Are Painful Periods a Sign of Good Fertility?

Are painful periods a sign of good fertility? We’ve all heard this one before—like it’s some kind of weird consolation prize for dealing with brutal cramps. But is there any truth to it? Let’s break it down and get to the real facts.

What Are Painful Periods?

Painful periods are menstrual cycles with accompanying severe pain (usually pelvic). Painful periods are also known as dysmenorrhea and along with severe pain, you may also experience other symptoms like diarrhea, nausea, vomiting, headaches, or dizziness. Many people who menstruate experience some pain, but dysmenorrhea is pain that is so severe it interrupts normal activities, and you may need treatment.

Painful periods can be considered primary or secondary. Primary dysmenorrhea is the usual cramping that comes before or during your period. Whereas, secondary dysmenorrhea is painful menstruation that is usually caused by an underlying physical condition. There are many reasons why you might experience secondary dysmenorrhea such as endometriosis, adenomyosis, fibroids, or PCOS (along with others). 

What Causes Painful Periods?

Not all painful periods are the same and there are different causes for the type of dysmenorrhea you may experience. 

Primary Dysmenorrhea

Primary dysmenorrhea is the pain before and/or during menstruation that is not associated with underlying conditions. It’s part of the whole package of menstruation and begins when you start menstruating or shortly after and is considered the most common type of period pain. 

Secondary Dysmenorrhea

Secondary dysmenorrhea is when severe period cramps are caused by an underlying physical condition. The physical cause of extremely painful periods often starts later in life and affects the uterus. Medical conditions such as endometriosis, adenomyosis, pelvic inflammatory disease, and fibroids can all cause really intense period cramps, along with a variety of other conditions. 

Hormonal and Physical Triggers for Pain

Severe period cramps can have both hormonal and physical triggers for pain. Primary dysmenorrhea period cramps are most often a natural response to the body’s production of prostaglandins, a hormone-like substance found in the lining of the uterine that helps with uterine shedding. If your body produces too much of this hormone-like substance, it can result in excess inflammation and pain. Levels are higher when you start your period and gradually go down as they are no longer needed. This is why cramping starts just before or during your period and gradually decreases as your period finishes.

Although not a direct cause of painful periods, hormone fluctuations during your cycle can also contribute to feelings of discomfort. And when the body is under a continued stress response from chronic pain, the knock on effects can cause other hormone levels to be less than optimal and create major hormonal problems. Your endocrine system (hormones) and nervous system are complexly woven mechanisms that work together, and any hormone imbalance can have an impact on pain. 

Physical triggers for painful periods include other conditions that affect the reproductive system like endometriosis, fibroids, PCOS, pelvic inflammatory disease, infections, tumors, or polyps. The pain is a symptom of another condition, rather than a part of regular menstruation. Endometriosis, a disease where uterine tissue grows outside the uterus, is the most common physical trigger and affects nearly 10% of reproductive age women and girls worldwide. 

Painful Periods and Fertility: Myth or Fact?

Are painful periods a sign of good fertility? This is just one of the many myths you might encounter about fertility, especially when it comes to menstrual cramps and what they might mean.

Debunking the Myth: Painful Periods and High Fertility

Old wives’ tales abound when it comes to fertility. Everyone’s been told to do this or that, but one myth that persists is that painful periods somehow indicate good fertility. There is no scientific evidence to support this claim and menstrual pain (or lack thereof) is not a sign of fertility. 

Scientific Evidence on Period Pain and Fertility

Thanks to research on menstrual pain, we know that the primary cause of menstrual cramps and painful periods is uterine prostaglandins. Prostaglandins are a type of hormone-like substance that have a variety of functions in the body but also play a role in pain levels and inflammation. 

Uterine prostaglandins cause the uterine lining to shed during your period. Found in most tissues and organs, prostaglandins act as a signal for certain processes, and your body produces them where needed. Once they’ve done their job, they are no longer needed and are broken down. This explains why period cramps are most intense at the start of your period and gradually taper off. Severe period cramps or pain, the kind that interrupts your life, is not normal and may indicate an underlying concern. 

Key Factors That Influence Fertility

There are a number of key factors that influence your fertility including maintaining a healthy weight, eating a healthy diet, getting enough sleep, and keeping your stress levels under control. Underlying health conditions (like thyroid disorders) can also have an impact which is why it’s important to be able to understand what is going on behind the scenes. While some hormonal imbalances are natural during certain phases (i.e. puberty or pregnancy), if you aren’t pregnant or undergoing puberty or menopause, this may be a sign of an underlying condition. 

