Menstrual cramps (period pain) – the best ways to stop it

More than 1 out of 2 people get menstrual cramps for at least 1 or 2 days every month as part of the menstrual cycle. It’s medically known as ‘dysmenorrhoea’.

As well as the pain of menstrual cramps, some people also get other symptoms such as nausea and diarrhea.

If you’re affected, there are steps you can take to lessen pain and stop symptoms from getting in the way of your day.

Discover more about menstrual cramps, plus find out how to get relief.

What are the symptoms?

People describe the pain of menstrual cramps in different ways – for example, it can be a ‘throbbing’ sensation or a ‘dull ache’.

The pain mainly affects your lower tummy (abdomen) area, but can also spread to your back and thighs.

Alongside cramps, you might also experience other symptoms such as:

• bloating
• mood changes
• headaches
• nausea
• diarrhea
• constipation.

For most people, menstrual cramps happen just before and during the first few days of their period, but this can vary.

Some people may get pain for just a few hours or a day before it goes away (either on its own or with help from self-care and painkillers). However, for some women, severe menstrual cramps affect daily life and may stop them doing the things they love.

If your period pain is affecting your life, speak to your doctor.

What causes menstrual cramps?

The cause of your pain – and even the sort of pain you get – can be separated into 2 groups:

• primary dysmenorrhea – period pain that’s caused by your womb (uterus) muscles tightening (contracting) to shed your uterus lining, that’s not due to another condition
• secondary dysmenorrhea – period pain that’s caused by another condition.

Primary dysmenorrhea

This is the period pain you get as part of your ‘normal’ menstrual cycle.

Chemicals called prostaglandins, made in the lining of your uterus (womb), cause the uterus muscles to contract, which results in cramps. The pain can go on for a few days but can last longer.

If you experience this kind of period pain, it might be because you have higher levels of prostaglandins in your body.

Secondary dysmenorrhea

Painful periods are caused by something other than your ‘normal’ menstrual cycle.

It can last longer than other period pain, starting several days before your period and continuing until your period has finished. Secondary dysmenorrhea can also get worse over time.

It’s usually caused by an underlying health condition, such as:

• endometriosis – where tissue that lines your uterus (womb) grows in other places, such as your ovaries or fallopian tubes. When you have your period, this tissue breaks down and bleeds, and so can cause pain and scarring
• fibroids – non-cancerous (benign) growths that can grow in and around your uterus, and cause heavy periods and pain
• adenomyosis – this is when tissue that normally lines your uterus starts to grow in your uterus muscles, causing abnormal bleeding and pain
• pelvic inflammatory disease (PID) – a bacterial infection that begins in your uterus and spreads to other reproductive organs, causing pain
• being born with certain conditions that affect your uterus or fallopian tubes, can cause painful periods.

Other health conditions can also flare up during your period, such as Crohn’s disease or urinary problems, which can lead to pain.

Sometimes, contraceptive intrauterine devices (IUDs) can cause period pain, particularly in the first few months after being put in.

How to manage menstrual cramps with self-care

There are things you can try at home to ease your symptoms, such as:

• applying heat – using a heat pad or hot water bottle wrapped in a towel, or taking a warm bath may help ease pain, as well as aiding relaxation
• gentle exercise before and during your period – including yoga, cycling and swimming, which may help improve blood supply to your pelvis and help relax your muscles
• massaging around your tummy and back – gentle massage can help to relieve pain
• maintaining a healthy lifestyle – eating a healthy balanced diet, high in fiber and low in sugary, salty foods could help ease period pain. Cutting down on alcohol and stopping smoking (which is thought to increase period pain) can also help
• taking painkillers such as acetaminophen (paracetamol) and ibuprofen, when you need to.

Some alternative therapies, such as acupuncture and acupressure, might help with menstrual cramps but more studies are needed to prove that they are effective.

Some supplements have been shown in research to possibly bring relief for menstrual cramps, such as omega-3 fatty acids, vitamin B1 and B6, plus vitamin E and magnesium. Talk to your healthcare professional before trying these.

When to see a doctor

Many people can manage menstrual cramps at home using self-care steps.

Speak to your doctor if:

• self-care methods and pain relief medications aren’t helping
• your periods are heavier or more painful than usual
• you have pain during sex or when peeing or pooing
• you’re bleeding between periods.

You should also speak to your doctor if you are worried that you may have an underlying condition that could be causing your symptoms.

Speak to a healthcare professional urgently if you have severe period or pelvic pain and painkillers aren’t helping.

How are menstrual cramps diagnosed?

Your doctor will ask you about your medical history and you may have a physical exam, including checking your pelvic area for signs of infection. You may also have an internal examination.

Certain tests may be needed, such as:

• ultrasound scan – to enable a closer look at your uterus (womb), cervix, ovaries, and fallopian tubes
• other imaging tests – that can include a CT or MRI scan to provide more detail of your reproductive organs
• laparoscopy – involves inserting a fiber-optic tube with a small camera lens into your abdomen to check for underlying conditions, such as endometriosis.

Treatments from your doctor

If your menstrual cramps are severe and can’t be managed with self-care, your doctor may recommend:

• anti-inflammatory medication such as naproxen
• hormonal birth control methods – such as the birth control pill, an intrauterine device (IUD), the ring, or the implant – to help make your period lighter and reduce the pain of menstrual cramps
• a transcutaneous electrical nerve stimulation (TENS) machine – this uses a small electric current to stimulate your nerves and reduce pain.

If your menstrual cramps are caused by an underlying condition then treatment will depend on the cause. For example, fibroids can be treated with medication to shrink the fibroids or surgery, and pelvic inflammatory disease will usually need to be treated with antibiotics.

Your doctor may refer you to a specialist if treatments aren’t working.

Support for menstrual cramps

Painful periods can impact your daily life – but there is support available from organizations and charities. These include:

• Office on Women’s Health (US) – for useful resources and information
• Jean Hailes For Women's Health (Australia) – provides lots of information and resources, from podcasts to fact sheets
• Wellbeing of Women (UK) – they run campaigns to increase awareness of menstrual health, along with sharing women’s stories and providing information.