Why Am I Experiencing Severe Menstrual Cramps and Fatigue?

Many women experience premenstrual syndrome (PMS) symptoms like cramps, mood swings, bloating, and fatigue before and during menstruation. These symptoms result from regular hormonal and physical changes that occur within the body during this time. Some symptoms, like cramps and fatigue, may become more severe due to underlying health conditions. Here are some causes of severe menstrual cramps and fatigue, and how that affects your reproductive health: 

Hormonal Fluctuations

The ovaries produce estrogen and progesterone, which are key in regulating the menstrual cycle and maintaining sexual health. As estrogen production decreases during the second half of the menstrual cycle, serotonin also declines. This often lowers your mood and energy levels before and during menstruation. Changes in mood and period pain may also impact sleep cycles, leading to fatigue the next day. 

Severe fatigue could indicate underlying hormonal imbalances. Estrogen and progesterone aid in immune system regulation, and diminished production might weaken the immune system during all parts of your cycle. A weak immune system can impact fertility, including fertilization, implantation, and pregnancy health. Hormonal testing indicates whether estrogen and progesterone meet recommended levels throughout the menstrual cycle. Your doctor may recommend hormonal therapy or lifestyle changes to diminish the effects of cyclical fluctuations.

Heavy Bleeding

Heavy bleeding can lead to anemia or iron deficiency. This prevents your body from producing the hemoglobin required to transport adequate amounts of oxygen to your cells, leading to fatigue. Incorporating iron-rich foods into your diet, such as fish, beans, and leafy greens, during menstruation helps restore your body's iron stores. Women who have chronic health conditions may be anemic throughout their cycle, and doctors can recommend iron supplements to improve overall health.

Medical Conditions

Underlying medical conditions affect the severity of menstrual cramps. For women with severe cramps, a persistent ache in the abdomen can be accompanied by nausea, headaches, and back pain. Some medical conditions that impact PMS symptoms include: 

• Endometriosis: Endometriosis causes tissue similar to the uterine lining to grow outside the uterus, including on the ovaries, pelvic tissue, and fallopian tubes. It can build up in the body, causing pelvic organs and tissues to stick together. Endometriosis may block the fallopian tubes, causing infertility. 

• Uterine fibroids: Fibroids are growths of the uterus, and they vary in size and number. Large fibroids distort the uterus, impacting implantation and fetal development. 

• Pelvic inflammatory disease: Though sexually transmitted diseases commonly cause pelvic inflammatory disease (PID), bacteria can enter the reproductive system any time the cervical barrier is compromised, such as during menstruation. PID symptoms include severe pain, irregular bleeding, and fever. Prolonged infection may damage reproductive organs. 

• Progesterone resistance: Progesterone resistance limits the body's ability to respond to the progesterone hormone. This can result in irregular periods, heavy bleeding, and more severe cramps. 

Some infertility tests are designed to detect underlying conditions that may be overlooked by traditional medical testing. Tests that identify the BCL6 marker help indicate progesterone resistance for women who have experienced recurrent pregnancy loss and implantation failure. Determining the underlying cause of severe PMS symptoms helps lessen symptom severity and increase fertility. 

Lifestyle Factors

Lifestyle choices like how you eat, sleep, and exercise can lessen or exacerbate cramps and fatigue during menstruation. Salt, caffeine, and sugar usually contribute to bloating and mood swings, while a well-balanced diet helps regulate blood sugar and sustain energy throughout the day. Getting the recommended amount of sleep throughout your menstrual cycle gives the body time to adjust to hormonal fluctuations and rest, which can limit the severity of PMS symptoms. 

Daily exercise helps balance hormones like serotonin and estrogen, which may improve mood, decrease fatigue, and lessen other PMS symptoms. Balancing hormones is also key in maintaining reproductive health, impacting fertility during pregnancy. Some doctors recommend exercise types and duration based on your current health conditions, the severity of your PMS symptoms, and other lifestyle factors. 

Caring for Reproductive Health

Though PMS symptoms are a common part of the menstrual cycle, severe fatigue or cramps may indicate underlying conditions. Fertility tests targeting key proteins within cells help identify underlying conditions affecting women's reproductive health and fertility. Comprehensive results allow you to address factors that trigger severe PMS symptoms. Talk to a fertility specialist today to learn more about ways to manage menstrual fatigue and cramps.