Patient education: Painful periods (The Basics)

Why do I have pain during my period? — 

During your period, your body makes chemicals called "prostaglandins." They cause the uterus to contract or tighten. It's the same kind of contraction that happens during labor and childbirth.

It's normal to have cramps during your period. These are often called "menstrual" cramps. Cramps can be mild or painful. The medical term for painful periods is "dysmenorrhea."

Some medical conditions can make the pain during your period worse. The most common one is "endometriosis." In this condition, cells that should grow only in the uterus grow outside the uterus.

What do painful periods feel like? — 

People with painful periods have cramping in the lower belly. The cramps can be mild or serious. You might also have pain in your back or thighs. Pain often starts with your period or right before your period.

Some people also have:

●Nausea

●Diarrhea

●Extreme tiredness

●Headache

●Bloating (a feeling of fullness in the belly)

Will I need tests? — 

It depends. Your doctor or nurse will probably start by doing a physical exam. They will check the size and shape of your vagina, cervix, uterus, and ovaries (figure 1). If the exam finds any problems or you have pain that isn't helped by medicines, they might do other tests, too.

Your doctor or nurse will decide which tests you should have based on your age, other symptoms, and situation. Tests can help them figure out if your pain is caused by something other than your period.

Possible tests include:

●Pelvic ultrasound – This uses sound waves to create pictures of your uterus, ovaries, and vagina to see if they look normal.

●Tests for infections you can catch during sex

●Laparoscopy – This is a type of surgery. The doctor will give you medicines to make you sleep. Then, they will make a small cut ("incision") just below your belly button. They will use a thin tool with a camera on it (called a "laparoscope") to see inside your belly.

How are painful periods treated? — 

It depends on what is causing them. If you have pain related to a specific condition, you might need treatment for that problem.

For pain related to your period, the most common treatments are:

●Pain medicines – Pain medicines such as ibuprofen (sample brand names: Motrin, Advil) or naproxen (brand name: Aleve) can help relieve cramps. Start taking them as soon as symptoms begin. Keep taking them for 2 or 3 days.

●Birth control – For people who do not want to get pregnant, certain birth control medicines can help reduce pain. Options include pills, skin patches, vaginal rings, intrauterine devices ("IUDs"), implants, and injections. Doctors can prescribe these medicines even if a person is not sexually active.

●Heat – You can put a heating pad or hot water bottle on your lower belly. Be careful to not burn your skin.

●Get regular physical activity – Exercise can sometimes help with pain. Even gentle forms of exercise, like walking, are good for your health.

If these things do not work, your doctor might suggest other treatments, such as:

●TENS therapy – Small patches called "electrodes" are placed on your skin. A machine delivers a very low electric current to your skin through the patches.

●Medicines to stop your periods

What else can I do on my own? — 

In addition to the treatments above, some people find other things help, too. There is not a lot of evidence for these things, but they are not likely to cause harm. Examples include:

●Counseling, which can help you learn ways to cope with pain

●Acupuncture

●Massage, yoga, or stretching

●Healthy diet

When should I call the doctor? — 

Call your doctor or nurse for advice if:

●Your pain gets worse.

●You still have pain after taking pain medicines.

●Your periods are very heavy.

●You also have pain at other times besides during your period.

●You have vaginal symptoms that bother you, such as unusual discharge.

More on this topic

Patient education: Menstruation (The Basics)
Patient education: Heavy periods (The Basics)
Patient education: Absent or irregular periods (The Basics)
Patient education: Endometriosis (The Basics)
Patient education: Uterine fibroids (The Basics)
Patient education: Pelvic ultrasound (The Basics)
Patient education: Chronic pelvic pain in females (The Basics)
Patient education: Choosing birth control (The Basics)

Patient education: Painful menstrual periods (dysmenorrhea) (Beyond the Basics)
Patient education: Heavy periods (Beyond the Basics)
Patient education: Absent or irregular periods (Beyond the Basics)
Patient education: Endometriosis (Beyond the Basics)
Patient education: Uterine fibroids (Beyond the Basics)
Patient education: Chronic pelvic pain in females (Beyond the Basics)
Patient education: Birth control; which method is right for me? (Beyond the Basics)