Each month, you know it’s coming. You start to feel irritable, bloated. Your head hurts and you start to feel cramping. Then your period strikes and those painful cramps really set in. You try to get through it — until next month when it all repeats.

Many experts believe premenstrual syndrome (PMS) is related to changes in estrogen and progesterone levels at the beginning of the menstrual cycle. During your period, cramps are caused by uterine contractions to help shed built-up lining.

Most women have some degree of period pain, but for some, the pain keeps them from normal activities for days every month.

The women more likely to have more intense period pain are those who are under age 30, started puberty early (age 11 or younger), have heavy periods or smoke. Some conditions can cause painful periods, such as:

• Uterine fibroids, ovarian cysts or polyps of the endometrium or cervix
• Endometriosis or adenomyosis
• Pelvic inflammatory disease
• Childbirth (although some women’s periods improve after having a baby)
• Certain birth defects or problems with the uterus, fallopian tubes and other reproductive organs
• Perimenopause
• Crohn’s disease and urinary disorders (can flare up during your period and cause pain)

Your period is a good indicator of what’s going on with your body and your overall health. Pay attention to what’s normal for you. If at any time you experience any unusual symptoms or sudden changes to your menstrual cycle, let your doctor know, especially if you notice:

• Period cramps so painful that you consistently can’t participate in daily activities
• Pain that worsens over time or bleeding gets heavier
• Severe menstrual cramps that are new for you, especially if you’re over age 25
• Pelvic pain/abdominal discomfort
• Bleeding between periods that keeps occurring or lasts for days
• Unusually heavy periods/missed periods
• Postmenopausal bleeding

If you’re tired of painful periods and bothersome PMS every month, your first step is to talk with your OB-GYN. Your doctor may suggest ways to ease pain and discomfort caused by your period, such as:

1. Over-the-counter medications. Certain pain relievers, including nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen (Aleve), can help relief menstrual pain. Some women shouldn’t take NSAIDs, so ask your doctor first.
2. Birth control methods, such as the pill, patch, vaginal ring, implant, injection and an intrauterine device (IUD), may help reduce the pain from period cramps and make periods shorter, lighter and more regular.
3. Exercise. The more you can move, the better you will feel. Walking, jogging, biking and swimming help produce chemicals that block pain. Research suggests exercise may even eliminate or reduce the need for pain-relief medication during menstruation.
4. Hydrate. Strangely enough, drinking water keeps your body from retaining water and helps avoid painful bloating during menstruation. Try warm water to relax cramped muscles and water-based foods like lettuce, celery, cucumbers, watermelon and berries to stay hydrated.
5. Dietary supplements. Some studies suggest that certain dietary supplements may help reduce symptoms associated with PMS. Magnesium supplements may help reduce water retention ("bloating"), breast tenderness and mood symptoms. One study has shown that vitamin E may help reduce symptoms of PMS. Calcium may help to reduce the physical and mood symptoms that are part of PMS. Ask your doctor before taking any supplements.
6. Balanced, anti-inflammatory diet. Avoid certain foods and drinks, such as salty foods, fatty foods, caffeine, carbonated beverages, alcohol. Instead, try chicken, fish, leafy green vegetables, brown rice, walnuts, almonds, avocados, bananas, chickpeas, berries and chamomile or ginger tea.
7. A heating pad. Take a warm bath or shower, or use a heating pad or hot water bottle on your stomach and lower back to help relieve pain.
8. Sleep. Getting enough sleep before and during your period can help you feel better overall, reduce stress and decrease pain sensitivity.
9. A massage, yoga and relaxation techniques. Try a massage, meditation, deep breathing, light stretching and/or other ways to relax. One study found certain yoga poses (Cobra, Cat and Fish) significantly reduced pain during menstruation for young women.
10. Acupuncture and acupressure. Both practices stimulate the body and may help you relax, release muscle tension and relieve period pain.

Need an OB-GYN? Edward-Elmhurst Health has hundreds of medical board-certified physicians to choose from. You can book online today to set up your first appointment.

Learn more about women’s health at Edward-Elmhurst Health.