Period cramps, also known as dysmenorrhea, typically occur due to the contraction of the uterus during menstruation. The uterus sheds its lining every month to prepare itself for potential pregnancy. The muscle contractions to expel the lining, triggered by the release of hormone-like substances called prostaglandins, can lead to discomfort and cramping. 

The pain we feel as cramps can also be enhanced by other factors in the body. Hormonal changes and imbalances can increase sensitivity. Reduced blood flow in the uterine lining can also result in pain. Stress and anxiety can increase pain perception. Even things like genetics, age, and lifestyle can affect the caliber of cramps.

Endometriosis can be another cause for extreme pain during periods. Endometriosis is a chronic condition where tissue similar to the uterine lining grows outside the uterus. During menstruation, the tissue also begins to break down and bleed, but it has no way to exit the body. It becomes trapped, which leads to swelling, pain, and the formation of scar tissue. It is a serious condition that should be discussed with a doctor if cramps are excessively painful.

For typical cramps, over-the-counter painkillers like ibuprofen can alleviate the pain. Heating pads or taking a warm bath can help relax the uterine muscles. Regular exercise and a balanced diet (reduced salt, sugar, caffeine, and processed foods) can ease cramps over time. Hormonal birth control, such as pills or IUDs, can regulate hormonal changes, leading to milder periods and cramps.