Period Cramps: What Actually Helps

Period cramps affect a large share of women and girls, and for some the first day or two means lying curled up with a hot water bottle. The internet offers a hundred remedies. Here are the ones with reasonable evidence behind them, roughly in the order worth trying.

Why periods hurt

Before and during your period, the lining of your womb releases prostaglandins. These chemicals make the womb muscle contract to shed the lining, and they narrow its blood vessels. Stronger contractions and less blood flow mean more pain. People with higher prostaglandin levels tend to have worse cramps.

Cramps that start with your first periods, and with no underlying condition, are called primary dysmenorrhoea. Pain caused by a condition such as endometriosis or fibroids is secondary dysmenorrhoea, and it needs a doctor.

What helps

1. Anti-inflammatory painkillers, taken early. These block prostaglandin production, which targets the cause of the cramps. They work best when you start them at the first sign of pain or bleeding, rather than waiting until the pain peaks. Ask a pharmacist which suits you, especially if you have asthma, gastric problems or kidney problems.

2. Heat. Warmth on the lower belly or back relaxes the womb muscle and dulls the pain. A small trial found steady low-level heat worked about as well as ibuprofen, and many people combine the two. How to do it: heating pad for period cramps. If you feel it mostly in your back, heat for lower back pain covers placement.

3. Exercise. Research reviews suggest that regular exercise through the month, such as walking, cycling or yoga three times a week, can reduce period pain. During your period, gentle movement often helps more than lying still.

4. TENS. A small battery device that sends mild electrical pulses through pads on the skin. Some people find it takes the edge off cramps. Physiotherapists can show you how to use one. The two compared: heat pad vs TENS.

5. Hormonal treatment. The pill, a hormonal IUD or other hormonal options thin the womb lining and can reduce period pain a lot. These need a doctor’s prescription and a conversation about what suits you.

Worth knowing

• Sleep and stress both affect how strongly you feel pain. A bad week often means worse cramps. On winding down, see warmth before bed.
• Supplements and herbal remedies like ginger have some small studies behind them, but the evidence is weaker. Check with a pharmacist before combining them with other medicines.
• Smoking is linked with more painful periods.
• Cramping that isn’t from your womb behaves differently. See heat for stomach ache and heat for IBS cramps.

See a doctor if…

• The pain regularly stops you working, studying or sleeping
• Painkillers taken early plus heat don’t bring it down
• Your periods have become more painful over the years, or started hurting in your late 20s or later
• You have pain between periods, during sex, or when you pass urine or stool during your period
• Your bleeding is very heavy, with clots, or you feel tired and breathless (possible anaemia)

Endometriosis in particular often goes undiagnosed for years because people assume severe period pain is normal. It isn’t, and treatments exist. A GP, polyclinic or gynaecologist is the place to start.

Go to A&E if…

• You have sudden, severe pain on one side, especially if your period is late or you could be pregnant
• Pain comes with fever, fainting or very heavy bleeding

Clinically reviewed by: Nigel Chua (Hand Occupational Therapist) & Louise Yow (Physiotherapist). This article is general information, not a diagnosis. electricheatpad.com sells electric heat pads.