Are my severely painful menstrual periods linked to pcos?

Sometimes: Pcos in itself does not cause painful periods. But if your periods are irregular and from too much buildup of the uterine lining. Then the periods can be heavy and painful. But there could be other reasons as well so it is worthwhile being evaluated.

Doubtful: Pcos is associated with pelvic fullness and bloating due mainly to the enlargement of the ovaries because of the increased number of follicles. Severe dysmenorrhea probably has a different cause, and may be due to endometriosis.