to get relief. Others swear by light exercise or herbal tea. For about 10 percent of women, though, nothing seems to work. Their pain sometimes becomes so debilitating that they miss school or work.

Severe menstrual cramps may be signs of an underlying health problem. If you’re not sure whether you’re dealing with normal discomfort or something more serious, here’s what to look for and when to call your doctor.

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Potential Causes of Severe Period Pain

Talking to your doctor about menstrual pain — what’s normal and what’s not — is the best place to start. Copper intrauterine devices (IUDs) can cause severe menstrual cramps in some women. If you’re using an IUD, ask your doctor if it may be the cause of increased cramping.

After examining you, the doctor may recommend tests to determine the cause of your abnormal period pain, which can include:


Occasionally, endometrial cells that grow within the uterus may develop outside the uterine walls. As the displaced tissue grows, it can cause pain and even infertility.

If you have these symptoms or want more information, contact the Endometriosis and Chronic Pelvic Pain Center at 412-641-4900.

Polycystic ovary syndrome (PCOS)

This disorder appears during puberty in up to 10 percent of women. That makes it the most common endocrine disorder among reproductive-age females, according to experts at the Center for Fertility and Reproductive Endocrinology at UPMC Magee-Womens Hospital. Besides irregular or painful periods, the condition can lead to miscarriage, infertility, heart attack, and even type 2 diabetes. Because the root of the disorder is an excess of the male hormone androgen, treatment may depend on the combination and severity of symptoms.

Uterine fibroids

Also known as fibromyomas, fibromas, myofibromas, and myomas, uterine fibroids are the most diagnosed pelvic tumor in females. Around half of all women have these noncancerous growths, but only a quarter of them experience symptoms. The most common symptom is period pain and excessive menstrual bleeding.

If you have these symptoms or want more information on fibroid treatment, contact the Fibroid Treatment Center at UPMC Magee-Womens Hospital at 412-641-4435.

Pelvic inflammatory disease (PID)

The most common symptom of PID is lower abdominal cramping and dull, achy discomfort. This condition is an infection of the reproductive organs caused by bacteria entering through the cervix. If left untreated, PID can cause irreparable damage, so it’s important to rule out this infection — especially if you’re experiencing a sudden worsening in menstrual cramps.

Seeking Help for Severe Menstrual Cramps

What can you do to ease severe menstrual cramps? First, try the usual home remedies. But if a heating pad and ibuprofen don’t help, you may have an underlying condition. It’s wise to get checked out so you can get treated.

With periods, you can expect some mild menstrual pain. But it shouldn’t interfere with daily life or occur along with other troubling symptoms.

Talking to your doctor about menstrual pain is the best way to know if you’re living with a treatable underlying medical condition. Don’t wait; make an appointment with your doctor or contact the Endometriosis and Chronic Pelvic Pain Center at UPMC (412-641-4900) or the Fibroid Treatment Center at UPMC Magee-Womens Hospital (412-641-4435) for more information.

Editor's Note: This article was originally published on , and was last reviewed on .

About UPMC Magee-Womens

Built upon our flagship, UPMC Magee-Womens Hospital in Pittsburgh, and its century-plus history of providing high-quality medical care for people at all stages of life, UPMC Magee-Womens is nationally renowned for its outstanding care for women and their families.

Our Magee-Womens network – from women’s imaging centers and specialty care to outpatient and hospital-based services – provides care throughout Pennsylvania, so the help you need is always close to home. More than 25,000 babies are born at our network hospitals each year, with 10,000 of those babies born at UPMC Magee in Pittsburgh, home to one of the largest NICUs in the country. The Department of Health and Human Services recognizes Magee in Pittsburgh as a National Center of Excellence in Women’s Health; U.S. News & World Report ranks Magee nationally in gynecology. The Magee-Womens Research Institute was the first and is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology, with locations in Pittsburgh and Erie.