Painful periods are an uncomfortable and common symptom during the menstrual cycle. But what do they mean for your fertility? Here’s what you need to know.
Painful periods are an uncomfortable and common symptom during the menstrual cycle. But what do they mean for your fertility? Here’s what you need to know.
If you’re experiencing pain during your menstrual cycle—specifically your period—you may wonder what exactly is going on inside your body. Could these uncomfortable symptoms be a sign of something positive? Are painful periods a sign of good fertility?
Unfortunately, the link between painful periods and good fertility is generally a misleading myth.
If you’re experiencing painful periods while trying to conceive or planning for future pregnancy, here’s what you need to know.
What are painful periods?
Painful periods are periods that cause you pain, typically in your lower abdomen, during your menstrual cycle. Menstrual pain (medically known as dysmenorrhea) affects many women during their reproductive years. There are two main types of dysmenorrhea that can impact your monthly cycle in different ways.
- Primary dysmenorrhea: characterized by cramping pain in the lower abdomen that typically begins a day or two before your period and can last for several days. This pain occurs without any underlying medical condition and often starts during adolescence.
- Secondary dysmenorrhea: develops later in life and is caused by specific reproductive disorders or conditions. The pain may begin earlier in the menstrual cycle and last longer than typical period cramps.
If you experience painful periods, you’re not alone. According to WHO data, as many as 94% of young girls aged 10-20 experience menstrual pain, and a little under 10% (8.8%) of women 19–41 experience the same.
What causes pain during your periods?
The primary cause of menstrual pain lies in your body's natural response to the menstrual cycle.
During your period, your uterus actively works to shed its lining through a complex series of muscular contractions. These contractions are orchestrated by natural compounds called prostaglandins, which your body produces in response to falling progesterone levels at the end of your cycle.
When prostaglandin levels rise, they trigger stronger uterine contractions. These contractions serve an important purpose: they help detach and expel the uterine lining. However, these same contractions can temporarily reduce blood flow to the uterus, similar to how squeezing a muscle can briefly reduce its blood supply. This reduction in blood flow can cause the pain-sensing nerves in your uterus to become more sensitive, leading to the cramping sensation many women experience.
Some women naturally produce higher levels of prostaglandins, which can result in more intense contractions and stronger pain.
Beyond the basic mechanism of uterine contractions, several other factors can contribute to menstrual pain:
- Hormonal fluctuations: hormonal changes can affect how sensitive your body is to pain and influence the strength of uterine contractions.
- Anatomical variations: the position and size of your uterus can influence how you experience menstrual pain. For instance, a tilted uterus (retroversion) might cause increased discomfort during menstruation because it can affect how easily menstrual blood flows out of the body.
- Inflammatory responses: During menstruation, your body releases inflammatory substances beyond just prostaglandins. These compounds can cause swelling and increased sensitivity in the pelvic region, contributing to pain and discomfort.
- Stress and emotional factors: Your mental and emotional state can influence how you experience physical pain. Stress can increase muscle tension and lower your pain threshold, potentially making menstrual cramping feel more intense.
- Underlying medical conditions: While some menstrual pain is normal, excessive pain might signal underlying conditions such as endometriosis, adenomyosis (where the uterine lining grows into the muscle wall of the uterus), or uterine fibroids. These conditions can intensify the normal pain of menstruation by creating additional inflammation, pressure, or anatomical changes that affect how your uterus functions during your period (more on those and fertility in the next section).
What’s the link between painful periods and fertility?
Unfortunately, having painful periods is not inherently a sign of good fertility. The intensity of menstrual pain doesn't correlate with your ability to conceive or carry a pregnancy. Many women with minimal menstrual pain conceive easily, while others with severe pain may also have no difficulty getting pregnant.
However, it's important to understand that some causes of painful periods can affect fertility. The relationship isn't with the pain itself, but rather with potential underlying conditions.
Painful periods and infertility
Sometimes, severe menstrual pain can be a symptom of conditions that may impact fertility, including:
- Endometriosis: a condition where tissue similar to the uterine lining grows outside the uterus. This can potentially affect reproductive organs through inflammation and make it harder for an embryo to implant.
- Uterine fibroids: Non-cancerous growths in the uterus that can cause pain. When fibroids are near the fallopian tubes, they can block the path of eggs or sperm. They can also affect blood flow to the uterine lining, making it more difficult for a pregnancy to establish and grow.
- Pelvic inflammatory disease: An infection that can lead to scarring of reproductive organs if left untreated. If scarring occurs in your fallopian tubes, it can partially or completely block these paths—making it harder or impossible for sperm to reach the egg or for a fertilized egg to reach the uterus.
These conditions often require medical attention not just for pain management, but also to protect your reproductive health and overall wellbeing.
How to know if you’re fertile
Fertility isn't determined by how much pain you experience during menstruation. Instead, the main factor of fertility is ovulation—when you’re ovulating, you’re fertile.
Ovulation is crucial for fertility because you need to be ovulating in order to conceive. Ovulation is the moment when your ovaries release an egg to potentially be fertilized and become a pregnancy.
Other factors that indicate healthy fertility include:
- Regular menstrual cycles (even if your cycle length varies)
- Healthy fallopian tubes
- Good egg quality
- Good overall health
If you're concerned about your fertility, tracking your menstrual cycle and ovulation can provide valuable insights. The Oova kit offers personalized insights into your reproductive hormones—by measuring your specific hormone levels—so you can confirm if you’re ovulating with confidence.
Finding relief from painful periods
Whether or not you're trying to conceive, you shouldn't have to suffer through intense menstrual pain.
Home remedies for painful periods include:
- Heat therapy with a heating pad or warm bath
- Gentle exercise and stretching
- Over-the-counter pain relievers (consult your healthcare provider if trying to conceive)
- Relaxation techniques and stress management
- Dietary changes to reduce inflammation
While some period pain may be best treated with home remedies, it’s important to seek medical attention if you have severe pain that interferes with daily activities, pain that gets worse, or pain outside of your normal pattern.
Your healthcare provider can help determine if there are underlying conditions causing your pain and develop an appropriate treatment plan that aligns with your fertility goals.
For underlying conditions causing painful periods, treatment options might include:
- Hormonal medications (though these may not be appropriate when trying to conceive)
- Physical therapy for pelvic pain
- Surgical interventions for conditions like endometriosis or fibroids
- Alternative therapies such as acupuncture
Are painful periods a sign of good fertility? The bottom line
Painful periods, while common, aren't a reliable indicator of fertility. Every woman's body is different, and the intensity of menstrual pain doesn't predict your ability to conceive—the main indicator of your fertility is whether you’re ovulating or not.
If you're experiencing severe pain or have concerns about your fertility, don't hesitate to seek professional medical advice. Your reproductive health deserves attention and care, and there are many treatment options available to help you manage pain while protecting your reproductive health and overall wellbeing.
About the author
Sources
- Barcikowska, Z., Rajkowska-Labon, E., Grzybowska, M. E., Hansdorfer-Korzon, R., & Zorena, K. (2020). Inflammatory Markers in Dysmenorrhea and Therapeutic Options.
- Latthe, P., Latthe, M., Say, L., Gülmezoglu, M., & Khan, K. S. (2006). WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity.
About the Oova Blog:
Our content is developed with a commitment to high editorial standards and reliability. We prioritize referencing reputable sources and sharing where our insights come from. The Oova Blog is intended for informational purposes only and is never a substitute for professional medical advice. Always consult a healthcare provider before making any health decisions.