Although menstrual cramping is common and usually subsides within a few days, painful period cramps can sometimes indicate an underlying condition affecting the reproductive organs. 

We're going to cover what causes menstrual cramping, why it occurs to some but not others, the 6 most common causes of painful period cramps, and tips for soothing the monthly pain. 

What Causes Menstrual Cramps?

Menstrual cramping is essentially your uterine muscles tightening and relaxing to expel the inner lining of the uterus (endometrium) when no egg has been implanted. It is experienced previous to and during menstruation by almost every woman at some stage during their reproductive years. 

In preparation for menstruation each month, cells within the uterine lining break down and release chemicals known as prostaglandins. Prostaglandins are designed to narrow the uterine blood vessels and stimulate muscle contraction to shed the endometrium. 

Sometimes, prostaglandins can pass into the bloodstream and result in diarrhea, headaches, and nausea before or during menstruation. 

What is Dysmenorrhea?

Dysmenorrhea is the medical name for painful period cramps and it typically involves more frequent and severe uterine contractions. Depending on what’s causing painful period cramps, dysmenorrhea is categorized as either primary or secondary. 

Approximately 50% of women are known to suffer from primary dysmenorrhea during their reproductive years, but it may not occur with every menses. Believed to be linked to higher levels of prostaglandins, primary dysmenorrhea normally passes after a few days and is not known to cause any grave side effects besides the temporary discomfort around menstruation. 

Secondary dysmenorrhea, however, is typically caused by an underlying condition affecting the reproductive organs and it normally worsens over time. The painful menstrual cramps associated with secondary dysmenorrhea are often a result of other symptoms linked to the underlying condition. 

6 Common Causes of Painful Period Cramps

Period cramps are part of every female’s reproductive years but for some, they are more intense than others. Below are 6 of the most common causes of painful menstrual cramps and some helpful tips to treat them naturally without medication, hormone therapy, or surgery. 

1. Increased Levels of Prostaglandins

Increased prostaglandin levels are generally linked to primary dysmenorrhea and are known to result in more frequent and severe contractions of the uterine muscles. Higher prostaglandin levels can cause a deeper compression of the uterine blood vessels, thereby temporarily inhibiting oxygen flow to the uterus and resulting in more intense and painful menstrual cramping.  

Although over-the-counter pain medication can help alleviate primary dysmenorrhea, many women prefer to avoid the frequent consumption of NSAIDs. Instead, try a natural supplement called Chasteberry (Vitex) to boost estrogen levels and reduce painful period cramps as well as tender breasts and mood swings. Applying a heat pack and exercising regularly will also help reduce primary dysmenorrhea. 

2. Endometriosis

Endometriosis occurs when tissue similar to the inner lining of the uterus (endometrium) grows on organs outside the uterus, like the ovaries and fallopian tubes, and it often results in secondary dysmenorrhea. 

When menstruation occurs and the endometrial lining is shed from the body, the same does not occur to the endometrial-like tissue growing outside the uterus. Instead of breaking down and leaving the body, it swells and forms scar tissue within the pelvis that can eventually develop into endometrial implants like cysts, lesions, and adhesions on pelvic organs. 

In response to the formation of endometrial implants during menstruation, healing white blood cells are sent via the bloodstream to manage and heal the pain. However, the body cannot heal endometriosis, therefore inflammation, and chronic pelvic pain often linger and worsen over time.

Pain during sex (dyspareunia), difficulties getting pregnant, heavy periods, and discomfort while peeing or pooping are also common symptoms of endometriosis. 

Health experts recommend scheduling an appointment with a pelvic health physical therapist or OB/GYN for guidance on using vaginal dilators and pelvic massage wands to reduce the chronic pain associated with endometriosis. An endometriosis diet to reduce inflammation is also helpful, and gentle exercise, pelvic stretching, yoga, and diaphragmatic breathing will reduce tension and improve blood circulation.   

3. Adenomyosis

Adenomyosis is regarded as another form of endometriosis, except endometrial-like tissue is found growing within the uterine muscle instead of outside the uterus. In addition to painful period cramps, adenomyosis can result in abdominal bloating, chronic pelvic pain, an enlarged uterus, pain during sex, and difficulties getting pregnant.

Relieving the pain and discomfort of adenomyosis naturally is similar to treating endometriosis. Scheduling an appointment with a pelvic health physical therapist or OB/GYN for guidance on using vaginal dilators and a pelvic massage wand in the comfort of your own home will help to relieve pelvic pain, dyspareunia, and painful period cramps.

