Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov test — the first and only FDA-cleared test to confirm successful ovulation at home.
If you experience periods, unfortunately there’s a pretty good chance you also experience some level of pain or discomfort. If that’s you, you may be wondering–is that pain at least good for something? What do painful periods mean for my fertility? Or, on the flip side, if you’re someone who doesn’t experience much period pain, you may also wonder if that’s normal too.
Good news: We’re here to help, and we’ve got answers to all your fertility questions! Bad news: This one isn’t entirely straightforward, and the answer is: painful periods MIGHT indicate a risk of infertility, but they might also be totally unrelated. So buckle up, and let’s learn about what causes painful periods, what it means for your fertility, and what you can actually control when it comes to trying to get pregnant.
What causes menstrual cramps?
Yeah, seriously-what causes menstrual cramps anyway? Menstrual cramps is just a general term for any pain that’s associated with the onset and continuation of your period. If your cramps are particularly bad (i.e. they interfere with your ability to live your normal life), we call that dysmenorrhea. Generally speaking, menstrual cramps are just caused by your uterus contracting as it tries to shed its lining during menstruation. Some of the chemicals necessary to cause the uterine lining to shed unfortunately also cause pain.
That doesn’t mean menstrual cramps are a given, though, and they can have specific (and treatable) causes too. Cramping, especially bad cramping or cramping that doesn’t start until after your teen years, or worsens over time, can be caused by specific conditions. These include:
Endometriosis
Endometriosis is a condition where you have tissues that look and act like the tissue of the uterine lining, but outside of the uterus. As these adhesions or lesions grow (on your ovaries, fallopian tubes, or possibly other parts of your abdomen), they can cause a lot of pain. About 10% of females have endometriosis, so this can be a common cause of menstrual pain. Unfortunately, endometriosis can only be definitively diagnosed surgically, but if you think you might have it, talk to your doctor and check out the resources at SpeakEndo.com.
Uterine Fibroids
Fibroids are muscular growths that can occur in the uterus, and are even more common than endometriosis. They’re typically harmless on their own, but they can cause additional pain during menstruation. Fibroids can be diagnosed with various imaging techniques by your primary care or OBGYN.
Pelvic Inflammatory Disease (PID)
PID occurs when you have an infection somewhere in your upper reproductive tract, often from a sexually transmitted infection that has spread. While you may have symptoms such as fever, unusual vaginal discharge (but not fertile ovulation discharge-that’s different), or pain, you may also experience no symptoms at all. PID can cause both menstrual cramps and infertility though, so especially if you have a history of STIs/STDs or have never been tested, talk to your doctor if you’re experiencing symptoms.
Is there a link between painful periods and fertility?
You may already be able to tell from the causes of painful periods that there’s not necessarily a clear link, but sometimes the same things that cause painful periods can also cause infertility. Neither fibroids or endometriosis automatically mean you’ll have fertility issues, but they can be a cause of infertility in some cases.
Fibroids or endometriosis may both block or impact fallopian tubes and the uterus, making implantation challenging or impossible. Similarly, PID can cause scarring that can impact your fertility by blocking sperm, eggs, or implantation.
If I am trying to get pregnant with painful periods, what should I do?
If you have painful periods (more than mild cramping, or you don’t feel like it’s easily managed with a normal amount of over-the-counter pain reliever), the first thing to do is talk to your primary care physician or OBGYN. They can help you address the causes of your painful periods and determine if you have endometriosis, fibroids, PID, or other conditions that might cause painful periods.
You can also consider supplements like fish oil, which is proven to both reduce period cramps and increase your chances of getting pregnant.
What else can I do to increase my chances of getting pregnant?
Especially if you’re having a difficult time getting pregnant, painful periods may be related, but don’t forget to consider the other major likely causes of infertility. Fortunately, many of these can be easily taken care of or tested on your own. Some of the best ways to get started are:
Find Your Fertile Days
Did you know that mistiming intercourse is a primary cause of infertility? You’re only fertile about 6 days during each menstrual cycle. You can find your fertile days with a number of different methods, including hormone testing, ovulation predictor kits, and tracking cervical mucus.
Confirm Successful Ovulation
The next thing to do is make sure you’re actually ovulating, and that you’re doing so successfully, meaning that your body makes enough progesterone after ovulation to support implantation. Confirming successful ovulation can help you screen for ovulatory disorders, which are another primary cause of infertility.
You can test for successful ovulation using Proov Confirm, the only at-home FDA-cleared test for progesterone’s urinary metabolite PdG. Your Proov Confirm results can help you understand if pregnancy is even possible in a given cycle and if you need to take steps to support ovulation.
