Some cramping during a period is common, but pain that stops you working, studying, sleeping or doing what you want is worth asking more questions about. Period pain that is severe, getting worse or comes with other symptoms can have an underlying cause, such as endometriosis or adenomyosis, and effective treatment is available either way.
If you are looking for painful periods treatment in Sutton Coldfield, this guide explains what a doctor considers. It is part of our women’s health service.
What is normal period pain?
Most women have some period pain at some point. It usually feels like cramping low in the tummy, sometimes spreading to the back or thighs, and is strongest in the first day or two. This is often called primary dysmenorrhoea. It is caused by natural chemicals that make the womb contract, it often starts within a few years of your first period, and it tends to ease with age.
Normal does not mean you have to put up with it. Pain that responds to simple measures, such as over-the-counter painkillers and warmth, and allows you to carry on with your life, is reassuring.
When is period pain a sign of something else?
Pain caused by an underlying condition is called secondary dysmenorrhoea. Signs that it is worth asking more questions include:
- pain that regularly stops you going to work, school or social plans
- pain that has got steadily worse over time
- pain that starts for the first time in your mid-20s or later
- pain before your period starts or after it ends, or pelvic pain at other times
- deep pain during or after sex
- painful bowel movements or pain passing urine during your period
- heavy or irregular bleeding alongside the pain
- difficulty getting pregnant
What conditions can cause painful periods?
Endometriosis
Tissue similar to the lining of the womb grows elsewhere, often in the pelvis. It can cause significant pain and affect fertility. Diagnosis often takes several years, partly because pain is dismissed as normal. A normal scan or examination does not rule it out.
Adenomyosis
Tissue like the womb lining grows into the muscle wall of the womb, often causing heavy and painful periods, usually in women in their 30s and 40s.
Fibroids
Non-cancerous growths in or around the womb can cause pain, pressure and heavy bleeding. Our guide on heavy periods: when to investigate covers these in more detail.
Pelvic infection
Pelvic inflammatory disease, often following a sexually transmitted infection, can cause pain, unusual discharge and fever. It needs prompt treatment to protect fertility.
A copper coil
Some women find their periods more painful with a copper coil, especially in the first few months.
How is the cause found?
It starts with a careful history: when the pain happens, what it feels like and what it stops you doing. A symptom diary over two or three cycles can be very helpful. Depending on your symptoms, a doctor may suggest:
- an examination, if you are comfortable with it
- swabs to check for infection
- a pelvic ultrasound scan
- referral to a gynaecologist if endometriosis is suspected, or if symptoms continue despite treatment
What treatments can help?
Treatment can often start while the cause is being looked into.
- Anti-inflammatory painkillers, available from a pharmacy if suitable for you, work best when started at the first sign of your period.
- Heat, gentle exercise and rest can ease cramping.
- Hormonal treatments, including some types of contraception and the hormonal coil, can reduce pain for many women. You can read about the procedure in what actually happens at a coil fitting.
- Specialist treatment, including surgery, where a condition such as endometriosis needs it.
When to see a doctor sooner
Contact a doctor promptly, or call NHS 111, if you have period or pelvic pain with a high temperature, unusual discharge, or pain that is new and different from your usual periods.
Call 999 or go to A&E if you have sudden, severe pain in your tummy, especially on one side, pain in the tip of your shoulder, or you feel faint or dizzy, and particularly if there is any chance you could be pregnant. These can be signs of an ectopic pregnancy or another emergency. Bleeding after sex or between periods should also be checked by a doctor.
This list is not exhaustive. If you are not sure about something, see a doctor.
How we approach this at Aarva
At Aarva you see a doctor first, and your pain is taken seriously. We listen to the whole story, examine you where it helps, arrange sensible investigations and explain what we think is going on.
Your plan is agreed with the doctor in the appointment, and any tests are priced before they are taken. We will tell you honestly if a treatment is unlikely to help. If a specialist opinion is needed, we will say so. See what to expect, meet our doctors, or explore our women’s health service.
Questions patients ask
How do I know if my period pain is endometriosis?
You cannot tell from pain alone, but severe period pain, pain during sex, painful bowel movements during your period and difficulty getting pregnant can all point towards it. A doctor can assess your symptoms and advise whether a specialist referral is needed.
Can a scan rule out endometriosis?
No. An ultrasound can find some forms of endometriosis and other causes of pain, but a normal scan does not exclude it. If your symptoms suggest endometriosis, a referral may still be appropriate.
Should I keep a pain diary?
Yes, it helps. Note when the pain starts and stops, how severe it is, what helps, your bleeding and any bowel, bladder or sex-related symptoms over two or three cycles.
Is it normal to miss work because of period pain?
It is common, but it is not something you should have to accept. Pain that regularly disrupts your life is a good reason to see a doctor.
If period pain is shaping your month, a conversation with a doctor is the right first step. Book a consultation, or find your starting point if you are not sure which appointment you need.
This article is general information and does not replace a consultation with a doctor.
