If you’ve ever had painful periods, also known as dysmenorrhea, you may be familiar with the intense cramping and pelvic discomfort that can come with your menstrual cycle. But what many women don’t expect is that this history of period pain can also make pelvic pain during pregnancy feel worse. If you’re noticing sharp round ligament pain or strong Braxton Hicks contractions, there may be a connection to the period pain you experienced before becoming pregnant.

The Link Between Dysmenorrhea and Pregnancy Pain

A study by Itani et al. (2022) highlights that women with primary dysmenorrhea—painful periods without an underlying medical condition—are more likely to experience heightened pelvic discomfort during pregnancy. The same biological mechanisms that cause severe menstrual cramps may also contribute to increased sensitivity to pain and stronger uterine contractions during pregnancy.

Here’s why:

• Prostaglandins and Uterine Sensitivity: Dysmenorrhea is driven by elevated levels of prostaglandins, which stimulate stronger and more painful uterine contractions. These compounds don’t disappear during pregnancy and may continue to influence the uterus, making ligament stretching and Braxton Hicks contractions feel more intense.
• Hypertonic Uterus: Women with a history of painful periods often have a hypertonic uterus, meaning their uterine muscles tend to be more reactive. This can lead to stronger, more frequent Braxton Hicks contractions, which mimic period cramps and sometimes cause concern.
• Heightened Pain Perception: If your body is accustomed to reacting strongly to uterine and pelvic pain, you may be more sensitive to the normal stretching and shifting of ligaments that occurs as your baby grows. 

Why Pelvic Pain Feels Worse for Some Women During Pregnancy

Pelvic pain in pregnancy often stems from the stretching and thinning of the round ligaments that support the uterus. As the uterus expands, these ligaments stretch and can cause sharp or pulling pains, usually on one or both sides of the lower abdomen.

For women with a history of dysmenorrhea, these normal changes can feel more intense due to an already heightened sensitivity to pain. Additionally, Braxton Hicks contractions—often described as “practice contractions”—can feel stronger or more uncomfortable for these women, even if they’re not signaling true labor.

If contractions become regular, increase in intensity, or are accompanied by bleeding or fluid leakage, it’s imperative to contact your healthcare provider.

How to Manage Pelvic Pain During Pregnancy

If you’re experiencing increased pelvic pain or Braxton Hicks contractions during pregnancy, there are practical strategies to ease your discomfort:

• Stay Hydrated: Dehydration can intensify Braxton Hicks contractions, so aim for 8-10 glasses of water daily.
• Gentle Movement and Stretching: Prenatal yoga, pelvic tilts, and gentle stretching can help relieve round ligament pain and promote flexibility.
• Heat Therapy for Comfort: Apply a warm (not hot) heating pad or take a warm bath to relax the muscles and ease discomfort.
• Practice Deep Breathing and Relaxation: Controlled breathing techniques can reduce the perception of pain and help your body relax.
• Change Positions Frequently: If you’re sitting or lying down for a while, shift positions or take a short walk to relieve pressure on your ligaments. 

When to Call Your Healthcare Provider

While mild to moderate pelvic pain and Braxton Hicks are typically normal, certain symptoms warrant a call to your provider:

• Severe, persistent pain that doesn’t improve with rest
• Vaginal bleeding or spotting
• Fluid leakage or decreased fetal movement
• Regular, painful contractions that become stronger or closer together

Empower Yourself with Knowledge

Understanding that a history of painful periods can influence your pregnancy experience gives you the tools to manage discomfort more effectively. While some degree of pelvic pain and Braxton Hicks contractions is normal, you don’t have to endure unnecessary discomfort. By staying informed and listening to your body, you can navigate these changes with greater ease and confidence.

If you’re feeling overwhelmed or experiencing concerning symptoms, don’t hesitate to contact your healthcare provider. They can provide reassurance and guidance to ensure you and your baby remain safe and comfortable.

Source:
 Itani R, Soubra L, Karout S, Rahme D, Karout L, Khojah HMJ. Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates. Korean J Fam Med. 2022 Mar;43(2):101-108. doi: 10.4082/kjfm.21.0103. Epub 2022 Mar 17.