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Writer's pictureKori Rae Kovacs

Are Periods Supposed to Hurt? The Truth About Menstrual Pain

woman cramps
Painful periods: Common, but is it normal?

This is a story about a woman who used to hate her period. She’d begrudgingly make her way through each cycle and couldn’t wait for the bleeding to stop. The pain she endured was excruciating at times, not to mention the fatigue and major mood swings that would wreak havoc on her relationships.


Then one day while sitting in anatomy class at nursing school, it occurred to her that natural processes of the body aren’t supposed to hurt. Given her background in midwifery and interest in women’s health, she immediately began to ponder this fact in relation to women’s experiences with menstruation and childbirth. This one thought led her down a beautiful path of exploration:

“If birth and menstruation are physiologically normal processes, why do they hurt? Are they supposed to hurt? What if they AREN’T supposed to hurt, just like every other function in the body?!?”

Five years later, she knows for a FACT: Women and people who menstruate are not meant to suffer through periods and even childbirth (that's a topic for another day!).


You might be thinking, “Yea, right.” And I get your skepticism!


After suffering from painful cycles for over two decades, I was pretty skeptical too. But these thoughts I kept having were like thorns in my mind, I couldn’t get them out! If periods weren’t supposed to hurt, I was going to find out why they do hurt, and how I could have less painful periods!


My Cycle Mindfulness adventure had begun!


Natural Body Functions Don’t Hurt


Okay, so let’s look at our bodies' regular functions. I'm going to get a little science-y on ya, but I promise, I'll make it easy to understand.


All these bodily functions I'm going to discuss have sensations, but they aren’t inherently painful sensations. Consider these ideas for just a moment, and then we’ll come back to periods.

 

Definitions before we go on:

Physiological – the way a body system or part is designed to function, what people call “normal”

Pathological – a malfunction in a body part or system connected to disease or injury, aka “abnormal”

 
floral lungs
Art by Trisha Thompson Adams

Body Function No. 1: Breathing. The most normal function of our bodies. We take about 20,000 breaths a day, and for most people, that’s a pain-free movement. There are sensations associated with breathing, like movement of the air in and out of the nasal passage, expansion of the chest, and release on the exhale.


If there IS pain during breathing, there’s probably something going on, like asthma, COPD, infection, cancer, a broken rib, or a collapsed lung... All definitely need checked out and the pain has a pathological for being present. Sometimes breathing hurts when out in the cold or breathing very heavy during exercise, which the pain is used to communicate to the person with the lungs to slow down or find warmer air. It is not physiologically normal for a person to experience pain while breathing. The pain is telling them something’s up and needs to be looked at or changed.


floral heart
Art by Trisha Thompson Adams

Body Function No. 2: Blood Circulation (heart beat). Another one of those activities that happens about 100,000 times a day, pain-free. Sensations can vary depending on activity level and body size, going from a gentle lub-dub in the chest to a more defined pounding sensation when exerting oneself.


If it hurts, something's up and needs to be looked at by a healthcare provider. Sometimes that pain is emergent, like a heart attack, and other times it's less so, like angina or even heartburn... which doesn't even involve the heart. Regardless, pain in the chest should be looked at, because it’s not physiologically normal.


floral kidney art
Kidney Art by Trisha Thompson Adams

Body Function No. 3: Urination. The average person pees about 7 times a day, and it’s usually uneventful. Sensations are gentle, usually a feeling of release as the bladder empties with minimal sensation at the urethra, where the pee comes out.


If urinating is painful, and it can become VERY PAINFUL very quickly, then a urinary tract infection is usually the culprit. Pain can also be caused by kidney stones, blockages from an enlarged prostate gland in men, or rare cases of cancer. Again, need to see a provider for urination pain, because something’s amiss and needs treated. Peeing is a normal function and should be pain-free.


floral anatomy art
Pelvis Art by Trisha Thompson Adams

Body Function No. 4: Defecation. Another normal function of our bodies that occurs at least once a day. Like all the other functions, there are often sensations associated with pooping, but it doesn’t HURT normally. Peristalsis—the bowel's process of moving food and waste through the intestines—can have sensations that tell the person that it’s time to use the restroom.


Painful cramping can come from eating spicy or greasy food, or an unfortunate run-in with food poisoning. Pain, in this case, is letting the person know that wasn’t good food for their system and to stay away from it. Chronic pain in the gut can happen for lots of reasons, from autoimmune conditions, infection, cancer, or hernias… all of which should be investigated by health professionals.


Other normal body functions: Walking, talking, seeing, grasping or holding items with your hands, sitting, standing, lying down... I could keep going, but I think you can see my point. Normal body functions don’t hurt, and if they do hurt, something needs attention.


