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Period pain is a common symptom of the menstrual cycle, affecting about 鈥� but it鈥檚 far from the .

Here are five lesser-known symptoms associated with the menstrual cycle 鈥� and what鈥檚 going on in your body to cause them.

1. Bowel disturbances (period poos)

Some people experience disturbances in their bowel habits leading up to their period and this commonly manifests as .

This happens because when you menstruate, your body releases a special chemical called prostaglandins. Prostaglandins help the uterus to cramp, which helps push 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 is activated.

This can cause a range of symptoms, including back pain. This same process can make the bowel sensitive, which can lead to bowel pain or irritable bowel syndrome and contributes to changes in bowel habits like or constipation.

2. Stabbing pains

Sometimes, the arrival of your period can come with stabbing pains down the legs, abdomen or into the buttocks.

For some, this pain can shoot up the vagina or back passage.

This is related to the cramping that occurs when prostaglandins are released in the body and the nerve in the back (the dorsal root ganglion) is activated.

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

Seeing a and learning to relax these can help manage this type of pain.
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3. Fatigue

It鈥檚 common to feel a bit run down around the time of your period. But for some people this can go beyond just regular tiredness.

A recent of 42,879 women showed about 70% experience this symptom. It is often as feeling 鈥渆xhausted鈥�, 鈥渄rained鈥�, 鈥渢ired鈥�, 鈥渓ethargic鈥�, 鈥渨orn out鈥�, and/or 鈥渨eak鈥�.

Fatigue can be due to the brain鈥檚 experience of pain. We can changes in the brain when people experience pelvic pain. Ongoing to the brain causes these changes, which results in extreme tiredness and sometimes headaches and nausea.

Having a , exercising and eating well can help with fatigue.

4. 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 produced by cells in the cervix (which is why seeing extra clear watery mucus at this time is a sign ovulation is approaching).

Most people feel pretty good when their estrogen levels are high. But when the follicle the egg is in gets bigger near ovulation, the pressure of the follicle and its release can cause pain. This ovulation pain is sometimes called mittelschmerz, which is German for 鈥渕iddle pain鈥�.

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

5. Mood changes

Between and of people who have periods experience changes to their mood leading up to or during their period.

But for between of people, the impacts on mood can be more severe and may be associated with a condition called premenstrual dysphoric disorder (PMDD).

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

When should you see a doctor?

Symptoms vary so much between people, there is a huge range of 鈥渘ormal鈥� and it can be tricky to decide when to follow up with your doctor. But it is worth chatting to a GP if:

• your period pain interrupts daily activities such as work, school or caring responsibilities
• the pain associated with your cycle is severe or changes
• you have difficulty going to the bathroom, pain with urination or bowel movements or your bowel habits change
• you feel emotionally or mentally overwhelmed
• you experience pelvic pain at other times (outside of your period).

When these symptoms are severe, they can be due to conditions such as endometriosis.

鈥� an evidence-based website co-created with people affected by endometriosis 鈥� has a for people trying to decide if their period symptoms require further medical care, and tips on how to describe them to a doctor.

, Grant Funded Researcher: Endometriosis, Robinson Research Institute, and , Professor and Endometriosis Group Leader, The Robinson Research Institute,

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