Cramps or period pain is known as dysmenorrhoea. It is usually caused by prostaglandins which are those naturally occurring chemicals found in tissues throughout the body, including in the uterus. Prostaglandins play a role in the regulation of body temperature, inflammation, cell growth, and smooth muscle constriction and dilation.
They also trigger the uterine muscles to contract, which helps expel the uterine lining during menstruation and are also involved in inducing labour contractions and childbirth.
If your levels of prostaglandins are too high, it can trigger more uterine contractions and when the uterine contractions are especially strong, oxygen is temporarily cut off to parts of the muscle, which can lead to painful period cramps.
As a teenager, according to fertility expert, Dr Abayomi Ajayi, you may have experienced worse period cramps because you naturally have higher levels of prostaglandins. As you get older and these levels decrease, the intensity of your cramps can also lessen. Some people also have easier, less painful periods after they give birth.
Your period cramps that are caused by the normal activity of prostaglandins are called primary dysmenorrhea. This type of painful period should not negatively impact on your fertility.
Period cramps that are caused or worsened by other diseases or abnormalities of the reproductive system are called secondary dysmenorrhea. It’s this type of painful period that can be associated with trouble getting pregnant.
Essentially, within the context of secondary dysmenorrhea, menstrual cramps can be caused by diseases that impact fertility. Some of these diseases develop over time, and the symptoms may only surface as time goes on.
One of the commonest reproductive health conditions that can affect your periods and fertility is endometriosis. This condition is particularly notorious for causing painful periods and possible infertility.
When you have endometriosis, the endometrium (the tissue that usually lines the uterus) grows in places outside of the uterus where it shouldn’t. This tissue responds to monthly hormone variation and bleeds often leading to scar tissue and pain.
Up to 50 per cent of women who struggle to conceive might have endometriosis. It is a condition that often goes undiagnosed and untreated for years, if not decades.
Another common cause of menstrual cramps is adenomyosis, which occurs when the endometrium grows within and into the muscle of the uterus.
This is slightly different from endometriosis, where endometrium-like tissue grows outside of the uterus. It’s also not the same as fibroids, which are a mass of tissue. Adenomyosis can cause painful and heavy periods and it may affect fertility.
Fibroids are another common cause of cramps. Fibroids are muscular growths that can occur in or on the uterus, cervix, and even pelvic ligaments. They are typically non-cancerous and tend to grow during the reproductive years.
As a woman you may have fibroids and never know you have fibroids. However, the growths occasionally can cause pain, reduced fertility, and possibly increase the risk of miscarriage.
Pelvic Inflammatory Disease (PID) is one other possible cause of bad menstrual cramps that can also impact on your fertility. PID is caused by an infection in the reproductive organs, often an untreated or under-treated sexually transmitted infection.
Quite commonly, PID is the most common cause of blocked fallopian tubes and leads to the formation of scar tissue, which often looks like webbing between the ovaries, fallopian tubes, and uterus.
Pelvic pain or ovulation pain can also occur when you are not expecting your period. Ovulation pain is common: Up to 50 per cent of women have had ovulation pain at least once in their lives, and 20 per cent say they get it every month.
By all means, experiencing pain during ovulation is not normal if it interferes with your daily life and causes painful sexual intercourse, or if it is sudden and severe. Ovulation pain can be so severe that it could prevent you from having sex when you are most likely to conceive. If you’re trying to get pregnant, and pain is preventing you from having sex, that can certainly lower your odds of conception.
You should not experience painful intercourse no matter what time of the month it is. Sex should not hurt. If you have recurrent, persistent, or severe pain with sexual intercourse or during ovulation, talk to your doctor. Ovulation pain and painful sex can be symptoms of a reproductive health condition, such as endometriosis.
If you’re experiencing painful periods or pelvic pain, it’s important you talk to your doctor who can assist you to find out what is causing your pain and recommend treatment. Sometimes, hormonal birth control is recommended for managing menstrual pain-related symptoms. However, this won’t be an option if you are trying to get pregnant, and likely isn’t going to treat the underlying cause of the pain.
The most common treatment for painful periods is common over-the-counter (OTC) pain medications. It’s best to take OTC pain reliever when your painful period symptoms are just starting (as opposed to waiting until they have already begun).
Surgery is another possible treatment option if the pain is caused by endometriosis, fibroids, or adhesions. However, you might want to consult with a gynecologist before considering surgery. They can help ensure that your fertility remains intact. In some cases, it is also beneficial to time fertility treatments soon after corrective surgery.
If you’re experiencing pelvic pain, talk to your doctor about the treatment options that are available. You might want to start with relatively simple treatment like OTC pain relievers.
While painful periods themselves are not linked to fertility issues, some of the causes behind the pain are associated with infertility and there is possibility that these conditions can get worse over time, which is why getting diagnosed and treated early is important.