Is period pain normal? When to get help

Period pain that stops your usual activities needs medical advice, as Cleveland Clinic’s guide to cramps explains. Some discomfort is common. What matters is how much the pain affects your day.

“Normal” is not a helpful word when you’re deciding whether to cancel work or get through a school day. Describe what the pain is doing to you. Other people’s cramps say little about how you are coping with yours. You can ask for help without knowing the medical name for the problem.

How quickly to get help

Use the advice below to decide how fast to get help. Outside the UK, use the local GP, urgent care or emergency service where you live.

Get emergency help now

The NHS says to get emergency care for severe or worsening pelvic pain, or pain when you move or touch the area. The same goes for pelvic pain with faintness, pain at the tip of your shoulder, trouble breathing, heavy vaginal bleeding or sudden confusion. In the UK, call 999 or go to A&E. Elsewhere, call your local emergency number.

Emergency signs come before the urgent advice below. Don’t wait to try another painkiller first.

Ask for urgent advice

• If your period or pelvic pain is severe or worse than usual and painkillers haven’t helped, ask for an urgent GP appointment or contact NHS 111 in England.
• If you have pelvic pain and you could be pregnant, or you have a very high temperature or shivering, contact NHS 111 in England or local urgent care.

Book a GP appointment

The NHS says to see a GP about these symptoms and changes:

• Your periods have become more painful, heavier or irregular.
• Pain stops your usual daily activities.
• You have pain during sex, or when you pee or poo.
• You bleed between periods.
• How often you pee or poo has changed.
• Your tummy is swollen, you’ve lost your appetite or you’re losing weight without trying.

If your bleeding has also got heavier, heavy periods and when to get help can help you describe it. Mention the pain and the bleeding together at the appointment. You don’t have to pick which one is the “main” problem first.

Primary and secondary cramps

Dysmenorrhoea is the medical word for painful periods. There are primary and secondary types of period pain. Primary dysmenorrhoea means cramps that aren’t caused by another health condition. Chemicals called prostaglandins make the muscles of the womb tighten and relax, and this causes cramps. Secondary dysmenorrhoea means period pain caused by an underlying condition.

Primary cramps tend to start near the beginning of bleeding. Secondary pain may start earlier and last longer, says Cleveland Clinic’s dysmenorrhoea guide.

A clinician may check for causes of secondary pain. These include endometriosis and fibroids (growths in or around the womb that are not cancer). They also include adenomyosis (tissue like the womb lining growing in the womb’s muscle) and pelvic inflammatory disease, or PID (an infection of the reproductive organs). Cramps and their timing can’t show the cause or which treatment might help. A clinician needs to look at your full history. If endometriosis is one of the possible causes, read about endometriosis symptoms and keeping a symptom diary.

Pain that comes every period is still worth talking about if it gets in the way of your life.

Warmth, movement and pain relief

Try a warm bath or shower, or a hot water bottle wrapped in a tea towel on your tummy. Gentle movement, such as walking, and massage may help too. These are some of the NHS tips for easing period pain.

You don’t need to try everything at once. Pick something easy and jot down whether it helped. If you’ve tried these things and they didn’t help enough, say so at your appointment. That is not your fault.

Paracetamol or ibuprofen may help with the pain. Follow the packet or leaflet. Ask a pharmacist if you aren’t sure which medicine suits you. The NHS advice on ibuprofen explains that some health conditions and other medicines can make it unsuitable. If you’re pregnant, avoid ibuprofen unless a doctor or pharmacist says it’s OK.

Don’t take more than the instructions say because the cramps still hurt. Ask for advice about what to do next. Tell a pharmacist what you took, when you took it and whether it helped. Bring the packet if you can’t remember the medicine’s name.

What happens at the GP appointment

The GP will start by asking about your symptoms and medical history. Depending on what they find, you may be offered a pelvic examination, an ultrasound or other tests. MedlinePlus explains how clinicians look into severe period pain.

Treatment may include prescribed pain relief, or hormonal contraception to ease period pain. If there is an underlying condition, treatment will depend on what is found. Tell the GP what you need and ask about anything you’re unsure of. If you’re offered contraception for pain, you don’t have to want it for any other reason.

Before you agree to a plan, ask what the treatment should change, what side effects it might have and when it will be reviewed. The NHS appointment guide suggests asking what your options are, what the results mean and what follow-up to expect. Ask who to contact if things get worse while you wait for a test or referral.

A short description of the pain is enough to start. MedlinePlus suggests noting where and when symptoms happen, how long you’ve had them and what has changed. Write down what you have tried. Bring a list of your medicines, including ones you bought without a prescription.

Not sure how to start? You could say: “The cramps used to be manageable, but lately I’ve had to leave work.” Add the dates you know, and say when you’re guessing. You can also describe one day, without comparing it with an earlier period. For example: “I couldn’t concentrate in class because of the pain.” These are only examples to help you explain what happened.

Use the appointment preparation guide to put your symptoms, dates, medicines and questions together. Put your main question at the top of your note. Leave space to write down the next step you agree on.