What is period pain?

Period pain (dysmenorrhoea) is usually felt in your lower abdomen (tummy).

Many people will have some form of pain during their period. Some people experience mild discomfort while others have severe pain.

Your period pain is normal if:

• it happens on the first 2 days of your period
• it doesn't affect your daily life
• it goes away with self-care measures — such as pain-relief medicines or using a hot pack

What symptoms are related to period pain?

There is a wide range of how period pain feels and how severe it is. It may feel like cramps, heaviness or a constant, dull pain in your abdomen.

You may also get pain in your stomach, back and thighs.

You may also have:

• nausea or vomiting
• diarrhoea
• paleness
• fatigue (tiredness)
• insomnia (sleep problems)
• premenstrual syndrome (PMS)

Period pain may affect more than 9 out of 10 people who have periods.

What causes period pain?

There are 2 types of period pain:

1. Primary dysmenorrhoea — pain caused by prostaglandins (chemicals made in the lining of your uterus that cause it to contract)
2. Secondary dysmenorrhoea — pain due to a health condition.

Primary dysmenorrhoea

Primary dysmenorrhoea is the more common type of period pain. It typically:

• feels like crampy pain in your lower abdomen
• happens just before or during your period
• lasts 8 to 72 hours
• starts 6 to 12 months after first getting your period

The pain is caused by contractions (tightening) of the muscle in your uterus. These contractions help your uterus shed its lining during a period. The contractions are caused by natural prostaglandins.

You are more likely to have primary dysmenorrhoea if:

• you started your periods before 12 years of age
• you are aged under 30 years
• your body mass index (BMI) is low (less than 20) or high (over 30)
• you haven't given birth before
• you smoke
• other people in your family have painful periods

Secondary dysmenorrhoea

This type of period pain is caused by an underlying medical condition that affects your uterus. Conditions that can cause painful periods are:

• endometriosis — when tissue from the lining of your uterus (womb) also grows in other parts of your body
• adenomyosis — when the cells that normally line the inside of your uterus also grow in the layer of muscle in the wall of the uterus
• fibroids — when you have non-cancerous growths in the muscle layer of your uterus (womb)
• pelvic inflammatory disease — which is often caused by sexually transmitted infections

How is the cause of period pain diagnosed?

Your doctor will ask about your symptoms and may do a physical examination. They may recommend tests for some people, such as:

• blood or urine tests
• an ultrasound scan

When should I see my doctor?

See your doctor if your period pain stops you going to work or school.

It's helpful to make a record of:

• when you get your period
• how long it lasts
• how heavy your period is
• how your period pain affects you

You should also see your doctor if you have any of the following:

• you start to get period pain when you haven't had it in the past
• your period pain gets worse
• your period pain lasts longer than it used to
• you have pain (similar to period pain) between periods
• you have pain during sex
• you bleed between periods or have irregular periods

Your doctor should do their best to listen to you and take your concerns seriously. If this doesn't happen, do not be afraid to find a new doctor.

How is period pain treated?

There are many ways to treat period pain.

Self-care at home

You can help reduce period pain by trying the following:

• using a heat pack or hot water bottle
• having a warm bath or shower
• regular, gentle exercise — 45 to 60 minutes, 3 or more times a week
• relaxation techniques to lower stress

Medicines for period pain

Over-the-counter medicines can give relief from period pain. Non-steroidal anti-inflammatory drugs (NSAIDs) stop the enzyme that makes prostaglandins, which cause your period pain. They should be taken:

• 1 to 2 days before your period starts
• regularly for your first 2 to 3 days of bleeding

Some examples of NSAIDs are ibuprofen, naproxen and mefenamic acid.

These medicines are not appropriate for some people. Ask your doctor or pharmacist if they are safe for you.

Other treatment options

Painful periods can be treated with combined hormonal contraception such as:

• the oral contraceptive pill (OCP, or 'the pill')
• a contraceptive vaginal ring

Long-acting reversible contraception can also be used to treat painful periods. Options include:

• a hormonal intrauterine device (IUD)
• contraceptive implants
• contraceptive injections

Some alternative therapies have also been shown to help painful periods, such as:

• high frequency transcutaneous electrical nerve stimulation (TENS)
• ginger — which also helps reduce nausea and vomiting
• dietary supplements — thiamine, pyridoxine, magnesium or fish oil
• physiotherapy
• acupuncture or acupressure

Always check with your doctor before starting any complementary or alternative treatments.

Complications of period pain

People with bad period pain are more likely to get other chronic (ongoing) pain conditions, such as:

• irritable bowel syndrome (IBS)
• low back pain
• fibromyalgia
• chronic headaches
• chronic fatigue syndrome

Resources and support

Learn more about the menstrual cycle on the Jean Hailes for Women's Health website.

If you have any concerns about your periods, go to your doctor or local sexual health clinic.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.