When Are Painful Periods a Concern for Fertility?

Extremely painful periods are not normal and if you find that the pain is interfering with your daily life or activities, it may be a cause for concern. Severe period cramps and pain that does not go away are a red flag, especially for fertility. Aside from really intense period cramps and debilitating pain, painful menstruation as a symptom of various gynecological conditions can also impact ovulation and pelvic inflammation can affect reproductive organs. 

Endometriosis and Adenomyosis: A Common Cause of Painful Periods 

Endometriosis is a condition that causes tissue similar to the lining of the uterus to grow on other organs and anatomic structures. The resulting inflammation, adhesions, and scarring can lead to debilitating pain. Although not all of those with endometriosis experience pain, it can occur at any time of the month, although it’s usually worse during menstruation, and be accompanied by other symptoms like dizziness, nausea, and constipation. It is a frequent cause of infertility in females and as many as 1 in 10 women of reproductive age (and those AFAB) have the condition. 

Adenomyosis is a gynecological condition where the tissue that lines your uterus (endometrial tissue) grows into the muscular walls of your uterus. Even though it’s not where it’s supposed to be, the tissue still continues the process of thickening, breaking down, and bleeding during each cycle which can cause extreme pain. We don’t know what causes this condition, but there are treatments available to manage the pain and other symptoms. 

PCOS and Its Impact on Menstrual Pain and Fertility

Polycystic ovary syndrome (PCOS) is an endocrine condition that disrupts hormone levels and leads to prolonged hormone imbalances. This can lead to a range of symptoms that interfere with fertility and general health – including PCOS menstrual pain. The hormonal imbalance that accompanies PCOS can lead to cystic ovaries and a chronic lack of ovulation, making it hard to get pregnant. 

When diagnosed, PCOS is highly manageable through fundamental lifestyle changes and dietary supplements. Several vitamins and minerals help regulate hormonal imbalances and promote ovulation, which can be especially helpful when you have PCOS. 

Mira’s own PCOS supplements (always third party tested) support ovarian health, promote hormonal balance, and assist metabolic function to help restore balance and feel in sync with your body. 

Other Conditions Affecting Fertility (Fibroids, PID)

Other gynecological issues that can lead to painful menstruation and intense period cramps include uterine fibroids and pelvic inflammatory disease (PID). Uterine fibroids are noncancerous tumors that grow in the external lining of the uterus or the uterine wall or under the uterine lining. Fibroids present a risk to your fertility since they can prevent implantation, and alter the womb environment.

Pelvic inflammatory disease (PID) is when you have a bacterial infection in your uterus, fallopian tubes, or ovaries. The bacteria usually (but not always) come from a sexually transmitted infection like chlamydia or gonorrhea and starts in the vagina or cervix before spreading to other reproductive organs. PID is a serious condition that can cause permanent damage to reproductive organs, spelling obvious trouble for fertility.

How to Manage Painful Periods and Protect Fertility

Lifestyle Changes to Reduce Menstrual Pain

Painful periods can often be managed alongside lifestyle changes that target the issue holistically and will have the biggest impact. This means addressing fundamental lifestyle issues such as managing diet, sleep, and stress levels, as well as getting enough exercise.

More specific treatments, like medication, can be used to fight localized pain. Most people who have had a period are familiar with really intense period cramps and taking over the counter pain medication to ease them. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are widely available and work well to reduce menstrual pain, especially since they target prostaglandins (a contributing factor to severe period cramps). 

Stress causes a natural surge of hormones and chronic stress can lead to a prolonged hormonal imbalance. We know this can contribute to extremely painful periods and lead to long-term health issues so managing stress is an important part of fertility. 

Meditation can help reduce stress and the physical benefits have been well-studied. From better sleep and lower blood pressure, to lower levels of stress hormones and a reduction in chronic pain, the physical benefits of meditation have been shown to help many health conditions and improve physical wellbeing. Fertility meditations, like the ones offered by Mira, can help put you in charge of your cycle’s wellbeing and focus on issues specific to your fertility journey. 

Not only can stress have a negative impact on your overall health, but it can also hurt your chances of getting pregnant. Having a relaxing ritual like making a cup of tea can help you get relaxation promoting vitamins and minerals in your body, and even put your mind in the right state to conceive. Mira’s Fertility Tea provides you with a mix of antioxidants, vitamins, and minerals that support your overall health, including your reproductive health. 

