Period pain

Last updated 11 November 2016 — Last reviewed 09 December 2013

If period pain is so bad that it interferes with your daily living, stops you from going to school or work please see your doctor to discuss it. Period pain, what causes period pain, what is 'normal' and some possible ways to get relief from period pain are discussed.

Period pain (dysmenorrhoea)

hot water bottleWhile some women experience minimal or mild discomfort during menstruation, other women suffer from severe, debilitating pain that prevents them from doing their day to day activities. None of us know what another woman's pain is like, so it is useful to understand what periods should feel like and then decide if all is normal. Some women may have always experienced painful periods, others may develop pain. Period pain is more common in adolescents and women in their 20s, but can also occur in older women.

Period pain happens when the muscles in the uterus contract or tighten. Pain may include cramping and heaviness in the pelvic area, as well as pain in the lower back, stomach or even legs. Some women also experience nausea, vomiting, paleness, diarrhoea or loose bowels.  Women who experience painful periods may have higher levels of prostaglandins – a natural body chemical that causes contractions of the uterus, bowel and blood vessels.

Period pain is the most common cause of pelvic pain. 

What is normal period pain?

Period pain should only be considered 'normal' if:

  • the pain is only there on the first one or two days of your period
  • it goes away if you use the contraceptive pill or take period pain medications
  • your ability to do your normal activities is not impaired

If the pain is not like this, it is not normal.

What causes period pain?

Painful periods can be due to:

  • pain in the uterine (womb) muscle (myometrium) especially if the pain is on the first one or two days of a period
  • pain from endometriosis and/or adenomyosis, especially if the pain is there for more than one to two days before the period starts

Many women with strong period pain have both these problems and women with adenomyosis have a more painful uterus than other women, even if it looks normal. Adenomyosis is a condition where the cells which normally form a lining on the uterus also grow in the muscle wall of the uterus. Endometriosis is a condition where tissue, like the lining of the uterus, grows outside the uterus where it shouldn't be.  It used to be thought of as an uncommon problem of women in their 30s and 40s.  We now know it is a common problem that usually starts in the teens (see our webpages on endometriosis).

Symptom relief for painful periods

Apply heat on the belly or lower back To help relax muscles.
Exercise

To release endorphins (natural feel-good hormones).

Relax with rest, warm baths or meditating To release stress.

Complementary therapies

Acupuncture or discuss with an accredited naturopath taking Vitex Agnus Castus and magnesium.
Pain relief: ibuprofen, naproxen or diclofenac Take period pain medications at the onset of pain and take regularly during the days you normally have pain. All these medications can cause stomach irritation, so they are best taken with food and discuss the pros and cons of using them with your doctor.

The oral contraceptive pill (OCP)

Ask your doctor about:

  • a pill with more progestogen than oestrogen for the best effect
  • planning a period only every 2-3 months or not at all
Mirena® intrauterine device (IUD

Currently the most effective treatment for pain from the uterus and lasts up to 5 years.

It slowly releases a progestogen medication to the uterus that makes periods lighter, less painful and it's also a contraceptive. 

It's common to have irregular bleeding and cramp pains for the first few months but these problems usually settle. 

If you have not had children or have a tender pelvis you can ask to have it inserted under an anaesthetic.

If simple treatments for period pain don't help, see your doctor to discuss the possible causes and what might be best to do in your individual case.

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at December 2013.

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