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I’m a doctor – here are six things that can make your period pain worse

Sticking to a hot water bottle every month is something many women deal with.

But the severity of period pain can vary drastically.

For some, it is so crippling that it can interfere with their daily lives, while others experience no pain at all.

Dr. Adiele Hoffman, a family doctor and medical advisor for Flo, the menstrual tracking app, told MailOnline about the things women may not know that are making their cramps worse.

An unhealthy diet, very overweight or very underweight, stress, some forms of contraception, smoking and gynecological conditions can make menstrual cramps worse

An unhealthy diet

Fast foods, cured meats, and sugary treats can make your period worse, Dr. Hoffman said.

A 2018 study involving 70 college students tested this theory.

Turkish researchers found that those who ate a lot of salty snacks and sweets had more menstrual cramps than those who did not.

“While there is no miracle cure that can magically cure menstrual pain, a healthy diet can make a difference,” Dr. Hoffman added.

Experts say research on the direct influence of diet on menstrual cramps is limited.

However, there is some evidence that foods high in omega-6 fatty acids — which are common in processed foods like cookies or fast food — that promote inflammation in the body may affect menstrual pain.

Instead, eating foods that reduce inflammation, such as fruits, vegetables, and whole grains, may relieve symptoms.

But another study, this time of 100 female college students in Iran, found that they got relief from their menstrual cramps after undergoing “diet therapy.”

The food they received was high in fiber and vitamins, a few servings of fish a week, and low in fat and salt.


Stress can make periods more irregular because hormones disrupt the menstrual cycle.

But research shows that excessive stress can also make menstrual cramps worse.

In a study of 388 textile workers in China, women who experienced high levels of stress during their last menstrual cycle were twice as likely to experience period pain.

And a 2017 Ethiopian study of 400 female university students came to the same conclusion.

Dr. However, Hoffman claims that when it comes to stress, it can go either way.

She said, “Pain can increase your stress level, while stress can make pain worse.

“That’s why relieving stress, in a way that works best for you, can help prevent this.”

Other experts have also suggested that elevated levels of the stress hormone cortisol may suppress reproductive hormones, leading to abnormal ovulation.


It is common knowledge that smoking is bad for your lungs.

But dr. Hoffman said women may be less aware of the link between smoking and menstrual cramps.

A review of previous studies by researchers in China found that smokers were 1.45 times more likely to develop menstrual cramps.

Experts analyzed 24 studies involving 27,091 participants.

And another study from the University of Queensland, which followed 9,067 Australian women for an average of 13 years, also found that women who smoked were “significantly more likely” to experience menstrual cramps.

Exactly how cigarette smoking may increase menstrual pain is not entirely clear.

But experts believe the link may be due to smoking causing vasoconstriction — narrowing of the blood vessels.

The NHS says: ‘During your period, the uterine wall begins to contract more forcefully to help shed the uterine lining as part of your period.

“When the uterine wall contracts, it compresses the blood vessels lining your uterus. This temporarily cuts off the blood supply – and oxygen supply – to your uterus.

“Without oxygen, the tissues in your uterus release chemicals that cause pain.”


Research from Public Health England found that almost half of women – 48 per cent – say they struggle with menstrual problems, such as heavy or irregular periods. So when should you worry about your period?

Menstrual pain is common and most women experience it at some point in their lives.

The pain is usually felt as cramps in the abdomen and is caused by the muscle wall of the uterus contracting and temporarily deprived of oxygen.

Consult your doctor if the pain is severe or suddenly different from what is normal for you, as this could be a sign of endometriosis or pelvic inflammatory disease.

Irregular periods happen when the length of your menstrual cycle changes.

They may be normal or easily explained by hormones, but you should see a doctor if they suddenly become irregular, if they are very close together or far apart (less than 21 days or more than 35 days), or if menstrual periods last longer than a week.

Heavy periodsloss of blood are common, but can seriously affect a woman’s life.

Heavy bleeding is defined as losing 80 ml (16 teaspoons) or more per period, with periods longer than 7 days, or both.

Heavy periods are not necessarily a sign of an underlying problem, but if you notice an unusual amount of blood, or if it is affecting your daily life, it’s a good idea to see your doctor.

Source: NHS Choices

Being very overweight or very underweight

Maintaining a healthy weight can also help with period pain, Dr. Hoffman said.

Research has suggested that you are significantly more likely to experience severe period pain if you are obese or underweight.

Australian doctors studied 9,688 women over 13 years and found that when obese women lost weight, their risk of pain decreased.

Dr. Hoffman added, “We don’t know exactly why, but there are some theories.

“More fatty tissue, for example, could mean higher estrogen levels and more inflammatory chemicals, potentially leading to heavier bleeding and more menstrual cramps.”

And at the other end of the scale, research also suggests that particularly low body fat may mean lower estrogen levels — which have been linked to more severe chronic pain.

Some types of birth control

Contraception is often prescribed to women who complain of menstrual cramps.

But some types can make symptoms worse.

The copper coil, an intrauterine device (IUD), can be the cause of increased cramping and heavier periods, especially in the weeks after it’s inserted, according to the NHS.

Experts aren’t yet clear on why the copper IUD makes periods heavier and more painful, but one theory is that its insertion may cause tissue damage and release prostaglandins.

Prostaglandins can cause the uterus to contract more, resulting in painful cramps.

However, alternative contraceptive options can relieve symptoms, such as the oral contraceptive pill and the Mirena intrauterine system (IUS) intrauterine device.

Health conditions

Less commonly, conditions such as endometriosis, adenomyosis, or uterine fibroids can cause menstrual cramps.

The most common of the three, endometriosis is a painful condition in which tissue similar to the lining of the uterus grows in other parts of the body, such as the fallopian tubes and ovaries.

Dr. Hoffman said this tissue breaks down and bleeds as hormones change and sometimes gets stuck. In this case, painful scar tissue may form.

Adenomyosis is where the tissue that normally lines the uterus begins to grow within the muscular uterine wall, according to the NHS.

It can be particularly painful if a person’s uterus swells during menstruation and bleeds into the uterine wall.

Fibroids, also called uterine fibroids or leiomyomas, are benign tumors that grow in or around the uterus.

Experts have suggested that they can make your periods heavier or more painful due to the weight of the fibroid itself pressing or resting on the pelvic organs.

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