What are Severe Menstrual Cramps?

According to the American College of Obstetricians and Gynecologists (ACOG), more than 50 percent of women who menstruate experience menstrual cramping during the onset of their periods. In most cases, period pain can be managed on one’s own, but for some women, the pain is more severe.

In cases where period pain is chronic and debilitating, an underlying menstrual condition, such as fibroids, adenomyosis, or endometriosis could be the cause. In order to relieve pain, women may need medical treatment, particularly if severe menstrual pain prevents participation in daily activities, such as work, school, or exercise.

Symptoms of secondary dysmenorrhea include:

  • Pain that gets worse over time and lasts longer than typical menstrual cramps
  • Pain that begins earlier in the menstrual cycle, such as a few days before a period starts
  • Cramping in the lower abdomen
  • Low back pain
  • Pain radiating down the legs
  • The pain from severe menstrual cramps can even cause additional symptoms, such as as nausea, vomiting, diarrhea, fatigue, weakness, and fainting
  • Pain that is accompanied by a heavy menstrual flow or irregular bleeding

Causes & Risks

Higher levels of prostaglandins are associated with more severe menstrual cramps. Menstrual cramps can also be a symptom of an underlying gynecologic condition such as fibroids, adenomyosis, and endometriosis.


Uterine Fibroids:

Uterine fibroids are noncancerous tumors that develop in and around the uterus for unknown reasons, most commonly affecting women of childbearing age or women approaching menopause.

These growths can cause a range of debilitating symptoms, the most common being heavy, prolonged, or painful periods and moderate to severe menstrual cramps. Symptoms can vary depending on the location, size, and number of fibroids. These tumors can apply pressure on the neighboring organs and may cause pain localized to a specific spot.


Adenomyosis occurs when the tissue that lines the uterus (endometrial tissue) grows into the muscular walls of the uterus. When the lining cells of the uterus bleed during the menstrual period, these misplaced cells in the muscle bleed as well. And bleeding directly into the muscle causes pain.

As the blood accumulates, the surrounding muscle swells and forms fibrous tissue in response to the irritation. This swollen area within the uterine muscle wall, called an adenomyoma, feels very much like a fibroid during medical examination.  The condition may affect your entire uterus or it can be localized to one area.


Like adenomyosis, endometriosis is a disorder of the endometrial tissue that lines the inside of the uterus. However, whereas adenomyosis occurs when tissue grows within the muscles of the uterus, endometriosis occurs when endometrial-like tissue grows outside of the uterus, affecting the surrounding pelvic structures.


Endometriosis can cause pelvic pain, severe menstrual cramps, and abnormal or heavy bleeding during periods. Left untreated, this chronic condition worsens, compromising the reproductive organs and pelvic structure. Fertility issues, pain, and other complications escalate over time.


Severe menstrual cramps can have a negative impact on a woman’s quality of life, and significantly impact work attendance and performance.

  • In a survey of women suffering from fibroids, close to 33 percent of women with fibroids say they’ve missed work because of symptoms.
  • 24 percent of working women say fibroid symptoms kept them reaching their career potential.
  • Menstruation-related symptoms cause a great deal of lost productivity and time away from work or school.

Diagnosis & Care

If your period pain lasts more than two or three days, and is severe enough to keep you from leaving the house, consult your health care provider for a diagnosis.

There are safe and nonsurgical treatments that significantly improve quality of life and ease symptoms. The Viva Eve team of fibroid and women’s health experts will be able to properly diagnose your condition and suggest the best course of treatment.

With longer, in-depth appointments, one-on-one patient education, and an interdisciplinary team of specialists all in house, we provide you with comprehensive, empowering care.

Talk to a specialist to see how we can help.

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