Here's why period cramps can hurt even more than a heart attack, according to science

Period cramps can be miserable. While one doctor compared them to a heart attack, another said that the comparison isn't accurate because many heart attacks are actually mild.

• Doctors are finally starting to take women's period pain seriously. 
• Some doctors say that period cramps can be just as painful — or more painful — than a heart attack. 
• Severe period pain could be caused by an underlying condition, like endometriosis. 

Millions of women around the globe know that period cramps can be miserable. But doctors are finally starting to validate just how painful these camps can be. 

Back in 2016, Quartz published an article with a quote from reproductive health professor John Guillebaud, who told Quartz that patients have described cramp pain as "almost as bad as having a heart attack." 

In 2018, gynecologist Dr. Jen Gunter, who writes a popular women's health blog, took that comparison one step further — she wrote that period cramps are often much more painful than heart attacks, which can often be quite mild. 

"If you are waiting for terrible, excruciating chest pain to tell you that you are having a heart attack, well, you are going to miss the heart attack," Gunter wrote. "Heart attacks often produce vague symptoms or mild pain, that is why many people ignore them ... In addition, more than 40% of women have no pain with heart attacks. It would be dangerous for women to think that a heart attack should be at least as bad as their menstrual cramps."

Why are period cramps so painful?

Primary dysmenorrhea — the scientific term for painful period cramps — affects 50 to 90 percent of women, according to a 2019 article in JAMA Insights, half of whom describe the pain as moderate to severe. Despite that, the article said, painful camps are often "often underdiagnosed, inadequately treated, and normalized even by patients themselves."

This cramping pain is caused by natural chemicals called prostaglandins, according to the American College of Obstetricians and Gynecologists, which are made in the lining of the uterus. These chemicals cause the muscles and blood vessels of the uterus to contract, and can also lead to a stimulation in pain receptors. And during these period contractions, pressure on the uterus can be just as high as it is during the "pushing" stage of labor, Gunter wrote.

"So if you need an analogy to describe period pain," Gunter wrote, "use labor or cutting your finger off without an anesthetic."

Severe period pain isn't normal

That being said, while mild discomfort with periods is normal, severe pain is not.

Khara Simpson, an assistant professor of gynecology and obstetrics at Johns Hopkins Hospital, was interviewed by Johns Hopkins Medicine and said that "pain that stops a woman from working or going to school or other daily activities is not normal and should be evaluated by a gynecologist."

Severe period pain could be a sign of an underlying health condition, like endometriosis or adenomyosis.