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Some women experience very severe menstrual cramps, or dysmenorrhea. This condition can also be accompanied by other symptoms such as headaches, diarrhea or constipation, nausea and dizziness or fainting. Women with dysmenorrhea may have higher levels of prostaglandin, the hormone that causes the uterus to contract. Most often, the severe cramps will go away within a few years, after hormone levels balance out. The cramps can be treated with prescription pain medicine if need be. Sometimes the birth control pill can help to control severe PMS.

Sometimes severe cramps can be caused by separate health conditions, such as endometriosis, uterine polyps, uterine fibroids, pelvic infection, ovarian cysts, adenomyosis or structural abnormalities. The use of an intrauterine device (IUD) for birth control also tends to increase the experience of cramping, at least for the first few months of use.