So I have to ask: Why do we as a society and a healthcare system make painful periods normal? Just because the majority of women in the world (84% according to this survey!) now experience menstrual cramps, that doesn’t mean it’s how it's supposed to be.


I think we can agree that menstruation is a normal function of the body, just like breathing, defecation, and blood circulation. It stands to reason that periods should include sensation, as in MILD squeezing, heaviness, or twinges, but it should not be painful. And if menstruation DOES cause pain, then something is amiss. If they are so painful that they keep the person from working or doing life, then there is DEFINITELY something that needs exploration.


Bottom Line: NO WHERE ELSE in the medical field do we say that pain is a normal function of the body, except when it comes to physiological functions of women. I’m calling bullshit on the whole situation.

The Role of Pain


Why do we experience pain in the body? Pain is a messenger to tell the person who’s experiencing the pain: HEY! STOP WHAT YOU’RE DOING, SOMETHING’S NOT RIGHT! WE COULD GET INJURED OR WORSE! HELP!


  • Put your hand on a hot stove? Pain tells your nervous system with a reflex to move your hand before severe tissue damage occurs.

  • Fall down the stairs and break an arm? Pain tells you that your arm is injured and needs attention immediately.

  • Got a tension headache? Pain tells you to rest your eyes to prevent eye strain, relax your shoulders and face because you’re going to hurt your muscles, drink some water because you’re dehydrated, or slow down because you're stressed out.


And just like I spoke about pain in those other normal body functions, it’s meant to tell you something. Pain that distracts you from what you’re doing or always requires pain medication is not normal and should be investigated and treated by the person experiencing it, as well as the healthcare providers caring for said person.


Period Pain: The Physical Stuff


To understand period pain (also known as primary dysmenorrhea), first, we have to understand what’s happening in our bodies when we have our periods.


All month, estrogen produced by our ovaries has been building an awesome nutrient and blood-rich endometrial lining that would eventually turn into a placenta for a fertilized egg. If a fertilized egg does not implant itself in the lining, then the body releases special muscle-moving chemicals, called prostaglandins, that help the uterus squeeze and contract. The uterus then sheds this month’s lining and you have your period.


This sensation would feel like a squeezing or heaviness, much like muscle contractions when you lift weights… Think like a 2/10 or less on the pain scale. You notice that something’s going on, but nothing to write home about, and CERTAINLY not enough pain that you need to take pain medicine for.

endometrium
The normal stages of the uterine lining

Primary dysmenorrhea happens when the body makes too much of a certain kind of prostaglandin (PGF2 alpha, if you’re a nerd like me!), causing the uterine spasms to be intense and prolonged. That would be like lifting a weight that’s twice as heavy as what you usually lift and holding the pumping the weight way faster and longer than normal—eventually, that starts to hurt a lot!


Physiologically, this type of prostaglandin is made in overabundance when the body is experiencing inflammation all over (called systemic inflammation) brought on by internal or external stressors, like blood sugar spikes, hormone imbalances (like cortisol, insulin, and estrogen), infections, autoimmune conditions, and other chronic inflammatory responses. Chronic stress, burnout, overdoing it in the gym, and anxiety can also contribute to inflammation and hormone imbalance.


So, the body is doing the best it can to manage chronic inflammation, and one way your body lets you know it needs for you to address it is through your uterus. Your cycle is known as the “Fifth vital sign” and if you’re experiencing these painful cramps every month, your body needs help.


Severe Pain During Menstruation: Now, there is another kind of period pain called secondary dysmenorrhea, and it’s connected to a pathological condition of the uterus, such as endometriosis or adenomyosis. This type of period pain can be very severe and is often paired with heavy bleeding that often gets worse as you age. Unfortunately, because our current society believes that painful periods are normal, people with these conditions can get dismissed by their doctors frequently. It takes an average of 10 YEARS for a woman with endometriosis to get a proper diagnosis… this is not ok!


Period Pain: The Other Stuff


Despite what modern Western healthcare would like us to believe, we are more than just a physical body. We have different parts of us that contribute to our overall wellbeing. We are people with thinking minds (our Mental Body), who experience a range of emotions and events throughout our lives (our Emotional Body) and have some sort of connection to others and the universe at large (our Spiritual Body). These bodies also connect to the Physical Body, and together they make up the Whole Self.


spiritual womb art
The womb holds energy

Many cultures around the world believe that the womb (or the hara for those who do not have a uterus) is the cradle of life, it’s the place where creation happens both physically and energetically. Think of it like the cup that holds all your passions, desires, dreams, and also holds traumas, fears, and hurts of the past. The womb acts as a bridge between all the bodies, connecting them together in a melting pot of Creative Life Force.


