A Working Checklist for Period Pain
Period Pain: what is worth doing, what is worth avoiding, and when to stop and see a doctor.
Cramping caused by prostaglandin-driven contractions of the uterus during a period. Pain severe enough to stop you functioning is not something to put up with, and is routinely dismissed for years before endometriosis is considered.
Key takeaways
- Mechanism: prostaglandin-driven uterine contractions
- Most effective over-the-counter option: NSAIDs such as ibuprofen or naproxen
- Most useful single change: Start an NSAID before or at the first sign of pain.
- Commonest mistake: NSAIDs if you have had a stomach ulcer, NSAID-sensitive asthma or kidney disease, without advice.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Do
- Start an NSAID before or at the first sign of pain
- Use a heat pad alongside painkillers
- Keep a pain and symptom diary before seeing a GP
- Ask directly about endometriosis if pain is severe or worsening
Do not
- NSAIDs if you have had a stomach ulcer, NSAID-sensitive asthma or kidney disease, without advice
- Accepting "periods are just painful" if it stops you functioning
- Combining two different NSAIDs
The numbers behind the list
Those two lists follow from the published figures here.
| Measure | Figure |
|---|---|
| Mechanism | prostaglandin-driven uterine contractions |
| Most effective over-the-counter option | NSAIDs such as ibuprofen or naproxen |
| Best timing | start the day before, or at the first twinge |
| Also supported | heat pads, regular activity, hormonal contraception, TENS |
| Endometriosis prevalence | roughly 1 in 10 women of reproductive age |
If you change one thing
Start an NSAID before or at the first sign of pain. That is the opening item above. Doing only that is still doing something.
Where to go next
- Period Pain in Five Minutes
- The Evidence on Period Pain, Without the Hype
- Period Pain — the reference entry
- Heavy Periods: What the Evidence Actually Says
- Menopause: What Published Guidance Supports
When to speak to a doctor
See a GP if period pain stops you going to work or school, is not controlled by over-the-counter painkillers, has worsened over time, or comes with pain during sex, pain opening your bowels, heavy bleeding or difficulty conceiving. Seek urgent care for severe sudden pelvic pain, pain with fever or fainting, or any chance you are pregnant — sudden severe one-sided pain in early pregnancy can indicate an ectopic pregnancy.
Where this comes from
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.
Spotted something wrong? Report an error on this page. We correct on the page and say what changed.
