What’s the real difference between period cramps vs something like endo/fibroids/PCOS, and when should I stop Googling and actually get my uterus checked?

Normal period cramps are annoying but manageable: they usually start right before or during your bleed, respond to ibuprofen/heat, and don’t regularly knock you out of school, work, or life. When pain is severe (think 7/10+), shows up *days* before your period, lasts most of the month, or comes with things like pain with sex/pooping/peeing, super heavy bleeding, or very irregular cycles, that’s when we start thinking endometriosis, fibroids, or PCOS. PCOS is more about irregular or missing periods, acne, hair changes, and fertility issues than intense cramps. The moment your pain makes you change your life—cancel plans, miss class, fear your own cycle—you’ve already hit the "get evaluated" threshold.Want to sort out whether your cramps sound more "average shitty" or "medically concerning shitty"? Gush can walk through your symptoms without minimizing you.

How to tell normal period cramps from endometriosis, fibroids, or PCOS

What causes normal period cramps?

Normal(ish) period cramps = **primary dysmenorrhea**.What’s happening:- Right before your period, **progesterone drops**.- The uterine lining breaks down.- Your body releases **prostaglandins**—chemicals that make the uterus contract to push blood out.Those contractions:- Cause crampy pain in the lower belly or back.- Are usually worst on day 1–2 of bleeding.- Often get better with:- Ibuprofen/naproxen (they block prostaglandins).- Heat.- Movement."Typical" cramps usually:- Stay in the lower abdomen/back.- Last a few hours to a couple days.- Are annoying but you can still function.- Don’t come with intense weird bleeding patterns or constant pain between periods.If that’s your experience, your uterus is probably just doing its grim little job.

When period pain points to endometriosis

Endometriosis = tissue *similar* to the uterine lining growing outside the uterus (on ovaries, bladder, bowel, etc.). It reacts to hormones every cycle, causing inflammation and often brutal pain.Red flags for endometriosis:- **Severe cramps** that start **days before** your bleed.- Pain that peaks *before* your period, not just on day 1.- Pain that **doesn’t fully go away** between periods.- **Pain with sex** (especially deep penetration).- Painful bowel movements or peeing around your period.- Nausea, vomiting, or pain that wakes you up at night.- Family history of "bad periods" or endo.- Infertility or trouble conceiving later.Hormones behind it:- Estrogen can feed endo lesions.- Progesterone drop still triggers inflammation and bleeding in those stray patches.If you’re curled up on the bathroom floor sobbing every month and being told "it’s just cramps," that’s neglect, not normal.If what you’re feeling doesn’t fit cleanly into these bullet points—maybe your pain is more GI, or only with sex, or only on one side—that’s still valid. Bodies don’t follow textbook vibes. You can vent and sort your pattern with Gush before (or after) dragging yourself to a gyn appointment.

How fibroids feel different from regular cramps

Fibroids = benign (non-cancerous) muscle tumors in or on the uterus. Super common, especially in Black women, and wildly under-discussed.Fibroid symptom clues:- **Heavy periods**:- Soaking a pad/tampon every 1–2 hours.- Needing double protection.- Periods lasting more than 7 days.- Passing clots bigger than a quarter.- **Bulk symptoms**:- Pelvic pressure or fullness.- Constant urge to pee.- Low back pain or pain with certain positions.- Cramps that feel **stronger and more drawn-out** than they used to.- Bloating that makes you look months-pregnant at times.Hormonal piece:- Fibroids grow in response to estrogen and progesterone.- They can make your uterus larger and heavier, so contractions during your period hit harder.You can have small, silent fibroids or big, dramatic ones. Either way, "you’re fine" doesn’t cut it if you’re bleeding through your life.

