Can Bad Menstrual Cramps Make It Harder to Get Pregnant?

The Possible Connection Between Painful Periods and Fertility

woman looking out window, bad periods preventing her from living her life
If your period pain is so bad that it interferes with your daily life, you may have trouble getting pregnant. Anakin Tseng / Getty Images

If you're trying to conceive, you may wonder if painful periods can impact your fertility. Cramps themselves won’t stop you from getting pregnant. However, whatever is causing the bad cramps may possibly impact your fertility.

What Causes Period Cramps?

Cramps are caused by prostaglandins. Prostaglandins are a naturally occurring chemical and can be found in tissues throughout the body, including in the uterus.

Prostaglandins are really important. They play a role in the regulation of inflammation, cell growth, regulation of body temperature, and smooth muscle constriction and dilation.

As you might have guessed by now, they also play an important role in the uterus.

During menstruation, they trigger the uterine muscles to contract. This helps expel the uterine lining during menstruation. They also are important in inducing labor contractions and childbirth.

If your levels of prostaglandins are too high, they can trigger uterine contractions that are more intense. 

When uterine contractions are especially strong, oxygen gets cut off temporarily to parts of the muscle. The lack of oxygen leads to painful period cramps.

Teens may experience worse period cramps. This is because they naturally have higher levels of prostaglandins. Usually, the levels go down as they get older, and the cramps become less intense.

Women may also have easier periods after childbirth.

The medical term for period pain is dysmenorrhea. Period cramps caused by the normal activity of prostaglandins is called primary dysmenorrhea. This should not negatively impact your fertility.

However, period cramps caused or worsened by other diseases or abnormalities of the reproductive system are called secondary dysmenorrhea.

It’s secondary dysmenorrhea that can be associated with having a harder time getting pregnant.

Bad Menstrual Cramps and Your Fertility

Intense menstrual cramps can be caused by a number of diseases that impact fertility. Some of these diseases develop over time, even years.

This is why you might start having problems with cramps when you didn’t have this issue before.

Possible causes for abnormal period cramps, that can also impact your fertility, include:

Endometriosis: Endometriosis is notorious for causing not only bad period cramps but also infertility. 

If you have endometriosis, endometrium – the tissue that usually lines the uterus – grows in places outside of the uterus. It is estimated that up to 50 percent of women who struggle to conceive may have endometriosis. Women frequently go years undiagnosed.

Fibroids: Fibroids are an abnormal mass of tissue that grows within the smooth muscle of the uterus. They are almost always non-cancerous.

Many women never know they have fibroids. However, they occasionally can cause pain, lower fertility, and possibly increase the risk of miscarriage.

Pelvic Inflammatory Disease (PID): Another possible cause of bad menstrual cramps that can impact fertility is pelvic inflammatory disease (PID).

PID is caused by an infection in the reproductive organs. It leads to the formation of scar tissue, which sort of looks like webbing between the ovaries, fallopian tubes, and uterus. It is the most common cause of blocked fallopian tubes.

Adenomyosis: Adenomyosis is when endometrium grows within and into the muscle of the uterus. This is different than endometriosis, where endometrium grows outside of the uterus. It’s also different than fibroids, which is a mass of muscle tissue that grows.

Adenomyosis can cause painful and heavy periods. It’s unclear whether or not it affects fertility, but some studies show it might.

Pelvic Pain and Fertility

Pelvic pain can also occur when you're not expecting your period.

Some women experience ovulation pain. Ovulation pain is common, with up to 50 percent saying they've had it at least once in their lives and 20 percent of women saying they get it every month. 

Ovulation is not normal if it interferes with your daily living, causes painful sexual intercourse, or is severe (even if sudden.) Ovulation pain can be a symptom of endometriosis. 

Ovulation pain can be so severe in some women that it prevents them from having sex when they are most likely to conceive. You should talk to your doctor if this is happening to you. 

Speaking of pain and sex, some women experience painful intercourse no matter what time of the month it is. 

Sex should not hurt. If you're trying to get pregnant, and pain is preventing you from having frequent sex, that can certainly lower your odds of conception. 

Can Treatments for Painful Periods Cause Infertility?

If you’re experiencing painful periods or pelvic pain, it’s important you talk to your doctor. Suffering in silence is not necessary.

Hormonal birth control is sometimes recommended. If you’re trying to get pregnant, this isn’t an option for you.

The most common treatment for painful periods is over-the-counter pain medications like ibuprofen (like Advil), acetaminophen (like Tylenol), or naproxen (like Aleve.) For the best results, taking the pain medication when your symptoms just begin—as opposed to waiting until you’re in a lot of pain—is best.

There’s been some concern that over the counter pain medications may interfere with fertility. Specifically, nonsteroidal anti-inflammatory drugs (NSAIDs) have been suspected of possibly interfering with ovulation.

While some early research found a possible negative effect of taking ibuprofen during the early stages of the menstrual cycle, further studies have not found this. In fact, there is some evidence that pain relief may slightly improve some fertility factors.

In a study of just over a thousand women, naproxen was found to possibly increase the time to conception in women trying to get pregnant. The effect seemed to increase the higher the dosage of naproxen. The impact was small but statistically significant.

Surgery is another possible treatment option for period pain, if the pain is caused by endometriosis, fibroids, or some other kind of internal adhesions. Before agreeing to this kind of surgery, make sure you consult first with a reproductive endocrinologist. You want to be sure your fertility remains intact post-surgery, and sometimes, it’s beneficial to time fertility treatments soon after corrective surgery.

In severe cases, removing the uterus may be recommended for period pain. This is not an option if you still plan to have children. Also, surprisingly, this doesn’t always completely eliminate all pelvic pain. Be sure to get a second opinion if your doctor recommends a partial or full hysterectomy.

A Word From Verywell

Your periods should not rule your life. If you're experiencing pelvic pain, there are treatment options available, and your doctor can explain them to you. While some early studies found a possible negative fertility effect to ibuprofen use, further studies did not find this. Naproxen may have a slight negative effect on fertility, but this is unclear.

Some causes of painful periods can lead to infertility. It’s important to know that some of these conditions worsen over time. Early treatment is vital. This is another reason you should talk to your doctor.

Besides hopefully reducing your pain, getting early treatment may possibly save your fertility or increase your odds of fertility treatment success in the future.

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    McInerney KA1, Hatch EE2, Wesselink AK2, Rothman KJ2,3, Mikkelsen EM4, Wise LA2. “Preconception use of pain-relievers and time-to-pregnancy: a prospective cohort study.” Hum Reprod. 2017 Jan;32(1):103-111. Epub 2016 Nov 5.

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