Monthly period pain can be very severe. Over 50% of menstruating women get period pain (dysmenorrhoea) at some time. However, effective treatments are available and distressing symptoms should be a thing of the past.

Two types of period pain

'Primary dysmenorrhoea' is the most common type. It usually begins in adolescence, within 6-12 months of the first period. Pain typically commences at the start of a period, and lasts one or two days. The pain is usually crampy and is felt mainly in the lower abdomen, lower back and thighs. There may also be nausea, vomiting and diarrhoea. Primary dysmenorrhoea is caused by high levels of prostaglandins (natural hormones) and improves with increasing age and childbirth.

'Secondary dysmenorrhoea' generally starts later in life after a number of pain-free years. It is caused by an underlying condition, such as endometriosis or infection. It is often a dull pain and may cause painful intercourse. This condition needs full assessment by your doctor.

Treatment of period pain

• Lifestyle changes. Period pain is more common in smokers and quitting often helps. Other successful strategies include regular exercise and stress reduction, eg yoga.
• Medicines that reduce the prostaglandin levels, eg naproxen, mefenamic acid, ibuprofen, give good relief for most women and work best if taken at the first sign of pain or bleeding.
• For women who also need contraception, the contraceptive pill is a very effective option and gives relief in 90% or more cases.
• For severe pain, bed rest and a hot-water bottle may help. Acupuncture and TENS treatment (nerve stimulation) can give relief in some cases.

See your doctor if you think you may have secondary dysmenorrhoea or if your pain does not respond to treatment.