Mother nature is a wonderful thing - period pain isn’t - so we’ve got the lowdown on the causes & all-important treatments


From the moment we’re graced with mother nature during our pre and early teens, right up until menopause begins, we can be faced with hormone fluctuations which can result in PMS, not forgetting the oh-so wonderful period pains.


For some of us, period pain is mild or even non-existent (you’re the lucky ones), but for others, cramps can impact our everyday lives. 


So what triggers them? There are many reasons behind menstrual cramps, so take a look at all things periods and get to know your womb.


What is period pain?


Period pain is a common and natural part of many women’s menstrual cycle but it’s no joke. In fact, if you’re someone who only experiences mild or zero pain, we’re eternally envious.  


Usually felt in your tummy, cramps can be intense spasms or a consistent dull ache. Although they can vary from period to period, cramps tend to happen in the days leading up to your period which is often a tell-tale sign it’s about to start. The pain usually lasts between 48 to 72 hours and is often more intense when your bleeding is at its heaviest.


This pain can also spread to your lower back and sometimes down to your thighs (luckily for you we have some top tips for managing these aches and pains below). This should naturally subside as your cycle does but it can last longer in some women.


All about PMS


In the weeks or days leading up to your period, some women experience notable symptoms, known as Premenstrual Syndrome (PMS).


These are often a clear indication that your period is due soon and the most common symptoms can include:


• Mood swings

• Headaches

• Breast tenderness 

• Bloating or tummy pain

• Feeling upset, anxious or irritable

• Tiredness or trouble sleeping

• Spotty skin

• Greasy hair

• Changes in appetite and sex drive


Although it’s not fully understood what causes PMS, it’s thought to be linked to the changing hormone levels in your body during your menstrual cycle. 


So what happens to your body during a period?


Ahh, the wonderous ways of the female body. It’s undeniably clever and each month, our wombs go through a vigorous cycle to prepare the body for pregnancy. With this, however, comes some serious hormone fluctuations.

Around 14 days into your menstrual cycle, rising levels in oestrogen cause an egg to be released from one of the two ovaries before travelling into your fallopian tube. The lining of the uterus then starts to thicken in preparation to receive a fertilised egg. 

If fertilisation doesn’t occur, the level of oestrogen begins to fall and the lining of the uterus breaks down, shedding from the body as a period.


What causes period pain?
Illustration of the uterus, fallopian tubes, ovaries, cervix & vagina.

Period pain occurs when the muscular wall of the womb tightens to help shed the lining of your uterus. When the wall contracts, blood vessels are compressed which deprives your womb of blood and oxygen. Although this sounds serious, trust the process – mother nature knows what she’s doing. 


Without this oxygen supply to your womb, the tissues release chemicals which trigger pain. The womb also releases other chemicals called prostaglandins, which encourage the womb muscles to contract more, triggering intense pain and cramping as a result. Some women may have a build-up of prostaglandins, meaning their period pains are worse than others. 


How to soothe the pain 


Life can be a little uncomfortable around the time of your period, but we’ve got some tips and tricks to help ease the symptoms so you can go about your day-to-day activities in a little less pain.


Apply heat


It’s the oldest tale in the book – and one of our faves. Applying heat to your lower abdomen, such as a covered hot water bottle, can cause the muscles of your uterus relax, increase blood flow and help soothe the level of pain. It also keeps you cosy when you can’t face moving out of bed (we’ve all been there).


Heat pads are another great way to help relieve pain if you want to be hands-free. Perfectly discreet, you can wear these under clothing so you can take on the world without strapping a hot water bottle to your tummy – oh the dream.


Pain relief medication


Sometimes period pain can arrive out of nowhere like an uninvited guest, so it’s always best to be prepared with some pain relief medication. Aspirin and ibuprofen are recommended for pain relief, so make these your go-to if they are suitable for you. You could also try paracetamol, but studies have shown that it does not reduce period pain as well as ibuprofen or aspirin.


