Period pain: what is normal and what is not

Many women have cramping during their period, caused by the womb contracting. It is usually strongest in the first day or two. What is not typical is pain severe enough to keep you from school, work or sleep every month.

What usually helps

• A warm compress or hot water bottle on the lower abdomen
• Gentle activity such as walking or stretching
• Simple pain relief taken early rather than waiting for pain to peak. Ask a pharmacist which option suits you, particularly if you have asthma or stomach problems.
• Staying hydrated and getting enough sleep around your period

Hormonal contraception is sometimes used to reduce painful or heavy periods, and is worth discussing if pain is affecting your life.

Signs worth a consultation

• Pain that does not respond to usual pain relief, or that is getting worse over months
• Bleeding so heavy you soak through protection hourly, or pass large clots
• Periods lasting longer than about seven days
• Bleeding between periods or after sex
• Pain during sex or when passing urine or stool
• Difficulty becoming pregnant alongside painful periods
• Periods that stop for several months without pregnancy

Conditions behind severe period pain

Endometriosis, fibroids, adenomyosis, ovarian cysts and pelvic infections can all cause significant pain and heavy bleeding. These are diagnosed with an examination and sometimes an ultrasound or other tests. Many are very treatable, but they are often missed for years because pain gets dismissed as normal.

Tracking helps your clinician

Note when your period starts and ends, how heavy it is, where the pain is, how bad it gets, and anything that makes it better or worse. A few months of records turns a vague conversation into a clear picture.

Iron and heavy periods

Regular heavy bleeding can lead to low iron, causing tiredness, breathlessness, dizziness and pale skin. A simple blood test checks this. Do not start iron supplements long-term without advice, since the cause of low iron should be identified.

Seek urgent care for

Severe sudden pelvic pain, pain with fever, fainting, or heavy bleeding with dizziness. In early pregnancy, one-sided pelvic pain with bleeding needs same-day assessment to rule out an ectopic pregnancy.