Your painful period could be caused by...

Bowel issues

Irritable bowel syndrome

Irritable bowel syndrome can cause cramps that flare up during your period. IBS and endometriosis have overlapping symptoms meaning the two conditions can mimic each other. It is also possible to have both IBS and endometriosis.

Bacteria

Pelvic inflammatory disease

Infections such as pelvic inflammatory disease (PID) can cause your uterus, fallopian tubes, and ovaries to become inflamed, which can lead to cramping and pain during your period.

Chlamydia, gonorrhea and yeast infections can have a similar effect.

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Physical abnormalities

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Endometriosis

Endometriosis tissue thickens, bleeds and sheds as you go through your menstrual cycle, causing irritation and swelling in the surrounding area. It can also cause organs to fuse, increasing your level of pain.

Adenomyosis

This condition is similar to endometriosis with one main difference: instead of tissue growing outside the uterus it grows into the muscular wall of the uterus. The severity of your symptoms will depend on how much the tissue has penetrated the uterine wall and the number of adenomyosis lesions that have formed.

Fibroids

Fibroids can increase the size of your uterus, causing it to contract more forcefully during menstruation, which can lead to cramping and pain.

In rare cases, painful periods can be caused by:

Gynecological cancers, which lead to changes in your normal periods such as unusual cramping and pain, depending on the size and location of the cancer.

Adhesions (scar tissue) caused by previous surgery. Scarring can lead to attachments in and around your pelvic organs, causing pain that gets worse during your period.