Painful intercourse; severe cramps starting a week or two before menstruation; bloating
Ask your doctor about endometriosis
"There's a misconception among women, and even some doctors, that it's normal to have extreme discomfort during your period," says Howard. But severe cramps may signal endometriosis, a condition in which the endometrium, or tissue that lines the uterus, grows outside of the uterine walls. Although there's no definitive cause, some experts believe that menstrual blood may carry endometrial cells to other sites in the body-most commonly, the ovaries, fallopian tubes, or the lining of your pelvis.
During your monthly cycle, hormone fluctuations cause the endometrium to thicken, break down, and bleed. But since there's no place for the blood to drain, it becomes trapped, irritating the surrounding tissue. Over time, it can lead to cysts, scarring, and infertility.
WHAT CAN HELP
Taking oral contraceptives continuously (skipping the placebo pills) to stop your period can relieve symptoms, so ask your gynecologist about taking an extended-cycle brand. Progesterone-only pills are another option, as are prescription drugs called gonadotropin analogs. Both stop the ovaries from producing estrogen, causing temporary menopause.
If you're trying to have a baby, ask your doctor about surgical removal of the errant tissue; studies show that this procedure decreases pain while increasing your odds of conceiving. "Schedule the surgery about six months before you want to become pregnant," says Howard.