What causes menstrual cramps?

Primary dysmenorrhoea — cramping pain without underlying pathology — results from prostaglandin-driven uterine contractions reducing blood flow to the uterine lining. Secondary dysmenorrhoea involves underlying pathology such as endometriosis, fibroids, adenomyosis, or pelvic inflammatory disease. Distinguishing primary from secondary is important — severe or worsening cramps, particularly outside the expected cramping window, warrant investigation.

What complementary approaches help with period pain?

Acupuncture has good evidence for reducing primary dysmenorrhoea severity and duration. Heat (applied to the lower abdomen) provides meaningful relief comparable to mild analgesics. Omega-3 supplementation has evidence for reducing prostaglandin production and cramping. Magnesium supplementation and anti-inflammatory dietary patterns are used clinically. NSAID medications (ibuprofen) taken preventively are highly effective for primary dysmenorrhoea.

Can the pill or hormonal treatment reduce period pain?

Yes — combined hormonal contraceptives reduce prostaglandin production and often significantly reduce dysmenorrhoea. The Mirena IUS (levonorgestrel) typically reduces or eliminates menstrual pain. These are both effective medical options worth discussing with a GP, particularly for those seeking contraception alongside pain management.

When should severe period pain be investigated?

Severe cramps that are worsening over time, associated with heavy bleeding, pain at other times of the cycle, painful sex, or bladder and bowel symptoms warrant investigation for secondary causes. Endometriosis in particular is commonly delayed in diagnosis — persistent severe pain should be taken seriously and investigated appropriately.

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Menstrual Cramps

Menstrual cramps are a common experience that can impact daily life

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Reviewed by Dr. Ian Henderson · Microbiobial Health & Medicine26 March 2026Emerging evidence

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Menstrual cramps are a common experience that can impact daily life

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Painful cramps, bloating, and mood changes

What is Menstrual Cramps?

Menstrual cramps are a common experience that can impact daily life, causing physical and emotional distress. In a holistic context, menstrual cramps can be seen as an imbalance in the body's energy and a sign of spiritual or emotional distress. It can manifest in various ways, including painful cramps, bloating, and mood changes.

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