Period pain (dysmenorrhoea)

A lot of people experience pain with their periods. The medical name for period pain is dysmenorrhoea. This can be anything from dull achy cramps to intense pain that feels unmanageable and cannot be easily relieved.

There are 2 types of painful period. These are known as;

• primary dysmenorrhoea
• secondary dysmenorrhea

Period pain should not be severe. Speak to your doctor if you're experiencing pain which is affecting your day to day life. For example, you can’t go to school or work or take part in day to day activities that you enjoy.

It can be helpful to keep a note of your period dates and symptoms using a calendar, a diary or an app. You can then discuss this with your doctor who can decide if any tests or treatments might be needed.

If you’re seeing your doctor, there are some useful pieces of information to think about beforehand:

• the first day of your last period (when it started)
• how many days your period usually lasts
• what was the shortest time between your periods (from the first day of one period to the first day of the next)
• what was the longest time between your periods (from the first day of one period to the first day of the next)
• how often you need to change your period products on a heavy day
• if you are over 25, when you had your last smear test

Period pain – primary dysmenorrhoea

Primary dysmenorrhoea is period pain which isn’t caused by any particular health condition. The pain usually begins when your period comes, but might start slightly before.

Symptoms

The main symptom of primary dysmenorrhoea is cramp or achy pains in your abdomen (tummy). You might also feel it in your lower back or the tops of your legs. You may have other symptoms when you get your period including:

• feeling tired
• feeling bloated – your tummy sticks out more than normal
• diarrhoea
• headaches
• mood changes

Further information about mental health and wellbeing

Treatment

There are lots of options for treating milder period pain such as:

• a hot water bottle
• gentle exercise
• pain relief, such as paracetamol or ibuprofen – always follow the manufacturer's instructions

Speak to your pharmacist for advice on pain relief. For more severe pain, there are other types of medications which are only available from your doctor.

It can be helpful to keep a note of your period dates and symptoms using a calendar, a diary or an app.

Period pain – secondary dysmenorrhoea

Secondary dysmenorrhoea is period pain that is caused by a health condition. Some women can start to experience more painful periods after years of ‘normal’ period pain.

If you experience severe period pain that stops you from doing day-to-day things, or that worries you at all, you should speak to your doctor. It's important to get checked if you have any worries – you don't need to suffer.

Symptoms

Symptoms can include:

• a change in your experience of period pain – your periods might be more painful, or the pain might last for longer
• a feeling of heaviness in your tummy, and/or back pain
• experiencing pain at other times during your cycle, not just during your period

You might have other symptoms with the pain such as:

• heavy periods
• irregular periods
• bleeding between periods
• unusual discharge
• painful sex, or bleeding after sex

If you experience any of these, speak to your doctor.

Diagnosis

Your doctor will usually examine you if they think that you have secondary dysmenorrhoea. This may involve an internal examination to check your womb (uterus) and pelvis as well as your tummy (abdomen). As this is a really intimate examination, the doctor who performs it will have another person (chaperone) present. You can ask for a female doctor to carry it out. If there isn’t a female doctor available, you can ask if there’s a female health professional who could carry out the examination.

The doctor will look for the possible cause of your painful periods. They may also suggest that they take some samples (swabs) during the examination to look for any signs of infection.

If your doctor thinks that you have secondary dysmenorrhoea, they may refer you to a specialist (usually a doctor called a gynaecologist). The specialist can investigate the likely underlying cause. The investigations that are carried out will depend on the likely underlying cause.

Some of the medical conditions your doctor might test for include:

• endometriosis – a long-term (chronic) condition where tissue similar to the lining of the womb is found elsewhere in the body.
• pelvic inflammatory disease – an infection of the womb, ovaries or/and fallopian tubes
• fibroids – growths that can develop in the muscular wall of the womb that are not cancerous
• adenomyosis – when the tissue that normally grows within the womb (the lining) grows into the muscular wall of the womb instead
• polycystic ovary syndrome – a hormonal condition

Treatment

Treatment for secondary dysmenorrhoea will depend on its cause. Your doctor will be able to advise on the best course of treatment for your symptoms and condition and they will discuss this with you. 

It's ok to ask any questions about your care to help you get the information you might need.

Contraceptive devices

Period pain can sometimes be caused by intrauterine devices (IUDs), especially in the first few months after insertion.

After an IUD insertion, your period might change and become more irregular, or last longer than normal. You also might bleed or spot in between periods. This is common with hormone-releasing IUDs. Some people might also experience pain during sex or a vaginal discharge.

If you experience any of these symptoms after having an IUD inserted, as well as period pain, you should speak to your doctor as soon as possible.