PERIODS can be a challenge full stop.
But if you find things particularly tough on day two, that's perfectly normal, experts say.
You've probably guessed it, but it's all down to your hormones – specifically prostaglandins.
Levels are highest during the first few days of menstruation and peak on the second as progesterone lowers, according to Dr Fatema Mustansir Dawoodbhoy.
This means cramps are at their worst and the pain is at its most intense.
Then, as bleeding continues and the lining of the uterus is shed, prostaglandins lessen – as do your symptoms.
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Dr Dawoodbhoy, an academic doctor who specialises in obstetrics and gynaecology, told Metro: "As the lining of your uterus breaks down, prostaglandins (hormone-like chemicals) are released in the body."
This encourages the uterus to contract, helping period blood to be released, she added.
The expert, who works with period care app Joii, said: "The prostaglandins also constrict the blood vessels in the uterus, reducing the amount of oxygen the uterine tissue receives, and this leads to cramping and pain."
Several other factors apparently influence the amount of pain you experience on day two, including lower oestrogen levels and a heavier flow.
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Dr Ashfaq Khan, a consultant obstetrician and gynaecologist and founder of Harley Street Gynaecology, said: "The second day of the period is typically associated with a heavier menstrual flow for many women.
"The increased blood volume can lead to more intense cramping and discomfort as the uterus works harder to expel the menstrual blood."
Social media users will be baffled by the revelation.
Previously, dozens of people have complained about "excruciating" symptoms on day two of their period.
One Twitter user said: "Why is day two of your period the worst? Please help."
While another wrote: "The first day is absolute hell, like I'll be crying, screaming, rolling around, feeling sick and even being unable to breathe properly.
"I even end up wishing I could just pass out so I don't have to feel the pain anymore. It's the worst."
While a certain level of period pain and discomfort is normal, doctors warn that it can be a sign of something more sinister.
According to the NHS, medical conditions that can cause period pain include:
- Endometriosis – where cells that normally line the womb grow in other places, such as in the fallopian tubes and ovaries; these cells can cause intense pain when they shed
- Fibroids – non-cancerous tumours that can grow in or around the womb and can make your periods heavy and painful
- Pelvic inflammatory disease – where your womb, fallopian tubes and ovaries become infected with bacteria, causing them to become severely inflamed
- Adenomyosis – where the tissue that normally lines the womb starts to grow within the muscular womb wall, making your periods particularly painful
Pain can also be caused by contraceptive devices like the intrauterine device (IUD).
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In most cases, pain can be treated at home with painkillers like ibuprofen.
If your periods become significantly heavier, more irregular or painful, you should see a GP.
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