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Period Pain
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Women

Period Pain

Painful periods, or dysmenorrhea, can range from common menstrual cramps to secondary conditions requiring medical intervention.

What are painful periods?

Menstruation is normal vaginal bleeding that happens as part of a woman's monthly cycle. Many women have painful periods, also called dysmenorrhea. The pain is most often menstrual cramps—a throbbing, cramping pain in your lower abdomen. You may also have lower back pain, nausea, diarrhea, and headaches. Period pain is not the same as premenstrual syndrome (PMS), which causes symptoms like bloating and irritability one to two weeks before a period starts.

Causes

There are two types of dysmenorrhea:

  • Primary dysmenorrhea: The most common kind, not caused by another condition. It is usually caused by high levels of prostaglandins, chemicals that make the uterus muscles tighten and relax.
  • Secondary dysmenorrhea: Often starts later in life and is caused by conditions affecting the reproductive organs, such as endometriosis and uterine fibroids. This pain often gets worse over time.

Management and Self-Care

To help ease period pain, you can try:

  • Using a heating pad or hot water bottle on your lower abdomen.
  • Getting some exercise.
  • Taking a hot bath.
  • Doing relaxation techniques, including yoga and meditation.
  • Taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, which reduce prostaglandin production.

Note: Do not take NSAIDs if you have ulcers, stomach problems, bleeding problems, liver disease, or an aspirin allergy. Always consult your provider.

When to Seek Medical Help

Contact your health care provider if:

  • NSAIDs and self-care measures don't help, and the pain interferes with your life.
  • Your cramps suddenly get worse.
  • You are over 25 and you get severe cramps for the first time.
  • You have a fever with your period pain.
  • You have the pain even when you are not getting your period.

Diagnosis and Treatment

To diagnose severe pain, your provider may perform a medical history review, a pelvic exam, an ultrasound, or a laparoscopy. Treatment for primary dysmenorrhea may include hormonal birth control (pill, patch, ring, or IUD) or prescription pain relievers. Treatment for secondary dysmenorrhea depends on the underlying condition and may include surgery.

Frequently Asked Questions

Combined oral contraceptives, the patch, or the vaginal ring suppress ovulation and reduce prostaglandin production, often relieving both primary and secondary dysmenorrhea. Progestin‑only methods (e.g., IUD, implant) can also improve pain, especially if endometriosis is present. Risks include breakthrough spotting, breast tenderness, mood changes, and a small increase in blood‑clot risk for estrogen‑containing products—especially in smokers over 35 years. Discuss personal risk factors with your clinician.
Typical primary dysmenorrhea lasts 1‑3 days, peaking in the first 24 hours of bleeding. If cramps persist beyond 4‑5 days, become progressively worse with each cycle, or are accompanied by heavy bleeding, fever, or gastrointestinal symptoms, you should discuss further evaluation with your provider.
Regular aerobic exercise (e.g., brisk walking, cycling) for at least 30 minutes most days reduces prostaglandin levels. Maintaining a balanced diet rich in omega‑3 fatty acids (fish, flaxseed) and low in saturated fats may also help. Limiting caffeine and alcohol, staying well‑hydrated, and using heat therapy (heating pad for 15‑20 minutes) at the start of menses are simple, evidence‑based measures.
Yes, worsening pain after age 25, especially if it spreads to the lower back, hips, or pelvis, or is associated with dyspareunia (painful intercourse), heavy bleeding, or bowel changes, raises suspicion for secondary causes such as endometriosis, adenomyosis, or fibroids. Schedule a pelvic exam, ultrasound, or referral to a gynecologist for further work‑up.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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