Painful Periods Are Common, but They Are Not Always Normal

Period pain is one of the most frequently dismissed symptoms in women's health. Many women grow up being told that painful periods are simply something to endure, and that reaching for a painkiller and a hot water bottle is the extent of what can be done. While some degree of menstrual discomfort is indeed normal, pain that significantly interferes with your daily life deserves proper investigation.

When is period pain "normal"?

Primary dysmenorrhoea — period pain without an underlying cause — is very common, particularly in younger women. It is caused by prostaglandins, chemicals that trigger uterine contractions to shed the womb lining. This type of pain typically begins with your period and lasts one to three days.

It becomes a concern when:

• The pain is so severe that it regularly prevents you from attending work, school, or social activities
• Standard painkillers (ibuprofen, paracetamol) do not adequately control it
• The pain is getting progressively worse over time
• Pain occurs at other times in your cycle, not only during your period
• You also experience heavy bleeding, pain during sex, or bowel or bladder symptoms around your period

What could be causing it?

Secondary dysmenorrhoea — period pain caused by an underlying condition — has several possible causes:

• Endometriosis: The most common cause of severe period pain in younger women
• Adenomyosis: A condition where the womb lining grows into the muscle wall of the uterus, causing heavy and painful periods
• Fibroids: Depending on their location, fibroids can contribute to both pain and heavy bleeding
• Pelvic inflammatory disease: Infection of the reproductive tract, often caused by untreated STIs

What should you do?

If your period pain is affecting your quality of life, the first step is a thorough gynaecological assessment including a detailed history, examination, and pelvic ultrasound. In many cases, a clear diagnosis can be reached without invasive procedures, and effective treatment can begin.