Pelvic pain during your period can range from frustrating to debilitating. Learning what causes your pelvic pain can help you understand how to treat your symptoms and find relief.
If you experience painful symptoms during your period, you’re not alone.
Pelvic pain is one possible period symptom among many, and you may know it well. Pelvic pain can feel like anything from cramps to sharp throbs, and may be accompanied by other period symptoms like nausea or headaches.
Here’s what you need to know about pelvic pain during your period, including causes, how to get relief, and when to talk to a doctor about period pelvic pain.
>>MORE: Are Painful Periods a Sign of Good Fertility?
What is pelvic pain during your period? Pelvic pain during your period is a common experience—although just because something is common doesn’t make it easy!
Period pelvic pain is often felt in the lower abdomen or belly. Pain may feel crampy, dull, achy, and throbby, or it may feel like a sharp burst.
Pelvic pain may come in waves or it may be constant. It may stay more or less at the same level of severity, or it may grow in intensity.
How severe your pelvic pain is, how long it lasts, and when in your cycle it occurs all depends on the cause behind your pelvic pain.
What causes pelvic pain during your period? If you have pelvic pain during your period, your symptoms are generally caused by dysmenorrhea (the medical term for “period pain”).
Dysmenorrhea is incredibly common: as many as nine out of ten people experience pain around their period, and pelvic pain is among the more frequent symptoms.
In medical circles, period pain is classified into two types: primary dysmenorrhea and secondary dysmenorrhea . The main differences between the two are severity and timing , with one being less severe and confined to your period, and the other being more severe and occurring at any moment (more on that later).
Let’s take a closer look at both primary and secondary dysmenorrhea, to understand what can cause pelvic pain during your period.
Period pelvic pain and primary dysmenorrhea To put it simply: primary dysmenorrhea is period cramps, and period cramps can cause pelvic pain (in addition to other pain and nausea symptoms).
When period pelvic pain stems from primary dysmenorrhea, pain symptoms generally :
Begin just before your period comes, or right at the start of bleeding Peak in intensity around 24 to 48 hours after the start of bleeding Last 72 hours at most, and go away when your period ends Importantly, pelvic pain from primary dysmenorrhea only occurs during your period , meaning you don’t experience pelvic pain at other moments in your cycle.
Pelvic pain from primary dysmenorrhea (period cramps) is typically less severe than pelvic pain from secondary dysmenorrhea—but that doesn’t minimize your experience! This pelvic pain during your period can still be distressing and frustrating.
Why does primary dysmenorrhea cause pelvic pain during your period? Pelvic pain and cramping are your body’s natural reactions to the uterine lining shedding during your period.
The reason is related to prostaglandins, a type of chemical produced by the uterine lining. When your uterine lining sheds, the cells release prostaglandins. Increasing prostaglandin levels trigger uterine contractions, which help the lining continue shedding.
But these contractions also trigger cramping and pain in the uterus, which you may experience as pelvic pain.
The higher the prostaglandins, the higher the pain. Since prostaglandin levels are highest at the beginning of your period, primary dysmenorrhea pelvic pain also tends to be most intense then.
>>MORE: Dysmenorrhea: Definition, Causes, and How to Get Relief
What if pelvic pain happens right before your period? If you experience pelvic pain in the days before your period, it’s likely caused by premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD, a more severe form of PMS).
This pelvic pain is still related to your period, but it’s technically classified as “premenstrual” pain (or pain in the lead-up to your period), rather than as dysmenorrhea. From your perspective though, pelvic pain likely feels similar whether it’s from PMS, PMDD, or primary dysmenorrhea.
Period pelvic pain and secondary dysmenorrhea Secondary dysmenorrhea is severe pain, including pelvic pain and other symptoms, caused by an underlying reproductive condition.
Pelvic pain from secondary dysmenorrhea can occur at any moment in your cycle , not just during your period. This pelvic pain tends to get worse with time, especially if the underlying condition isn’t treated, and it may intensify during your period.
Since secondary dysmenorrhea pelvic pain isn’t confined to your period, you can think of this pelvic pain more largely as reproductive system pain.
Why does secondary dysmenorrhea cause pelvic pain during your period? If your period pelvic pain stems from secondary dysmenorrhea, an underlying reproductive condition is causing your pain.
Endometriosis is the most common cause: as many as 60% of pelvic pain cases are related to this condition.
Other reproductive health conditions can also cause secondary dysmenorrhea pelvic pain, including:
Ovarian cysts Pelvic inflammatory disease (PID) Adenomyosis Abnormalities in reproductive anatomy >>RELATED: Secondary Dysmenorrhea and How To Find Relief
When to talk to a doctor about pelvic pain If pelvic pain during your period is so severe that it impacts your ability to function, it may be time to talk to your doctor.
It’s crucial to share symptoms if your pelvic pain:
Occurs outside of your period Significantly intensifies during your period Suddenly changes Progressively worsens These scenarios may indicate secondary dysmenorrhea, which could mean you have an underlying health condition requiring treatment. Your doctor will run tests, like pelvic examinations and ultrasounds, to determine what’s causing your pelvic pain. Then, they’ll help you determine how to treat the condition and manage symptoms.
Regardless of your pain level, consulting your doctor on any concerns or questions about your health is always an option! Even if you don’t have an underlying condition, your doctor can help you find strategies to treat pelvic pain during your period.
>>MORE: Why Do I Have Perimenopause Cramps?
How to get relief from pelvic pain during your period When pelvic pain during your period is related to PMS, PMDD, or cramps (as in primary dysmenorrhea), symptoms will generally go away when your period ends.
To get relief from pelvic pain in the meantime, try:
Taking pain relievers , like aspirin, ibuprofen, and acetaminophenApplying heat to your lower belly, like with a hot water bottle, heating pad, warm bath, or showerDoing light exercise to open your muscles and release endorphins (your body’s natural painkillers), like gentle stretching or yogaGently massaging your belly , but stop if anything hurtsGetting acupuncture or acupressure Using TENS devices (transcutaneous electronic nerve stimulation), as comfortableResting and relaxing until you feel ready to do moreIf your period pelvic pain stems from an underlying health condition (as in secondary dysmenorrhea), these methods may not be as effective—although it’s certainly possible that they offer short-term relief, so they’re still worth a try!
Exercising regularly throughout your cycle has also been shown to help ease pelvic pain related to both primary and secondary dysmenorrhea. Trying low-intensity, gentle workouts while on your period may offer pelvic pain relief, too.
When pelvic pain is related to secondary dysmenorrhea, you’ll likely also need long-term treatment to help you address the underlying condition and manage pelvic pain. Your doctor will help you evaluate your options and find the right treatments for you.
Options often include:
Hormonal contraceptives, like an IUD or the pill Prescription medication, like gonadotropin-releasing hormone (GnRH) agonists Surgery, in more extreme cases Pelvic pain during your period: the bottom line Pelvic pain during your period can be a troubling and distressing symptom, and may even be debilitating in certain cases. Period cramps and underlying reproductive conditions can cause period pelvic pain.
If pelvic pain is particularly severe or occurs outside of your period, talk with your doctor to get to the bottom of your pain and find a treatment strategy.
No matter your pain level, you deserve relief. To help ease pelvic pain during your period, you can try remedies like pain relievers, heat application, or gentle stretching. In more severe cases, hormonal birth control is another option for managing pelvic pain.
