How Bad Are Your Cramps? 6 Signs Period Cramps Are Abnormal

Oh, menstrual cramps. If you’ve never complained about the aches and pains of your period to a friend, you’re a rare individual. It’s a frequent topic of conversation. And yet, with all that talking, you probably still don’t know what’s considered normal and what’s not. Or what you can do to find relief.

You might get the impression that very painful periods are the norm. Discomfort during menstruation isn’t uncommon, especially in younger people. About half of all people who menstruate experience pelvic achiness during their periods. But even if menstrual pain is common that doesn't mean you need to suffer, so seek out advice and care options from your OB/GYN to find relief.

With that said, really bad menstrual cramps are not normal. Severe period cramps can signal a problem—a problem that may impact your fertility.

Here are six ways to know that your cramps might not be normal. As always, if you have any questions or concerns about your health, talk to your doctor.

signs period cramps aren't normal — Verywell / Brianna Gilmartin

Your Life Is Disrupted

If your period pain is so bad that you need to call off work, school, or other activities on a regular basis, you should speak to your doctor. The condition is not rare. But it’s not normal, either.

Depending on which study you look at, between 5% and 20% of women experience painful periods that interfere with their daily life.

Some countries offer a couple days off every month for menstruation. Don’t misconstrue this for saying that menstruation should be so painful that you can’t go about your regular life. The issue is more complex than that. It’s not even clear whether these laws are good or bad.

In 2013, Russian lawmaker Mikhail Degtyaryov proposed that Russia should offer days off for menstruation. He argued that sometimes the "pain for the fair sex is often so intense that it is necessary to call an ambulance.” Not exactly a realistic portrayal (or understanding) of menstruation.

If your pain is bad enough to call an ambulance, please call one. Those aren't period cramps. Something much more serious is going on. In a more likely scenario, if your pain is bad enough to regularly miss work or school, make an appointment to speak to your doctor. There may be something else going on that needs treatment and/or treatment options that can soothe your discomfort.

Pain Medications Don't Work

For those 20% who experience monthly discomfort, most can typically get relief with over-the-counter pain medications, like Advil (ibuprofen) or Tylenol (acetaminophen). If over-the-counter medication is not enough to help you get on with your day, however, then your period cramps aren’t normal.

Very important side note: Some people will take more than the recommended dosage of over-the-counter pain relievers thinking that since they are over-the-counter, they are therefore harmless. Over-the-counter is not a code word for dosage-doesn’t-really-matter. Don’t do this. It can be extremely dangerous and even deadly.

Never take more pain medication than is indicated on the label or prescribed to you by your doctor. If recommended dosages aren't enough, speak to your healthcare provider.

You Have Random Pelvic Pain

Pelvic discomfort just before your period and during the first few days of your period can be normal. You may also experience some sensitivity around ovulation. But if you have pelvic pain at other times during your cycle, that may signal a problem.

Another possible sign your cramps aren’t normal is if you experience pain during sex. Some causes of painful sex are also responsible for abnormally bad period cramps.

If severe cramping is accompanied by fever, vomiting, dizziness, unusual vaginal bleeding, vaginal discharge, or if the pain is especially severe, call your healthcare provider immediately.

Menstrual Cramps Last Too Long

It’s normal for the bleeding during menstruation to last anywhere from two to seven days. It’s not normal, however, to have bad period cramps that entire time.

Two or three days of menstrual discomfort is considered to be normal.

Cramps may start the day of or day just before the bleeding starts, but they should not continue all the way until the end of your period. They certainly shouldn’t still be there after your period ends.

Your Cramps Don't Feel "Normal"

If you’re worried your period cramps aren’t normal, then you should take that concern seriously. Worrying isn’t a sign that something is wrong, but it could suggest things might be wrong. Many people are afraid to talk to their doctors about symptoms that can’t easily be quantified.

If you have a fever, your doc can confirm that by taking your temperature. If you’re experiencing pain, your doctor has to take your word for it. This keeps a lot of people from seeking help.

Additionally, complaints about pain (especially coming from women and other historically marginalized groups) are sadly sometimes dismissed. If you brought up your pain to a doctor in the past, and they brushed it off as not serious, you may be reluctant to bring it up again. But you should bring it up again. Especially if you’re concerned about it.

