Many women experience some discomfort or pain around the time of their menstrual period, especially for the first day or two of their flow. In some cases, pain may be experienced a few days before your period begins. While this sort of pain isn't usually a cause for concern, sometimes it might indicate a problem that requires medical attention.
Normal Menstrual Discomfort
The American College of Obstetricians and Gynecologists (ACOG) reports that 50 percent or more of menstruating women experience some pain associated with their periods. When a period is near, levels of hormone-like compounds called prostaglandins increase. One of the effects of prostaglandins is contraction of the uterine muscles, which can result in some cramping abdominal pain. Although it can be unpleasant, the pain does not signal a medical problem. Many women report that menstrual pain improves as they get older or after they have a child. If your monthly pain is severe, talk with your doctor.
Sometimes, monthly abdominal pain is caused by a problem other than the normal process of menstruation. One such condition is endometriosis, a disorder in which the cells that make up the uterine lining grows outside the uterus, typically onto the ovaries or fallopian tubes. Less commonly, the tissue grows in other areas such as the rectum or bladder. This can cause monthly pain in the days leading up to or during your period. About 10 percent of women develop endometriosis during their child-bearing years, according to ACOG.
Tumors and Cysts
Certain reproductive system tumors or cysts can cause pain, which sometimes occurs before a period. Noncancerous growths called fibroid tumors commonly develop in the uterine wall. Depending on their size and placement, they can cause pain before your period. Many women have fibroids and never know it. If they cause pain or other problems, your doctor may recommend surgery to remove them. An ovarian cyst -- a fluid-filled sac on your ovary -- is another potential cause of pain before a period. Most cysts cause no symptoms, however, and disappear without treatment.
There are many possible causes of abdominal pain. Therefore, the development of abdominal pain before your period might have nothing to do with your menstrual cycle. For example, you might have the stomach flu or constipation, or could have overindulged in a food that doesn't agree with you. Particularly if your period is overdue, abdominal cramps might indicate a very early miscarriage. Abdominal pain before your period that is unusual for you suggests a possible cause other than normal premenstrual pain.
If you experience mild pain before a period starts, you might try applying a heating pad or taking an over-the-counter anti-inflammatory medication, such as ibuprofen (Motrin, Advil) or naproxen (Aleve), as advised by your doctor. If the pain persists, changes over time, becomes severe or is accompanied by other symptoms -- such as fever, irregular bleeding, heavy bleeding, constipation or diarrhea -- talk with your doctor.
Reviewed by: Tina M. St. John, M.D.
- American College of Obstetricians and Gynecologists: Dysmenorrhea
- American College of Obstetricians and Gynecologists: Endometriosis
- American Family Physician: Uterine Fibroid Tumors -- Diagnosis and Treatment
- American College of Obstetricians and Gynecologists: Uterine Fibroids
- WomensHealth.gov: Premenstrual Syndrome (PMS) Fact Sheet
- American College of Obstetricians and Gynecologists: Premestrual Syndrome
- American College of Obstetricians and Gynecologists: Ovarian Cysts
- Journal of Obstetrics and Gynecology: Transvaginal Ultrasound-Guided Aspiration of Benign Ovarian Cysts