It’s that “time of the month.” For many women, that means it’s time for those painful cramps again. Why?

Cramps occur when the uterus contracts, causing pain in the lower belly or back. Common treatments include taking an anti-inflammatory pain reliever or applying heat, such as a heating pad, to the area. However, not all period pains are created equal. Some women may experience more painful cramping due to poor diet, lack of exercise, increased stress or gynecologic conditions such as ovarian cysts, uterine fibroids, adenomyosis, endometriosis or pelvic infections.

How do you determine the source of your menstrual cramps? The first thing to do is pinpoint the location of your cramps and then look at other symptoms you may be experiencing.

Pains from irritable bowel syndrome will typically occur in your abdomen, and can be accompanied by bloating and constipation. Inflammatory bowel disease, such as Crohn’s disease and ulcerative colitis, will also cause pain near the abdomen. Additional symptoms could include diarrhea, weight loss and fatigue.

Constipation pain often occurs in your lower belly, hips, and back. If you suspect constipation is the cause of your pain, try adding more fiber to your diet. Gas pains may also occur in your lower abdomen. Certain foods and herbs can combat gas. Try stocking up on pineapple, papaya and kimchi, or pick up herbs such as chamomile, basil, parsley and peppermint. A gas-reducing tea made from peppermint or ginger might be beneficial.

If you have worsening cramps on an ongoing basis and you’re not sure the cause, talk to your gynecologist to find the appropriate treatment.

– Angela Chaudhari, MD, Northwestern Medical Group, Obstetrics and Gynecology