Period Pain: Causes, Self-Care and When to See a Doctor

Pain or cramps before or during a period are very common. For many people it is a normal part of the menstrual cycle, but sometimes the pain is strong enough to stop daily life, and occasionally it points to another condition. This guide explains what is going on and when to ask for help.

What is period pain?

According to the NHS, period pain mainly affects girls and women around the time their periods start, but anyone who has periods can have it. The pain often lasts up to 3 days and can disrupt daily life.

It can feel like:

• pain in the tummy at the start of a period or just before it
• cramps that spread to the back and thighs
• a sharp pain or a dull ache in the tummy

Why does it happen?

The womb tightens during a period, and the NHS says this is often a normal part of the menstrual cycle. Sometimes, though, painful periods have another cause. The NHS lists:

• Endometriosis or adenomyosis, where tissue like the womb lining grows in other places
• Fibroids, which are growths in or around the womb
• Pelvic inflammatory disease, an infection of the womb, fallopian tubes and ovaries
• An intrauterine device (IUD), which can cause period pain, especially in the first 3 to 6 months after it is fitted

Simple self-care ideas

The NHS suggests several things that may ease the pain:

• take a warm bath or shower
• hold a heat pad or a hot water bottle wrapped in a tea towel against your tummy
• massage your tummy and back
• try gentle exercise such as yoga, swimming, walking or cycling
• use over-the-counter painkillers, following the instructions on the pack or a pharmacist's advice
• cut down on alcohol and stop smoking, which may also help

If you are not sure that a painkiller is safe for you, for example because of another health condition or because you are pregnant, ask a pharmacist or doctor first.

What a doctor may suggest

If pain is severe, a doctor may talk about other options. The NHS mentions anti-inflammatory medicines prescribed for period pain, a TENS machine (a small device that uses mild electrical pulses to reduce pain), and contraception such as the pill, implant or injection, which thins the womb lining so periods become lighter and pain may ease.

A doctor may refer you to a gynaecologist if the pain does not improve or if a condition such as fibroids may be the cause. An ultrasound scan may be used to look for the cause. Treating an underlying condition should help. For example, medicine may shrink fibroids or surgery may remove them, and pelvic inflammatory disease usually needs antibiotics. The right choice is always the doctor's decision after examining you.

When to see a doctor

The NHS advises asking for an urgent appointment, or calling a health helpline, if your pelvic or period pain is severe or worse than usual and painkillers have not helped.

See a doctor soon if:

• your periods become more painful, heavier or irregular
• period pain stops you doing your usual activities
• you have pain during sex or when peeing or pooing
• you bleed between periods
• you notice a change in how often you pee or poo
• you have a swollen tummy or lose your appetite
• you lose weight without trying

Pain that is sudden, sharp and intense, or that comes with fainting, a high temperature or heavy bleeding, needs urgent care.

In an emergency, call your local emergency number (112 in India, 911 in the United States).

Key points

• Mild to moderate cramps are common and often part of a normal cycle.
• Heat, gentle movement and over-the-counter pain relief may help.
• Pain that is severe, getting worse, or comes with other symptoms should be checked, as conditions such as endometriosis, fibroids or infection can be behind it.
• You are not overreacting if period pain stops you living normally. A doctor can look for causes and discuss options.