Period Pain: What Helps and what Does not

Almost every woman gets cramps at some point. The NHS explains that period pain happens when your womb tightens during your period, and that this is often a normal part of the menstrual cycle. What is not normal is pain bad enough to keep you off work, school or your daily routine.

What actually helps with period pain?

The NHS lists these self-care steps:

• Have a warm bath or shower
• Put a heat pad or hot water bottle wrapped in a cloth on your tummy
• Massage your tummy and your lower back
• Do gentle exercise such as walking, swimming, cycling or yoga
• Use simple painkillers you can buy at a pharmacy, taking them as the packet says. Ask the pharmacist which one suits you, especially if you have stomach or kidney problems, asthma, or you are pregnant or might be.

Gentle exercise surprises people, because moving is the last thing you feel like doing. But it is on the NHS list, and a short walk is enough to count. Heat is the other one worth trying first, because it is cheap, safe and works within minutes for many women.

What does not help?

The NHS notes that cutting down on alcohol and stopping smoking may help period pain, so carrying on with either is working against you.

The bigger thing that does not help is quietly putting up with it. Many women in Pakistan are told that severe period pain is just part of being a woman and that nothing can be done. That is not what the health evidence says. Pain that stops your normal activities, gets worse over time, or does not respond to painkillers is a reason to be examined, not a reason to lie down and wait.

Also be careful with unlabelled powders, "period tonics" or remedies sold without a pharmacist's advice. If you do not know what is in something, do not take it while you are also taking painkillers.

Could there be another cause?

Sometimes painful periods are caused by an underlying condition rather than the normal cycle. The NHS names endometriosis, adenomyosis, fibroids and pelvic inflammatory disease. An intrauterine device (IUD) can also cause period pain, particularly in the first 3 to 6 months after it is fitted.

Endometriosis is worth knowing about because it is often missed for years. The NHS lists its signs as severe period pain that stops you doing normal activities, heavy periods where you need to change a pad or tampon every 1 to 2 hours, pain in the lower tummy and back, pain when passing stool or urine, pain during or after sex, extreme tiredness, and difficulty getting pregnant. The NHS says it can take a long time to diagnose and may need several different tests, so keep going back if you are not getting answers.

What counts as a heavy period?

The NHS says you may have heavy periods if you need to change your pad or tampon every 1 to 2 hours, or your periods last more than 7 days. Heavy periods are one of the very common causes of iron deficiency anaemia, and the NHS says blood tests may be done to check for it. So if you are both bleeding heavily and constantly exhausted, mention both things together to the doctor.

When to see a doctor

The NHS advises asking for an urgent appointment if your pelvic pain or period pain is severe, or worse than usual, and painkillers have not helped.

Book a routine appointment if:

• Your periods have become more painful, heavier or irregular
• Period pain stops you doing your normal daily activities
• You have pain during sex, when passing urine, or when passing stool
• You bleed between periods
• Your bladder or bowel habits have changed
• Your tummy is swollen, you have lost your appetite, or you are losing weight without trying

If you have sudden, severe pelvic pain with fever, fainting or heavy bleeding, treat it as an emergency: call Rescue 1122 where available, or go to the nearest hospital emergency department.