Why are my mentrual cramps so bad?

There are many reasons for cramps to be severe.  It is important to know that normal menstrual cramps start within 12-24 hours of the onset of bleeding.  Menstrual cramps that start several days prior to the onset of bleeding are not normal.  The severity of menstrual cramps generally parallel the amount of bleeding that you are experiencing.  Heavier flow makes people typically cramp more than patients with lighter flow.  This is one reason that birth control pills are often used to control menstrual cramps.  Severe menstrual cramps should never be ignored.  The longer you have bad menstrual cramps with each cycle the more likely you will develop a medical problem called central sensitization.  Patients who experience severe menstrual cramps for many years will at times develop hypersensitivity in the nerves that carry the pain signals from the pelvis. Therefore, management of this problem should be pursued.  Bad menstrual cramps that do not respond to simple therapies such as nonsteroidal anti-inflammatories-medications like Motrin or Advil-combined with birth control pills is suggestive of more serious pelvic pathology such as endometriosis.