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Women's Health

Period Pain: Separating Myth From Guidance

Period Pain: what people commonly get wrong, set against what published UK guidance says.

Dr Amara Nwosu, PhD, RD Editor-in-chief and registered dietitian 3 min read 6 views
Period Pain: Separating Myth From Guidance

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.

What the guidance actually says

These are the numbers the corrections below are measured against.

Published figures for Period Pain
MeasureFigure
Mechanismprostaglandin-driven uterine contractions
Most effective over-the-counter optionNSAIDs such as ibuprofen or naproxen
Best timingstart the day before, or at the first twinge
Also supportedheat pads, regular activity, hormonal contraception, TENS
Endometriosis prevalenceroughly 1 in 10 women of reproductive age

Where people go wrong

All of these come up regularly. All of them run against the published position.

  • 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

What to do instead

  • 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

The part that is genuinely uncertain

Guidance changes, and it changes because evidence does. The figures above reflect current UK guidance from the bodies named at the foot of this page; where those bodies revise their position, theirs is the account to follow rather than this one.

Where to go next

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

  • NICE — Dysmenorrhoea clinical knowledge summary
  • NICE — Endometriosis: diagnosis and management

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.

Dr Amara Nwosu

Editor-in-chief and a registered dietitian of fourteen years. Spent six of them in NHS outpatient clinics, which is where she learned that the advice people actually follow beats the advice that is technically optimal.

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