If your pain is significantly worse than usual or you’re struggling to manage it with ordinary painkillers, speak to your pharmacist or GP or visit the Boots Online Doctor service


Self-care measures


For those who want to try some self-care techniques, there are a couple of things you can do:


• Relaxation methods – why not channel your inner zen with some yoga and pilates? These activities can help distract your mind from the discomfort


• Massage – gently massaging your lower abdomen in light, circular motions may help to soothe the pain


Another great tip is to enjoy a lovely long soak in the bath or take a warm shower to get those muscles – and you – to relax and ease the pain. Pop on a face mask while you’re there and really sink into the tranquillity.


TENS


A different approach you can take is Transcutaneous Electrical Nerve Stimulation (TENS), which is a method of pain relief using mild electrical currents. 


The small, battery-operated machine has leads connecting to pads which are applied to the skin. TENS works by delivering small electrical impulses to the affected area which gives a tingling sensation – it’s nothing compared to period pains.


These electrical impulses can reduce the pain signals going to the spinal cord and brain, which can help to relax the muscles. What’s more, they can also stimulate the production of endorphin, known as the body's natural painkillers.


Lifestyle changes 


Painkillers and heat might be the favourites for managing period pain, but there are a few lifestyle changes you can make to help ease your period pain and PMS symptoms in the long run and help keep you generally fit and healthy too!


• Stop smoking – this can make a big difference to your period pain


• Reduce alcohol consumption – alcohol can increase the level of oestrogen, making PMS worse and can also impact the balance of prostaglandin, triggering painful cramps


• Eat a healthy diet – tuck into plenty of fruits and veggies to keep your body balanced and symptoms manageable


• Regular exercising – you might not feel like it when you’re on your period but even light exercise such as walking or swimming can help ease the pain


• Reduce stress levels – easier said than done but stress can influence a hormonal imbalance – something you want to avoid!


Conditions that could make period pain worse


If you’re finding it hard to manage your period pain, there could be an underlying cause to your discomfort. You might notice your previously manageable periods have either become consistently worse in terms of pain, or there are changes in your flow such as heavier bleeding or irregular periods. We’ve listed some of the most common conditions below, but if you’re ever concerned about a change in your periods, you should see your GP who’ll be able to advise you.


Endometriosis 


Endometriosis is a long-term condition where cells similar to the lining of the womb start to grow in other places, such as the ovaries or fallopian tubes. 


Each month, unlike cells that break down and leave the body as a period, the blood has no way of escaping which can cause intense inflammation pain when these endometrial cells eventually shed.


PCOS


Polycystic Ovary Syndrome (PCOS) is a common condition that affects the function of a woman’s ovaries. 


Caused by immature and harmless follicles that grow on the ovaries, PCOS can trigger an imbalance in hormones which in turn cause irregular periods and bloating, plus other symptoms. 


Pelvic Inflammatory Disease


Pelvic Inflammatory Disease (PID) is a bacterial infection that’s spread from the vagina or cervix to the reproductive system which includes the womb, fallopian tubes and ovaries. 


In many cases this is triggered by Sexually Transmitted Infections (STI) such as chlamydia or gonorrhoea. Alternatively, this can be caused by bacteria that is already living in the vagina.


The most common symptom of PID is lower abdomen pain which is much more noticeable and aggressive than ordinary period cramps. This intense pain is triggered by the inflammation, as a result of the bacteria. But in many people, PID is mild or may not cause any noticeable symptoms.


Adenomyosis


Adenomyosis is a condition where the lining of the womb starts to grow deep within the muscular wall of the womb, making your periods particularly painful. 


It’s not very well known and can often take a long time to diagnose but what we do know is that it’s treatable and non-cancerous.


When to seek help


If you’re concerned about a change in your period or you think your pain might be a sign of something more serious, it’s important to get checked out by your GP.

*Subject to availability and clinician approval.