Five lesser-known symptoms of the menstrual cycle and their causes

Menstrual pain is a common symptom of the menstrual cycle, which affects around 70 percent of young women – but it is by no means the only symptom.

Here are five lesser-known symptoms related to the menstrual cycle — and what’s going on in your body to cause them.

Intestinal disorders (period stool)

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Some people experience disruption in their bowel habits before their period, which often manifests itself as diarrhea.

This happens because your body releases a special chemical called prostaglandins during your menstrual period. Prostaglandins help the uterus to tighten, which pushes menstrual blood out of the uterus and into the vagina so it can leave the body.

When you get period pain (especially if a person has endometriosis), a nerve in the back called the spinal ganglion gets activated.

This can cause a range of symptoms, including back pain. The same process can make the intestines sensitive, which can lead to intestinal pain or irritable bowel syndrome and contribute to changes in bowel habits such as diarrhea or constipation.

stabbing pains

Sometimes the arrival of your period can be accompanied by sharp pains in your legs, stomach or buttocks.

For some, this pain can shoot into the vagina or posterior passage.

This is related to the spasms that occur when prostaglandins are released in the body and the nerve in the back (the spinal ganglion) is activated.

This can trigger spasms in the pelvic floor muscles (a group of muscles in the pelvic floor that support the bladder, bowel and uterus).

Visiting a pelvic health physical therapist and learning to relax these muscles can help manage this type of pain.


It’s common for you to feel a bit exhausted during your period. But for some people, this can go beyond normal fatigue.

A recent survey of 42,879 women found that about 70 percent have this symptom. It is often described as “exhausted,” “depleted,” “tired,” “lethargic,” “exhausted,” and/or “weak.”

Fatigue may be due to the brain’s experience of pain. We can measure changes in the brain when people have pelvic pain. Persistent pain signals to the brain cause these changes, leading to extreme fatigue and sometimes headaches and nausea.

A good sleep schedule, exercise, and a good diet can help with fatigue.

A recent survey of 42,879 women found that around 70 percent experience fatigue during their period. Recognition: Getty Images

ovulation pain

Ovulation occurs when a mature egg is released from the ovary.

During this time, estrogen levels are high and a lot of clear watery mucus is being produced by the cells in the cervix (which is why seeing extra clear watery mucus at this time is a sign that ovulation is imminent).

Most people feel pretty good when their estrogen levels are high. But if the follicle that contains the egg gets bigger just before ovulation, the pressure of the follicle and its release can cause pain. This ovulation pain is sometimes called middle pain.

This can feel like a sharp, relatively short-lived stabbing pain in the lower abdomen on one side.

mood swings

Between 50 and 70 percent of people who have their period experience mood swings before or during their period.

However, in 1 to 5 percent of people, the effects on mood can be more severe and associated with a condition called premenstrual dysphoric disorder (PMDD).

This occurs when people experience severe mood swings, anxiety, or depression in the week leading up to their period, which usually improves within a few days of their period starting.

When should you see a doctor?

Symptoms vary greatly from person to person, there is a wide range of “normal” symptoms and it can be difficult to decide when to see your doctor. But it’s worth speaking to a GP if:

  • Your period pain interrupts everyday activities like work, school, or caring responsibilities
  • the pain associated with your cycle is severe or changing
  • You have trouble going to the toilet, pain when urinating or having a bowel movement, or your bowel habits change
  • You feel emotionally or mentally overwhelmed
  • You have pelvic pain at other times (outside your period).

When these symptoms are severe, they may be due to conditions like endometriosis.

EndoZone — an evidence-based website co-created with people affected by endometriosis — provides a self-assessment for people trying to decide if their period symptoms require further medical attention and tips on how to describe them to a doctor.

This article first appeared in The Conversation

Rebecca O’Hara is an Endometriosis Fellow at the University of Adelaide’s Robinson Research Institute

Louise Hull is Professor and Endometriosis Group Leader at the University of Adelaide’s Robinson Research Institute

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