Reviewed by The Wellness Team. Last reviewed October 2026.
Period pain is so common that many people assume they simply have to put up with it. Up to nine in ten women get some cramping, and for around one in five it is severe enough to disrupt work, sleep and daily life. Common does not mean untreatable, and severe pain is never something to just endure.
This guide explains what is normal, what is not, and the treatment that actually works.
What is normal and what is not
Normal period pain, called primary dysmenorrhoea, is cramping in the lower abdomen or back that starts as bleeding begins, peaks in the first day or two, and responds to simple painkillers and a hot water bottle. It is caused by prostaglandins, the chemicals that make the womb contract to shed its lining.
Pain deserves a proper assessment when it stops you living normally each month, is getting worse over time, comes with very heavy bleeding, pain between periods, pain during sex, pain opening your bowels or passing urine during your period, or difficulty conceiving. Those features raise the possibility of secondary causes such as endometriosis, adenomyosis or fibroids, all of which are common and all of which are worth finding.
Treatment that works
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The evidence supports a clear order:
- Anti-inflammatory painkillers such as ibuprofen or mefenamic acid, started as bleeding begins or just before, are the most effective first treatment because they block prostaglandins at the source
- Heat, whether a hot water bottle or a heat patch, has trial evidence comparable to simple painkillers
- Regular exercise, even gentle movement, reduces pain scores in studies
- Hormonal contraception, the pill, patch, ring or hormonal coil, is the most effective long-term option when contraception is also wanted, and often transforms severe periods
- Paracetamol alone is the weakest option, though reasonable if anti-inflammatories do not suit you
If pain continues despite these measures, that is the point to investigate rather than to push through.
What a GP can do
A consultation gives you a proper history and examination plan, the strongest painkiller options by prescription where appropriate, and a decision about whether an ultrasound scan is worthwhile. Endometriosis takes an average of around eight years to diagnose in the UK, mostly because pain gets normalised. A doctor who takes the history seriously shortens that dramatically.
Where a scan or a gynaecology opinion is needed, we arrange it and stay involved in the plan. A video consultation is £150, a telephone consultation is £59 and an in-person consultation is £220.
To talk to a doctor, message WhatsApp, call 020 3951 3429 or email team@thewellnesslondon.com.
Questions people ask
Why are my periods so painful?
Most period pain is primary, caused by prostaglandin-driven womb contractions with no underlying abnormality. Pain that is severe, worsening, or comes with heavy bleeding, pain between periods or pain during sex can signal endometriosis, adenomyosis or fibroids, and deserves assessment.
When should I see a doctor about period pain?
See a doctor if pain regularly stops you working, studying or sleeping, if over-the-counter treatment is not enough, if the pattern is changing or worsening, or if you have pain between periods, during sex, or trouble conceiving. You do not need to wait until it is unbearable.
Does the pill help period pain?
Yes. Hormonal contraception thins the womb lining and reduces prostaglandin production, and for many women it turns severe periods into light, manageable ones. The hormonal coil is particularly effective for heavy, painful periods.
Can endometriosis be ruled out with a scan?
Not completely. Ultrasound can find endometriomas and adenomyosis, but milder endometriosis often does not show on a scan. The history guides how far to investigate, and a normal scan does not mean your pain is not real or not treatable.
Can I get period pain treatment online?
Yes. A video or telephone consultation covers the history, first-line prescriptions and planning for any scan or referral. Physical examination and imaging are then arranged where needed.