Painful menstrual periods may include pain in the abdomen, back and legs; abdominal cramps; headache; and fatigue. Most women have painful periods at some time in their lives. In some women, the pain is severe enough to interfere with normal activities.


Menstrual cramps are often caused by contractions of the uterine muscle during menstruation. Some women have a higher level of hormones called prostaglandins which can increase the intensity of the contractions. Stronger contractions lead to more severe cramping.

Cramps may also be caused by other conditions such as:

  • Endometriosis
  • Ovarian cysts
  • Pelvic inflammatory disease – infection of the female reproductive organs
  • Uterine fibroids – noncancerous growths in the uterus
  • Intrauterine device (IUD)
  • Scars inside the abdomen from previous surgery
  • Tumors
  • Inflammatory bowel disease

Home Care

To help ease discomfort:

  • Place a heating pad on your abdomen or lower back
  • Consider taking a warm bath
  • Exercise regularly
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen may help reduce pain (check with your doctor before using this type of medicine.)

Find out if alternative treatments are a good option for you, for example:

  • Some herbs and supplements – like vitamin B1, magnesium and Chinese herbal medicine – may be helpful (talk to your doctor before taking any herbs and supplements as they may interact with your other medicines and conditions.)
  • Acupuncture may also help to reduce pain

When should I call my doctor?

Call your doctor if you have:

  • Severe or unusual cramps
  • Cramps that last for more than a few days
  • Signs of infection, such as fever or chills
  • Cramps with heavy menstrual bleeding
  • Abdominal or pelvic tenderness
  • Vaginal discharge other than menstrual bleeding
  • Vaginal bleeding or pain that is not related to menstruation
  • Menstrual pain that started later in your life
If you think you have an emergency, call for medical help right away.