Menstrual Pain: Why Your Period Hurts and How to Relieve Symptoms

In medical terms, menstrual pain, menstrual cramps, or dysmenorrhea can condition the routine of people who experience it, so it is essential to identify the causes of pain and the methods to relieve it. This article will explain why menstrual pain occurs, what treatments can be applied, and when it is necessary to go to a specialist.

Before addressing the causes of menstrual pain, it should be clarified that there are two types of dysmenorrhea, primary and secondary. Primary dysmenorrhea is the pain that causes the period and is very common. Secondary dysmenorrhea is menstrual pain due to some abnormality or health disorder, such as endometriosis. In this article, we will refer mainly to primary menstrual pain.

What causes menstrual pain

Why does the period hurt? A fundamental aspect in the appearance of pain is the presence of ovulation; for this reason, the usual thing is that it does not arrive with the first period but within the following year.

In painful menstruation, the leading cause has been identified: increased production by the uterus of substances called prostaglandins. These substances are similar to those produced during childbirth for uterine contraction and are released by the uterine lining (endometrium) when it is preparing to detach. Prostaglandins cause the uterus to contract and relax so that the endometrium detaches and leaves the body (the period). An excess of this substance is what can lead to aches and pains.

On some occasions, this compound can enter the bloodstream and reach the intestines, causing the small intestine’s muscle tissue to contract and cause diarrhea.

What menstrual cramps are like

They are described as dull pressure associated with spasms or cramps inside the pelvis. It usually affects both sides, reaching the lumbar region and sometimes the upper thighs.

  • Mild cases: the discomfort lasts for a day.
  • Moderate cases: symptoms last 2 or 3 days and only occasionally alter daily activity.
  • Severe cases: lasts between 3 and 7 days, significantly interfering with daily activity and sometimes presenting unbearable menstrual cramps. Other symptoms such as vomiting, tiredness, headache, and pain in the lumbar region may also occur. In this-case, it would be necessary to visit with a specialist since there could be some health problem.

Menstrual pain is more frequent than it may seem since it affects women between 30 and 50%. It is more common and intense among those who have not given birth and, in general, decreases as age increases, regardless of whether you have given birth.

Other factors associated with painful periods are: having heavy bleeding, having long periods, having had your period at a very young age, or having irregular periods.

How to relieve menstruation pain

To remove paint from the period, it seeks to achieve one of these: reduce inflammation, limit the production of prostaglandins, block pain or increase blood flow in the uterus. For this, we have different remedies and treatments to apply according to the intensity and response of each patient to them:

  • Basic measures:
    • Local heat
    • Regular moderate exercise
  • The first line of treatment
    • Analgesics such as NSAIDs and Paracetamol
    • Hormonal treatment: Combined contraceptives or only based on gestates
  • The second line of treatment:
    • Electrostimulation (TENS)
    • GnRH analogs
    • Surgery
  • Supportive therapies
    • Acupuncture
    • Diet and food supplements

Heat for menstrual pain

The heat helps relax the uterus and, at the same time, improves blood flow. It can be applied with a hot water bottle on the belly or a bag of cherry bones. Some studies match their effectiveness to that of treatments such as Ibuprofen, with the advantage of combining them since they have no side effects.

Regular exercise practice

There is evidence of the benefit of exercise in reducing menstrual pain. The mechanism by which it occurs involves the increase in the production of natural progestogens and the decrease in the production of pain mediators, contributing to improved dysmenorrhea, especially in sedentary women, while improving other aspects of patients’ health.

What medications to take when our period hurts

Anti-inflammatories, such as Ibuprofen, are an effective way to relieve menstrual cramps because they inhibit the production of prostaglandins, which cause uterine contractions and inflammation.

Paracetamol can also be effective as an analgesic, but the absence of anti-inflammatory action makes its effectiveness less.

Electrostimulation (TENS) for menstrual pain

It consists of a small machine that sends a soft, low-voltage electric current over the skin. This alters the body’s ability to perceive pain signals and stimulates the natural production of endorphins. TENS is typical in rehabilitation, physiotherapy, and other pain units.

This treatment can be associated with pharmacological therapies increasing the effectiveness of both.


This is the final step of menstrual pain treatment. There are times when-surgery will be indicated as a diagnostic method to find the cause of dysmenorrhea (diagnostic laparoscopy), and at other times, it will be the method to eradicate the organic cause of that pain (hysterectomy, endometrial ablation, excision of foci of endometriosis )

Usual treatments of menstrual pain

As for the treatment of menstrual pain, women with mild symptoms who have not started sexual activity are usually prescribed anti-inflammatories and do not need to go to the gynecologist to undergo a genital examination.

In moderate or severe cases or women with sexual activity, it is advisable to visit the specialist since he will carry out a complete pelvic examination, being desirable the realization of an ultrasound. As we have mentioned before, sometimes pain can be a symptom of pelvic diseases such as endometriosis, ovarian cysts, uterine fibroids, complications of previous surgery, etc.

In almost all cases, except in women who wish to take contraceptives, anti-inflammatories are used between 3 and 6 months. Most respond to treatment (70-90%), and its effect begins to be noticed in 30-60 minutes, so the lack of response should make suspect the existence of an organic problem.

Finally, it is essential to underline the need to reassure the patient because most of the discomfort is related to ovulatory cycles and has a good prognosis in the medium term.