Some of the possible causes for painful cramps—like endometriosis—are diseases that take years to get properly diagnosed. Keep asking for help until someone hears you.

You Have Other Symptoms

Maybe you’re really not sure whether your cramps are normal or not, but you also experience other related symptoms. Other worrisome symptoms may include:

Cramps accompanied by nausea or diarrhea
Difficulty getting pregnant
Heavy bleeding
Irregular cycles
Pain during sex
Pelvic pain at times beside your period
Spotting between cycles

Bottom line: If you’re worried, talk to your doctor.

Possible Causes of Pelvic Pain

Let’s say your cramps are worse than average. What could be wrong? There are a few possibilities.

Bad menstrual cramps may be caused by:

Adhesions
Cervical stenosis
Endometriosis
Fibroids
IUD birth control devices
Ovarian cysts
Pelvic inflammatory disease (PID)

To evaluate what may be wrong, your healthcare provider may suggest:

Blood work
Exploratory laparoscopy (in especially severe cases)
Pelvic exam with sexually transmitted infection (STD/STI) testing
Pelvic ultrasound

It’s important to know that endometriosis can only be diagnosed with exploratory laparoscopy. It can’t be ruled with ultrasound or a pelvic exam. However, laparoscopy is an invasive, surgical procedure, so your doctor may not recommend having it unless your symptoms are especially bad.

Severe abdominal or pelvic pain may indicate something more serious than your period, like an ectopic pregnancy, toxic shock syndrome, acute PID, or appendicitis.

Treatment Options

Occasionally, it happens that you see your doctor and are told everything is fine, particularly if underlying causes have been ruled out. If your cramps aren’t interfering with your daily life, this may be a reassuring and acceptable answer. However, if your cramps are making it difficult to work and live, don’t accept “You’re fine” as an answer. Seek out another doctor.

Medications, heating pads, resting, exercise, breath work, and other treatments may help you find relief. Sometimes, going on birth control pills can help regulate your cycle and reduce your period pain. Some types of birth control medications allow you to skip having your period for multiple months in a row, which is called menstrual suppression and means you will get your period—and any discomfort—much less often.

However, the right treatment for you will depend on your personal situation and medical history, so consult with your doctor to create a plan that will reduce your monthly discomfort.

11 Sources

Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

American College of Obstetricians and Gynecologists. Dysmenorrhea: Painful Periods.
Ju H, Jones M, Mishra G. The prevalence and risk factors of dysmenorrhea. Epidemiol Rev. 2013;36(1):104-113. doi:10.1093/epirev/mxt009
De Sanctis V, Soliman A, Bernasconi S, et al. Primary dysmenorrhea in adolescents: Prevalence, impact and recent knowledge. Pediatr Endocrinol Rev. 2015;13(2):512-520.
Cleveland Clinic. Mittelschmerz.
Osayande AS, Mehulic S. Diagnosis and initial management of dysmenorrhea. Am Fam Physician. 2014;89(5):341-346.
Cleveland Clinic. Dysmenorrhea.
Harada T. Dysmenorrhea and endometriosis in young women. Yonago Acta Med. 2013;56(4):81-84.
Cleveland Clinic. Abnormal Menstruation (Periods).
Kuznetsov L, Dworzynski K, Davies M, Overton C. Diagnosis and management of endometriosis: summary of NICE guidance. BMJ. 2017;358:j3935. doi:10.1136/bmj.j3935
Kruszka PS, Kruszka SJ. Evaluation of acute pelvic pain in women. Am Fam Physician. 2010;82(2):141-147.
Hillard PA. Menstrual suppression: current perspectives. Int J Womens Health. 2014;6:631-7. doi:10.2147/IJWH.S46680

Additional Reading

Clinical Evidence Handbook: A Publication of BMJ Publishing Group. Dysmenorrhea.

By Rachel Gurevich, RN
Rachel Gurevich is a fertility advocate, author, and recipient of The Hope Award for Achievement, from Resolve: The National Infertility Association. She is a professional member of the Association of Health Care Journalists and has been writing about women’s health since 2001. Rachel uses her own experiences with infertility to write compassionate, practical, and supportive articles.

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