Where PCOS fits in (spoiler: it’s usually not about cramps)

PCOS = polycystic ovary syndrome. Despite the name, it’s more of a **hormonal and metabolic condition** than a "cyst" issue.Typical PCOS signs:- **Irregular periods**:- Cycles longer than 35 days, or fewer than 8 periods a year.- Months without bleeding, then a heavy, delayed period.- Signs of **higher androgens**:- Chin/jaw hair or chest hair.- Acne, especially jawline/cystic.- Thinning hair on the scalp.- Trouble ovulating or getting pregnant.- Weight changes, insulin resistance in some people.Pain-wise:- Many with PCOS don’t have intense cramps.- Cramps may show up **only when you do finally bleed**, because the lining built up for longer.So if your main issue is **chaotic cycles + hormone-y skin/hair changes**, PCOS is more on the table than endo or fibroids.

Cycle phases and how they affect pain

Understanding your phases helps you clock patterns:1. **Follicular phase (period to ovulation)**- Estrogen rising.- Usually less pain after the first few bleed days.2. **Ovulation (~mid-cycle)**- LH and estrogen peak.- Some feel a one-sided twinge (mittelschmerz) for a few hours.- If you get *severe* mid-cycle pain repeatedly, a cyst or endo could be involved.3. **Luteal phase (post-ovulation to period)**- Progesterone rises.- Bloating, breast tenderness, mood changes can show.- Endo pain often ramps **here**, before bleeding even starts.4. **Menstrual phase (bleeding)**- Hormones drop.- Uterus contracts; typical cramps live here.- Fibroid-heavy uteruses may crank harder and longer.Tracking *when* the pain hits in this cycle has huge diagnostic value; write it down.

Concrete signs you should get your uterus checked

You deserve an actual exam if you notice any of this on repeat:Pain-wise:- Pain regularly 7/10 or higher.- Pain that makes you **miss school/work** or cancel plans.- Pain that doesn’t improve with max-dose ibuprofen/naproxen + heat.- Pain with sex (especially deep penetration).- Pain with pooping or peeing around your period.Bleeding-wise:- Periods longer than 7 days.- Soaking through pad/tampon in under 2 hours repeatedly.- Needing to change period products overnight multiple times.- Big clots (bigger than a quarter) often.- Bleeding between periods or after sex.Cycle-wise:- Cycles shorter than 21 days or longer than 35 days.- Months with no period (and you’re not pregnant or on continuous birth control).Emergency now (ER/urgent care) if:- Sudden, intense one-sided pain.- Pain with fever, vomiting, or feeling faint.- Positive pregnancy test + strong lower abdominal pain or shoulder pain (ectopic pregnancy risk).

What an evaluation for pelvic pain usually includes

Expect some combo of:- **History**: they should ask about timing, severity, cycle patterns, sex, bowel/bladder.- **Pelvic exam**: feeling uterus/ovaries, checking for tenderness.- **Ultrasound**: to look for fibroids, large cysts, adenomyosis clues.- **Blood tests**: hormones, anemia, pregnancy test.- Sometimes **laparoscopy** (surgery with a camera) is needed to *confirm* endometriosis.None of this means pain is "in your head" if imaging is normal. Endo and adenomyosis especially can hide on scans.

How birth control fits into managing pain

Hormonal birth control isn’t a cure, but it’s often used to:- Calm prostaglandins and make periods lighter → fewer cramps.- Suppress ovulation and cycle swings → helpful in endo.- Regulate or reduce bleeding in PCOS or fibroids.Options used:- Pills, patch, ring.- Hormonal IUD.- Shot or implant.If your provider only throws birth control at you **without** explaining what they suspect—or refuses to investigate further when meds don’t help—that’s a care problem, not a you problem.

Bottom line: when to stop Googling and get seen

Use this rule:If your pain or bleeding:- Makes you dread your period every single month,- Forces you to plan your life around your uterus,- Or leaves you feeling dismissed or crazy after appointments,…it’s time for a proper workup. Normalizing women’s pain is a system-level failure, not a medical truth.You’re not "weak" for wanting answers. You’re paying attention—and that’s the smartest, most rebellious thing you can do for your future self.