I've heard it described many ways... achy, crampy, throbbing... but no matter what adjective you use it means the same thing... my period is hurting me. For most women, menstrual pain is annoying but short-lived.

Because the uterus is a muscle it has the ability to contract. During your period, the uterus contracts to help push out the menstrual blood. Many women feel this as an abdominal cramp. These symptoms can usually be relieved with home remedies like using a heating pad, taking a warm bath or by using over-the-counter pain relievers like Ibuprofen (Advil®, Motrin®), or Acetaminophen (Tylenol®). But if these home remedies are no longer working or your pain is severe enough to stop you from doing your normal activities, then it's time to see your doctor.

When doctors think about pain associated with your periods (the medical term is dysmenorrhea), we break down the problem based on the potential source of the pain. In other words, is it really your uterus that's causing you pain OR is the pain coming from somewhere else.

Uterine pain is usually just your uterus contracting. Some women can also have non-cancerous tumors called fibroids that grow from the uterus and can get so big that they bump into surrounding organs and cause pain. But, size doesn't matter with fibroids. Some women have small fibroids that cause painful cramping and other women can have fibroids as big as footballs and their only complaint is that their tummy looks big.

Ovarian pain is usually caused by cysts that form on the ovary. Now, it's normal for the ovary to make simple cysts each month (these are fluid filled sacs where potentially an egg can form). Normal cysts are small and your body reabsorbs them each month. Sometimes a cyst will linger or get big. Bigger cysts can bump into other structures or cause the ovary to twist and can cause pain.

Muscle pain. The muscles in your back or abdomen can be strained from overuse or mild trauma during daily activities that can cause pain. If these injuries occur in your lower back or abdomen, you may attribute the pain to your period but it's actually from the superficial muscles located under your skin.

Intestinal/Bowel pain. As the bowel contracts and moves digested food through your system, you may experience crampy, achy pain in your low back or abdomen. Many women suffer from intermittent constipation and/or diarrhea and the bowel can actually be overactive in trying to eliminate this waste material from your system which causes pain.

Bladder pain. Not all bladder pain is from a urinary tract (bladder) infection. Some women can have a condition called interstitial cystitis where the bladder is just chronically irritated and this can be very painful.

Somewhere else ...this is why medicine is an art and not a science. There are other pain syndromes (like fibromyalgia, chronic pelvic pain, or endometriosis) or even a history of sexual, mental, or physical abuse that can cause women to have low abdominal pain. Symptoms may or may not occur in conjunction with the menstrual cycle.

So don't suffer in silence. Let your healthcare provider know what you're going through. There are special tests we may to order to help diagnosis the problem so that we can help you get back to your life.

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