“Periods are supposed to be painful.” I hear this far too often. And while some degree of cramping during menstruation is normal, severe pain – the kind that puts you in bed, makes you miss school or work, or doesn’t respond to standard pain relief – is not normal. It deserves investigation.
Normal Period Pain (Primary Dysmenorrhoea)
Normal period cramps are caused by prostaglandins (chemicals released during menstruation) causing uterine contractions to shed the lining. They:
- Begin 1–2 days before or at the start of the period
- Peak in the first 24–48 hours
- Are located in the lower abdomen or lower back
- Respond to ibuprofen or mefenamic acid
- Do not cause severe nausea, vomiting or passing out
- Allow you to function (even if uncomfortably)
When Pain Suggests Something Else
See a gynaecologist if your periods:
- Have become progressively more painful over the years
- Require prescription pain relief or make you miss school/work
- Are accompanied by pain during sex (especially deep penetration)
- Are associated with pain during bowel movements
- Are accompanied by bloating, nausea or fatigue throughout the cycle
- Have started to cause chronic pelvic pain outside of your period
What Is Endometriosis?
Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus – typically on the ovaries, fallopian tubes, bowel, bladder and pelvic lining. This tissue responds to hormonal cycles, bleeding and causing inflammation and scar tissue.
The classic symptoms are:
- Severe, progressive dysmenorrhoea
- Deep dyspareunia (pain during sex)
- Cyclic bowel or bladder symptoms
- Chronic pelvic pain
- Subfertility or infertility
The Diagnostic Delay Problem
In India, the average time between symptom onset and endometriosis diagnosis is 6–10 years. Women are repeatedly told their pain is normal. This delay allows the disease to progress, affecting fertility and quality of life. If your pain fits the pattern above, please insist on investigation.
How Is Endometriosis Diagnosed?
Ultrasound can detect endometriomas (ovarian cysts from endometriosis) and deep infiltrating disease in experienced hands. Mild endometriosis may not be visible on ultrasound – the definitive diagnosis requires laparoscopy (keyhole surgery).
Don’t accept severe period pain as normal. Book a consultation at Sadhbhavna Clinics Chandigarh for a proper evaluation and answers.