Health

Ask an SHS Nurse: Is My Period Supposed to Hurt This Much?

When cramps cross the line: what’s normal, what’s not, and when to check in

Many menstruating people navigate aches and pains. There’s so much information out there and so many products available on the market, but also a lot of stigma, making it hard to navigate period pain and which products to buy. To learn more about menstrual health, I interviewed Deborah Lipkin, a Nurse Practitioner and Assistant Director of Primary Care at BU Student Health Services (SHS). She is also a vulvovaginal specialist who has worked in women’s and reproductive health for over 30 years. During our conversation, she shared some helpful tips on how to support yourself through period pain. 

First, what does a typical period look like? 

• Duration: 3–7 days 
• Flow: Typically measured by how often you need to change a pad or tampon. The average is 3–6 changes per day. Bleeding is usually heaviest during the first few days and then lightens. 

It is normal for a cycle to fall outside these averages occasionally. 

However, you should seek evaluation if you experience: 

• Spotting between periods 
• Bleeding heavily enough to soak a pad or tampon every hour for 2 consecutive hours 
• Passing large clots (quarter-sized or larger) 

So, what causes strong menstrual cramps?

To explain menstrual cramps, it’s helpful to understand what’s happening in the body hormonally. Before your period starts, estrogen (a hormone that encourages cellular growth) causes endometrial cells to grow in the lining of the uterus, causing it to thicken. Endometrial cells release a chemical known as prostaglandin. 

Prostaglandin causes the muscles within the uterus to contract, shedding the uterine lining during menstruation. High levels of prostaglandins increase muscle contraction, resulting in more painful cramping. Prostaglandin also contributes to the headaches, nausea, vomiting, or diarrhea you may experience during your period. 

What are some ways to manage menstrual pain?

There are both non-medication and medication options for managing strong cramping. 

Non-Medication

• Exercise regularly: Frequent and enjoyable movement helps relieve pain and intensity, and decreases the length of your cramps.
• Eat a balanced diet: Including foods like whole-grain breads and pastas, beans, and sunflower seeds provides your body with Omega-3 Fatty acids and other micronutrients essential for reducing inflammation.  
• Manage your stress levels: Stress reduction techniques like journaling or meditation may help reduce symptoms and calm your mind.
  • Order a stress kit to learn more about stress, ways to manage it, and get free tools to help. 
  • Use your free subscription to Headspace to practice mindfulness.

Medication

• Address your pain: Painkillers or NSAIDs like Ibuprofen or Naproxen work by reducing prostaglandin production, easing cramps. 
• Talk to a provider about birth control: Hormonal birth control can reduce cramping by thinning the uterine lining, which decreases prostaglandin production. Talk to a healthcare provider about whether this option is right for you. 

If your cramps are so severe that you cannot carry out your normal daily activities, further evaluation is recommended. Make an appointment at SHS. Our providers can help determine next steps. 

Is there anything else you’d like students to know?

SHS is here to support you! In addition to medical appointments, we also  provide free menstrual products, like tampons and pads,  at the following locations: 

• 1st Floor of SHS Lobby, 881 Commonwealth Ave
• 2nd Floor of SHS Lobby, 881 Commonwealth Ave
• Survivor Advocacy, Response and Prevention office, 930 Commonwealth Ave

For many people, periods are a part of life. But excessive period pain doesn’t have to be. If you want to learn more or get support, schedule an appointment at SHS.