How do I tell if my cramps/bloating/fatigue are just “normal period stuff” vs something I should actually get checked out (like endo or PCOS)?

Here’s the blunt version: “Normal” period symptoms suck, but they don’t consistently ruin your life. Mild–moderate cramps, some bloating, and feeling tired for a day or two around your period can be normal. Red flags: pain that makes you vomit or pass out, pain that doesn’t improve with heat + OTC meds, needing to miss work/class regularly, very heavy bleeding (soaking a pad/tampon every 1–2 hours), pain with sex or pooping, cycles that are super irregular, or symptoms getting worse over time. That’s when you start thinking: endometriosis, fibroids, PCOS, thyroid issues, anemia, or something else.Your body is not “dramatic” or “weak” for struggling. If your period is running your schedule, that’s a medical issue, not a personality flaw.If you want to talk through what your cycle’s actually doing (instead of doom-scrolling symptoms at 2 a.m.), you can always chat with Gush and walk through your cramps, bloat, and energy levels step-by-step.

How to tell if period cramps, bloating, and fatigue are normal or a sign of endometriosis or PCOS

First: what “normal” period symptoms usually look like

Let’s set a baseline, because the bar for women’s health has been buried underground.Typical/“normal-ish” period symptoms:- Cramps: Achy, crampy pain in your lower belly/back that starts right before or during your period, lasts a few hours to a couple days, and gets better with heat, rest, and over-the-counter pain meds.- Bloating: You feel puffier, gassier, or your jeans fit tighter a few days before your period and the first 1–2 days of bleeding, then it eases.- Fatigue: You’re more tired or low energy, but you can still function, show up to work/class, and get through the day without collapsing.Normal period symptoms are uncomfortable, not disabling.If you can’t move, can’t focus, or are crying from the pain every month, that’s not “just being a girl.” That’s your body yelling.

Hormones 101: what’s actually happening each cycle

Your menstrual cycle is a hormone roller coaster, and cramps/bloating/fatigue are part of how your body rides it.Rough cycle breakdown (assuming ~28–35 days):1. **Menstrual phase (bleeding)** – Days 1–5-ish- Estrogen and progesterone are at their lowest.- Your uterus sheds its lining. Prostaglandins (chemicals that cause muscles to contract) trigger cramps and can also cause diarrhea and nausea.- Low hormones + blood loss = fatigue and brain fog.2. **Follicular phase** – After your period until ovulation- Estrogen rises.- You usually feel lighter, clearer, more energetic.3. **Ovulation** – Mid-cycle- Estrogen peaks, luteinizing hormone (LH) spikes.- Some people feel a small twinge on one side; others don’t notice anything.4. **Luteal phase** – After ovulation until next period- Progesterone rises, then drops before your period.- This is where PMS lives: bloating (water retention), cravings, mood swings, sore boobs, irritability, fatigue.If your symptoms roughly follow this pattern, ease with basic care, and don’t progressively worsen, they’re more likely to be in the “normal but annoying” range.

Red flags your period cramps are not normal

If you see yourself here, that’s your sign to get checked:- **Pain that is severe**: You’re doubled over, vomiting, fainting, or can’t walk upright.- **Pain that lasts long**: Cramps start days before bleeding and keep going most of your period.- **Pain that doesn’t respond**: Heat + standard doses of ibuprofen/naproxen barely touch it.- **Pain between periods**: Pelvic pain with ovulation, sex, or random days, not just during your period.- **Pain with sex or pooping**: Deep pain with penetration, or sharp pain with bowel movements, especially during your period.That profile screams “not normal period cramps” and is VERY endometriosis-coded.

When it might be endometriosis

Endometriosis = tissue similar to the uterine lining growing outside the uterus (on ovaries, bowel, bladder, etc.). It’s inflammatory and highly painful, and it’s chronically underdiagnosed because people keep being told they’re "just sensitive."Common endometriosis signs:- Period pain that is way out of proportion to what anyone calls “normal”- Needing to miss school/work or cancel plans every month- Pain with sex (especially deep penetration)- Pain with pooping/peeing during your period- Chronic pelvic pain even when you’re not bleeding- Heavy periods or bleeding longer than 7 days- Fertility struggles later onEndo pain often starts as a teen/early 20s and gets worse with time. If your pain graph is trending up, not staying stable, pay attention.

When it might be PCOS (even if cramps aren’t your main issue)

PCOS (polycystic ovary syndrome) is more of a hormone and ovulation problem than a “cramp” disease.Common PCOS signs:- Irregular periods (cycles longer than 35 days or skipping periods)- Very light or very heavy bleeding, but not super predictable- More acne (especially jawline), oily skin- Hair growth on face/chest/stomach or thinning hair on scalp- Difficulty losing weight or weight gain around the belly- Intense fatigue and carb/sugar crashesPCOS doesn’t usually cause extreme period pain like endo does, but the **fatigue, bloating, and hormonal chaos** can be intense. If your main issues are exhaustion, irregular cycles, and metabolism/skin/hair changes, PCOS deserves a look.

Other stuff that can cause heavy symptoms

Cramps, bloating, and fatigue can also come from:- **Fibroids** – Non-cancerous growths in the uterus. Think: pressure, heavy bleeding, big clots, pelvic fullness, back pain.- **Adenomyosis** – Uterine lining growing into the muscle wall. Very heavy, painful periods, enlarged tender uterus.- **Thyroid issues** – Extreme tiredness, feeling cold, hair loss, weight change + period irregularity.- **Anemia (low iron)** – Shortness of breath, dizziness, pale skin, exhaustion, often from heavy periods.Your body is a system. If your fatigue feels bone-deep, not just “ugh I’m tired,” it’s worth checking your thyroid, iron, and vitamin levels too.

BTW, if you’re reading this like, “My symptoms kind of match but also… not really,” that’s valid. Bodies are chaotic. You can walk through your exact cycle pattern with Gush and get help sorting what feels normal-for-you vs worth pushing a provider about.

How to track your symptoms so you’re taken seriously

Doctors take patterns more seriously than vibes. So weaponize data.For at least 2–3 cycles, track:- **Cycle days** – When you bleed, how long, how heavy (how many pads/tampons/cups, how often you change them).- **Pain level** – 0–10 scale, what it feels like (sharp, stabbing, dull, burning), where it is, what makes it worse/better.- **Bloating** – When it starts (before period? after?), how long it lasts, how intense.- **Fatigue** – Can you function? Are you missing class/work? Napping constantly? Struggling to focus?- **Other symptoms** – Nausea, diarrhea, constipation, headaches, mood swings, pain with sex, random spotting.Bring this to a provider and say clearly: “My pain/fatigue is interfering with school/work. I want to rule out endometriosis, PCOS, fibroids, and thyroid or iron issues.” Name the things. You’re not “overreacting”; you’re being specific.

When to actually book the appointment (not just think about it)

Stop waiting for it to get “bad enough.” Go in if:- You regularly miss work/class or cancel plans due to period symptoms.- You have severe pain that doesn’t respond to usual pain relief.- Your periods are super heavy (soaking through products, needing to double up, bleeding longer than 7 days).- Your cycles are wildly irregular or you skip periods for months (and you’re not on certain birth control).- You have new or worsening pelvic pain, or pain with sex.- Your fatigue is crushing and out of proportion to your lifestyle.You deserve a body that doesn’t destroy you every 28 days. “Normal” doesn’t mean “miserable.”