Severe period cramps go beyond typical period discomfort and can be intense enough to make you pause your normal routine. Period cramps can start even before your period begins.

• Primary dysmenorrhea, or typical menstrual cramps, can affect 50-90% of menstruating women.
• Secondary dysmenorrhea, caused by underlying health issues (see next question), can affect about 1 in 10 women.

• Endometriosis: This is when tissue similar to the lining of your uterus grows outside the uterus, often on other reproductive organs. This can cause severe pain during menstruation as the tissue sheds during your cycle, but it has no way to exit the body. Catching and managing endometriosis early can help prevent fertility problems downstream.
  
  
• Fibroids: These are non-cancerous lumps that develop in the uterus. They can cause significant pain and heavy menstrual bleeding if they grow into the wall of the uterus or interfere with the uterus's ability to contract. Finding out about fibroids early can help prevent complications like anaemia due to heavy blood loss.
  
  
• Adenomyosis: In this condition, the inner lining of the uterus breaks through the muscle wall of the uterus. This can cause severe menstrual cramps, heavy bleeding, and bloating during your period.
  
  
• Infections: Pelvic inflammatory disease (PID) and other infections can affect the uterus and other reproductive organs, leading to severe cramps, pain during sex, fever, and unusual discharge. Getting treatment early can help prevent dangerous conditions like ectopic pregnancies.
  
  
• Ovarian Cysts: Ovarian cysts are fluid-filled sacs that form on the ovaries. While many women have cysts at some point and they often go unnoticed, larger cysts can cause discomfort or pain, especially during your period. If a cyst ruptures, it can lead to sudden, severe cramping as the fluid irritates pelvic tissues.
  
  In some cases, a cyst can cause the ovary to twist, which results in intense pain. This is an emergency that requires immediate medical attention to prevent severe and irreversible damage to the ovary.

If your pain is debilitating, affecting your daily life, or getting worse, it's time to see a doctor. If you've just started having severe menstrual cramps after your mid-20s, it's important to get checked to rule out any underlying conditions. Even if you're used to the pain or have been given painkillers, it's still crucial to get a thorough check-up to ensure nothing serious is missed.

Keep an eye out for other symptoms like heavy bleeding, nausea, vomiting, fever, or loss of weight/appetite. These could be signs of more serious health issues that need medical attention.