An endometriosis diet will reduce inflammation, and gentle exercise, yoga, and diaphragmatic breathing can help patients cope with the nature of this ongoing condition.   

4. Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is an infection of the female reproductive tract, and it is most commonly caused when a sexually transmitted infection (STI) like chlamydia or gonorrhea is left untreated. Vaginal douching and taking antibiotics for another condition, both of which can upset the natural microbiome of the vagina and result in an overgrowth of harmful bacteria, can also cause PID. 

Symptoms of PID include painful menstrual cramps, pelvic pain, unusual vaginal discharge, pain during sex, a frequent urge to pee, a burning sensation while peeing, and spotting between periods. 

When PID is left untreated it can permanently damage the ovaries and fallopian tubes, cause long-term pain, and result in infertility. Treating PID is easily done with an antibiotic to treat the underlying STI along with a daily probiotic to rebuild and rebalance a healthy vaginal microbiome.  

5. Cervical Stenosis

Although rare, cervical stenosis can also cause painful menstrual cramps. The cervix is the opening from the vagina to the uterus and stenosis refers to a narrowing or blockage.

During menstruation, for example, when the inner lining of the uterus is shed, it passes through the cervix and into the vagina to exit the body. If the cervix is damaged or blocked for any reason, menstrual flow is obstructed and an increase of pressure in the uterus can result in dysmenorrhea. 

Pelvic surgery and radiation therapy can instigate cervical stenosis through the formation of scar tissue or adhesions on the cervix. The cervix can also be damaged by vaginal infections or pushed aside during rough sex or sexual abuse. In addition to painful period cramps, cervical stenosis can also cause dyspareunia.  

The best way to alleviate cervical stenosis and the pain during sex that often goes hand in hand is through the slow and gentle process of vaginal dilation. 

6. Uterine Fibroids

Uterine fibroids are non-cancerous tumors that grow on the wall of the uterus. Up to 75% of women are known to have uterine fibroids, but the majority are microscopically small and symptomless. Women with larger uterine fibroids, however, can experience an enlarged uterus, pain during sex, problems getting pregnant, urinary issues, and chronic pelvic pain. 

Painful period cramps and heavy menstrual bleeding are also common symptoms of uterine fibroids. Due to the heavy menstrual bleeding, the uterine muscles are required to work harder to expel the blood clots that can form, often resulting in secondary dysmenorrhea. 

When uterine fibroids are large enough to cause pain or affect fertility, they are typically surgically removed. 

How to know if Menstrual Pain is Normal or Secondary Dysmenorrhea?

If you’re experiencing painful menstrual cramps regularly and you’re not sure what is causing them, schedule an appointment with your healthcare provider to discuss primary and secondary dysmenorrhea. After a vaginal swab, your healthcare provider may diagnose high prostaglandin levels and your symptoms may be reduced with an anti-inflammatory diet, heat packs, gentle exercise, yoga, and Chasteberry supplements. 

Painful period cramps that are caused by secondary dysmenorrhea, however, may need some further investigation. Depending on your symptoms, your healthcare provider may need to carry out a pelvic exam or take some vaginal fluids for testing. If evidence of an underlying condition is found to be causing secondary dysmenorrhea, your healthcare provider will discuss the possible treatment options. 

If your healthcare provider fails to mention natural treatment options for primary or secondary dysmenorrhea, don’t be afraid to ask.  


Painful period cramps are often temporary and mild for some but they can be severely painful and incapacitating for others. If you are experiencing intensely painful period cramps along with any other symptoms like pain during sex, urinary issues, or chronic pelvic pain, make an appointment with your healthcare provider for help. 

Primary dysmenorrhea is experienced by most women at some stage during their lives, however, secondary dysmenorrhea is often caused by a separate condition linked to the female reproductive system. Your healthcare provider can help you to treat either form of dysmenorrhea naturally.  


Cleveland Clinic - Dysmenorrhea (Menstrual Cramps) -

Endometriosis Foundation of America – Endometriosis: Defining It, Recognizing It, and Treating It -

Johns Hopkins Medicine – Adenomyosis -

Women’s Health - Uterine Fibriods -

National Library of Medicine - Effect of yoga on the menstrual pain, physical fitness, and quality of life of young women with primary dysmenorrhea -

Physicians Committee for Repsonsible Medicine -

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