In my personal experience, and in many others I’ve done womb work with, we see that period pain isn’t only a physical experience, but it also is connected to other emotional, mental, or spiritual challenges. Since we live in a world full of senses, the physical body is usually the representative of these other bodies, trying to let the person know that something in their experience needs love and attention. This is why taking a holistic approach to wellness is essential because if you only address the physical components, you’ll only go surface level in the healing process.


Caroline Myss says that internal conflicts with role and identity as a woman can be a cause of cramps and PMS. Louise Hay also says that cramps and female reproductive problems are related to rejection of self and our bodies. Other people understood the emotional and spiritual connections to physical symptoms and wrote extensively about them throughout their lives, like Deepak Chopra, Bessel van der Kolk, and Carl Jung.


Through years of cycle mindfulness work, I’ve connected several imbalances to menstrual pain. Here are a few of them:


  • Needing stronger boundaries with people

  • Overextending myself and not asking for help

  • People pleasing, putting others' needs before my own

  • Rejection of my body and the way I look

  • Not doing creative activities

  • Not doing things that bring me joy and playfulness

  • Unprocessed sexual and birth trauma

  • Unprocessed grief and loss

  • Not doing my meditation or journal practices, leading to a disconnect from my Divine Self

  • Spending too much time indoors


When I started to pay attention to what was going on energetically when cramps came up, things started to change. I’d take action to support my body physically, set boundaries, and repair my self-image, leading to cramps becoming less and less, and my experience of my period completely changing.


The Holistic Approach to Reducing Menstrual Pain


If you’re serious about reducing your menstrual pain, then you’ve got to put on your Curiosity Cap and start asking yourself how your body needs support. Making new habits takes time, but for me, this was life-changing work and well worth the time and effort I put into myself. I went from being a consistent 7 or 8/10 on the pain scale with my periods to most cycles being pain-free or minimal discomfort at a 2/10. If the cramps do happen, I see them for what they are: My body communicating with me that something needs changed or addressed. Then I know EXACTLY what to do to support my body in the moment and for future cycles.


Here are some first steps you can take to reducing your period pain:


Step 1: Try a different period product. If you’re using tampons and experiencing cramps, try not using them for a couple cycles and see how you feel. There are lots of alternatives now… pads and tampons aren’t the only game in town anymore. Many women experience less pain after switching to a cup, period underwear, or free bleeding at home.


Step 2: Get to know your body. Spend time working on your relationship with your body and your period. Try to shift your perspective on the pain, that your body does not hate you nor is it rebelling, it is trying to get your attention and ask for your help. Journal your insights, energy, and stress levels over a few months and you might start to see patterns. Cycles Journal really helped me out with building that relationship.


Step 3: Take on your habits. Try addressing inflammation to combat period pain and restore hormonal balance with an anti-inflammatory nutrition plan, intentional movement, improved sleep, and stress reduction. There are TONS of resources out there to help you with specifics. Record how these changes affect your cycles and pain levels over a few months.


If you go through these changes and nothing improves, or if your cramps are so severe that you miss school or work, then it’s time to talk to your doctor. If they won’t listen, find a doctor who will. You deserve to have your voice heard.


Final Thoughts


Painful periods are common, but they are not normal my friend. Pain is your body’s attempt to get your attention, and instead of squashing it with NSAIDs all the time, maybe it’s time to start getting curious about what the pain is trying to tell you. I’m not against pain medication, because I am a nurse, a woman, and a freaking human being and I don’t believe you should suffer. If you need to take an ibuprofen because the cramps are kicking your ass and you’ve got a mandatory mom duty, by all means, please take it.


At the same time, ignoring what your uterus and body are telling you about the pain by automatically silencing her with a pain pill every month isn’t helping you build a better relationship with yourself. I believe society has dismissed the wisdom and cries of our bodies for way too long, and all its gotten us is a very sick human population. What may benefit you in the long run is taking the time to sit and ask your body, why are you hurting? And how are my actions, habits, and thoughts contributing to that pain?


If you’re really struggling with this topic, please shoot me a message on socials or email me at hello@koriraewellness.com. Sometimes we just need an ear to hear our stories so we can take steps to advocate for our most precious gift: our bodies.



Much Love,


💋Kori Rae



Medical Disclaimer: The contents of this article should not be taken as medical advice. It is not intended to diagnose, treat, cure, or prevent any health problem - nor is it intended to replace the advice of a physician. Always consult your physician or qualified health professional on any matters regarding your health.

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