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Women's health Symptom

Menstrual cramps / painful periods

Painful periods (dysmenorrhoea) affect up to 80% of women at some point and are one of the most common reasons for time off work or school among young women. While some pain around menstruation is normal, severe pain that disrupts daily life is not something you simply have to endure. A range of medical, complementary and lifestyle approaches can significantly reduce period pain.

See therapies that may help

What is Menstrual cramps / painful periods?

Dysmenorrhoea is classified as primary (period pain without an underlying pathological cause) or secondary (pain caused by an underlying condition such as endometriosis, fibroids or adenomyosis).

Primary dysmenorrhoea — the most common form — is caused by prostaglandins produced by the uterine lining, which cause uterine contractions and reduce blood flow to the uterus. Pain typically begins a day or two before the period and improves within 2–3 days of it starting.

Severe or worsening period pain, pain that occurs at times other than menstruation, or pain accompanied by heavy bleeding, should be assessed by a GP to rule out underlying conditions such as endometriosis, which requires specialist management.

Signs and symptoms

Period pain typically involves:

  • Cramping pain in the lower abdomen, starting 1–2 days before or at the onset of menstruation
  • Pain that may radiate to the lower back or thighs
  • Associated symptoms: nausea, diarrhoea, headaches, fatigue
  • Primary dysmenorrhoea typically improves over the course of the period and often improves with age or following pregnancy

Features suggesting secondary dysmenorrhoea (warranting medical assessment): pain getting progressively worse over time, pain between periods or during sex, heavy or irregular bleeding, pain not responding to standard analgesia.

How therapy can help

For primary dysmenorrhoea, a combination of approaches is typically most effective:

  • NSAIDs (ibuprofen, naproxen) — the most evidence-based pharmacological option, reducing prostaglandin production. Most effective when started 1–2 days before the period is due rather than waiting until pain begins
  • Heat therapy — a heated pad or hot water bottle applied to the lower abdomen has good evidence for pain relief comparable to ibuprofen
  • Acupuncture — good evidence for reducing primary dysmenorrhoea; NICE recommends acupuncture for period pain
  • TENS therapy — high-frequency TENS has evidence for reducing period pain
  • Yoga and exercise — regular aerobic exercise and specific yoga practices have evidence for reducing period pain severity
  • Massage therapy — abdominal and lower back massage during menstruation can reduce cramping
  • Nutritional approaches — omega-3 fatty acids, vitamin D and magnesium have some evidence for reducing period pain

Seeking help

If period pain is severe, worsening, or not responding to standard analgesia, see your GP. Ruling out endometriosis or other secondary causes is important, as these require specific treatment. For primary dysmenorrhoea, a physiotherapist, acupuncturist or nutritionist with women's health experience can provide effective complementary support.

Therapies that may help with Menstrual cramps / painful periods

Showing 13 therapies linked to Menstrual cramps / painful periods.

Therapy Evidence Notes
Maya Abdominal Therapist
limited

Supportive bodywork; ensure medical screening for severe symptoms.
Abdominal-Sacral Masseuse
moderate

Abdominal/sacral massage for menstrual pain.
Acupuncturist
moderate

Used for menstrual pain; some evidence.
Cognitive Behavioural Therapist
moderate

CBT for menstrual pain psychological component.
Herbal Medicine Practitioner
moderate

Herbal approaches for menstrual pain.
Massage Therapist
moderate

Commonly used for menstrual cramps.
Mindfulness Practitioner
moderate

Mindfulness for menstrual pain.
Reflexologist
moderate

Used for menstrual cramp support.
Shiatsu Practitioner
moderate

Used for menstrual pain.
Yoga Therapist
moderate

Yoga for menstrual pain.
Aromatherapist
limited

Sometimes used for menstrual discomfort.
Homeopath
limited

Used for menstrual cramp support.
Hypnotherapist
limited

May help menstrual pain via relaxation.

Frequently asked questions

Is severe period pain normal?

Some degree of period pain is common and normal. Severe pain that prevents you from going to school, work or performing normal activities is not something you simply have to accept. It warrants assessment to rule out underlying conditions such as endometriosis, and active treatment to improve quality of life.

Can acupuncture really reduce period pain?

Yes — acupuncture has a reasonable evidence base for primary dysmenorrhoea, with multiple trials showing reduced pain scores and reduced need for analgesia. NICE recommends acupuncture for period pain. A course of treatment before the expected period, as well as during menstruation, tends to produce the best results.

Does exercise help period pain?

Yes — regular aerobic exercise throughout the month (not just around periods) has evidence for reducing primary dysmenorrhoea. It works through effects on prostaglandins, endorphins and blood flow. Some women find exercise during their period uncomfortable, but gentle movement and yoga can actively reduce cramping.

Can diet affect period pain?

Yes — diets high in omega-3 fatty acids (oily fish, flaxseed) and low in inflammatory foods may reduce prostaglandin production and period pain severity. Magnesium-rich foods may reduce uterine cramping. Reducing caffeine and alcohol around menstruation also helps some women.

When should period pain be investigated?

Period pain that is severe, worsening over time, not responding to standard pain relief, accompanied by heavy bleeding, or occurring outside of menstruation should be assessed by a GP. These features can indicate endometriosis, fibroids or adenomyosis — conditions that benefit from specific diagnosis and management.