The combination of vitamins and minerals found in prenatal vitamins can also help to promote hormone balance among individuals trying to conceive (TTC) and even help with cramps. For example, vitamin B, magnesium, and vitamin D help to regulate the menstrual cycle, promote ovulation, and improve chances of conception. While ingredients like vitamin E can help reduce inflammation and target prostaglandins to reduce the severity of menstrual cramps. Mira’s own Prenatal Multi-Vitamins include the essential nutrients required before, during, and after pregnancy to help support your overall reproductive health. 

Natural Remedies for Pain Relief

There are also natural remedies you can use for relief from really intense period cramps. Regular exercise can help reduce painful periods by releasing endorphins that help relieve pain. Or you can use a hot water bottle or heating pad to relax muscles and help ease the cramps. Another proven technique for pain management is mindfulness meditation, which teaches you to relax the body while noticing your pain so you can manage it. Other natural remedies for pain relief include massaging with essential oils, avoiding certain foods, adding herbs to your diet, or even having an orgasm. 

Medical Treatments and When to Use Them

Over-the-counter pain relievers are often the first line of medical treatment for painful periods. If that’s not enough, there are even prescription level nonsteroidal anti-inflammatory drugs to try and address the issue. Hormonal birth control is another option since it prevents ovulation and can help to reduce period pain. Although research is limited in these areas, alternative therapies like acupuncture and acupressure may work to relieve period cramps as well. 

When to See a Doctor About Painful Periods

Slight period pain is a normal part of menstruation, but when the pain becomes unbearable or interferes with your daily activities, it’s time to see a doctor. Pain that leaves you debilitated or unable to function isn’t normal, and you don’t have to live with it. 

Signs of Underlying Health Issues

Severe menstrual pain isn’t normal and may be a sign of an underlying health issue. Your healthcare provider will perform a variety of exams and tests to determine what might be causing your pain ranging from physical exams to a detailed medical history. 

Tracking Symptoms for Better Diagnosis

Gynecological problems can be notoriously hard to diagnose so it can be helpful to keep track of your symptoms. A great place to start is by tracking your cycle and paying attention to how you feel at every phase. You can do this with the free Mira App that allows you to track symptoms and help you predict your fertile window and ovulation. 

Since the menstrual cycle is a key driver of hormonal changes, being able to test and track a variety of hormones involved can give you detailed information and enable you to see your unique hormone patterns over time. For daily hormone monitoring, the Mira Hormone Monitor can help you track up to four key fertility hormones in urine with lab-grade accuracy. Depending on your goals, we have four wand options that detect hormones alone or in combination with one another. Your numeric results are tracked in real-time in the Mira App, enabling you to see your unique hormone patterns over time. You can even share this information with your healthcare provider to help manage your hormones or achieve your fertility goals. 

For a ‘big picture’ perspective of your overall reproductive health, you can also utilize Mira’s Panorama Fertility Lab Test. This one-time blood test can provide insights into other hormones that affect the menstrual cycle – including Anti-Müllerian hormone (AMH), thyroid-stimulating hormone (TSH), Free Thyroxine (fT4), Prolactin, and Free Testosterone. Once your hormones are tested, you’ll receive five detailed reports that provide insights into your menstrual cycle rhythm, ovarian reserve, hormone balance, and more. 

*Please note that Mira’s Panorama Fertility Lab Test is not the same as the Mira Monitor. The Panorama Fertility Lab Test is a one-time screening that provides a broad picture of overall reproductive health and ovarian reserve. The Mira Monitor is designed for ongoing use to help monitor hormonal trends related to fertility and ovulation.

Diagnostic Tests for Period Pain and Fertility Concerns

There are a number of tests you may undergo to understand what is going on with your painful menstruation. Your doctor may suggest an ultrasound or other imaging test to get a better look at your reproductive organs or even insert a tiny camera into your abdomen to view the organs in the pelvis. This is known as laparoscopy, a minimally invasive surgical procedure that can help detect underlying physical conditions like endometriosis or fibroids. 

Conclusion: What Does Period Pain Mean for Your Fertility?

Some discomfort with menstruation is to be expected, but severe period cramps are not normal and may indicate an underlying health issue. There is no evidence to suggest that painful periods are a sign of good fertility, and they may even indicate the opposite – an underlying health issue that can threaten your fertility. If your period cramps are especially severe or debilitating, it’s worth getting it checked out so you can address any issues and improve fertility outcomes if possible. 

If you’re not sure where to start or how to seek a diagnosis for severe period cramps our Hormone Health Clinic for fertility is a great place to start. Our empathetic fertility experts have experience navigating all things fertility and provide personalized support that can address your specific issues and even help you advocate for yourself and take control of your fertility journey. 

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