How is period pain treated?

Period pain, also known as dysmenorrhoea, is a common problem that affects many women during their menstrual cycle. Symptoms range from mild cramping to severe discomfort which can affect every day activities. Understanding the causes and the treatments available can help make periods more manageable and improve overall quality of life.

What causes period pain?

Period pain is caused by contractions of the uterus as it sheds its lining. During this process, the body releases chemicals called prostaglandins, which trigger cramping and can also lead to nausea, headaches or diarrhoea.

The main reasons for period pain are:

Primary dysmenorrhoea
due to high levels or prostaglandins;

or;

secondary dysmenorrhoea linked to conditions such as:

Endometriosis
Adenomyosis

Identifying whether the pain is primary or secondary is an important step in choosing the right treatment. Whereas all conditions can be treated with painkillers and contraceptive hormones, some types of endometrioses respond with good pain relief from laparoscopic surgery.

What self-care options can help?

Mild to moderate period pain can often be relieved with simple measures, including:

Heat therapy: Applying a warm water bottle or heating pad to the lower abdomen helps relax the muscles.
Tens technology: such as Menstrual Relax© combines healing electrical impulses with heat. The device can be worn under clothes.
Gentle exercise: Activities such as walking, yoga or swimming increase blood flow and reduce cramps.
Relaxation techniques: Mindfulness, progressive muscle relaxation and Pranayama breathing can ease tension and discomfort. There is evidence that relaxation techniques provide benefit when done three times a week. They can help even if they are done outside a pain crisis.
Balanced diet: If you experience bloating you could try the low fodmap diet. Over the counter medication such as Mebeverine and Simethicone are worth trying. If you have constipation, try a tablespoon of linseed in the morning and increase fluid intake.

Keeping track of symptoms in a diary can help identify triggers and patterns.

What medications are available?

Several medicines can reduce the intensity of period pain:

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen block prostaglandins and are often the first-line treatment.
Paracetamol can be used for mild discomfort, particularly if NSAIDs are not suitable.
Hormonal contraception (e.g., the pill, patch, or hormonal coil) regulates or lightens periods, which may reduce cramping.
Endometriosis is suppressed during breastfeeding, pregnancy and with hormonal contraception, especially progesterone (pill injection, implant, tablets, intrauterine device (IUD)).
Adenomyosis (which can be diagnosed on scan) often responds well to the IUD.
Heavy menstrual bleeding can be reduced by taking tranexamic acid during the heavy days (Cyklokapron, Evana).

It’s best to start pain relief as soon as bleeding or discomfort begins for maximum benefit.

When to consider medical treatments

If self-care and standard medicines aren’t enough, a doctor may recommend:

Stronger prescription painkillers for severe symptoms.
Hormonal treatments such as the combined contraceptive pill or progestogen-only options to suppress ovulation and reduce bleeding.
Treatment of underlying conditions, such as surgery for endometriosis.

Regular reviews help ensure the treatment remains effective and tailored to your needs.

When should you seek specialist advice?

Seek medical help if period pain is very severe, starts suddenly after years of painless periods, or is accompanied by heavy bleeding, fever or unusual discharge. These symptoms may suggest an underlying gynaecological problem that needs further assessment.