Painful Periods (Dysmenorrhoea): Causes and Integrative Treatment

Clinical content by Trevor Wing MBRCP FRCHM MBAcC BSc (Hons) MSc (Dist) DMed (Img). Last reviewed October 2026.

Key facts

More than half of women have some period pain, and for around 1 in 10 it is severe enough to disrupt daily life.
Primary period pain has no underlying disease and usually starts in the teenage years.
Pain that is new, worsening or not helped by painkillers should be checked for causes such as endometriosis, adenomyosis or fibroids.
Anti-inflammatory painkillers and heat are effective first steps.
Chinese herbal medicine and acupuncture can be used alongside or instead of hormonal treatment.

What is dysmenorrhoea?

Dysmenorrhoea is the medical term for painful periods. Most women have some discomfort, but dysmenorrhoea describes pain that stops you doing normal activities or needs medication. There are two types:

Primary dysmenorrhoea: cramping pain with no underlying disease. It usually starts within a year or two of the first period and often eases with age.
Secondary dysmenorrhoea: pain caused by a condition such as endometriosis, adenomyosis, fibroids or pelvic infection. It often starts later in life or gets worse over time.

What does period pain feel like?

Typical primary period pain is cramping or spasmodic pain in the lower abdomen, sometimes spreading to the lower back and thighs. It usually starts just before or at the beginning of bleeding and lasts one to three days. It can come with nausea, vomiting, diarrhoea, headache, tiredness and light-headedness.

What causes period pain?

As the womb lining breaks down, it releases prostaglandins, chemicals that make the womb muscle contract and reduce blood flow to it. Women with more painful periods tend to produce higher levels of prostaglandins, especially on the first two days of bleeding. In secondary dysmenorrhoea, the underlying condition adds inflammation or pressure.

When should painful periods be investigated?

Pain that has started or worsened after years of manageable periods
Pain between periods, during sex or when opening your bowels
Very heavy or irregular bleeding
Pain not helped by regular anti-inflammatory painkillers
Difficulty getting pregnant

A pelvic ultrasound is a simple first step to look for endometriomas, adenomyosis and fibroids. We offer specialist gynaecological scanning at our Twickenham clinic.

What are the conventional treatment options?

Anti-inflammatory painkillers (NSAIDs) such as ibuprofen, naproxen or mefenamic acid, which reduce prostaglandin production. They work best taken regularly from the first sign of pain, or just before it is expected. They are not suitable for everyone, for example people with stomach ulcers or some types of asthma.
Heat on the lower abdomen or back, which studies show can work as well as ibuprofen for some women.
Hormonal contraception such as the combined pill, which thins the womb lining and often reduces pain significantly.
Specialist treatment for underlying conditions found on investigation.

How do we treat period pain at the Women’s Natural Health Clinic?

We start by making sure there is no underlying condition, then create a treatment plan based on your pattern of symptoms. Chinese Medicine is our main approach for period pain. It sees healthy menstruation as depending on smooth flow of qi and blood, and identifies several patterns:

Qi and blood stagnation, often linked to Liver qi stagnation: pain before or at the start of the period, breast tenderness, dark clotted blood and pain eased once clots pass.
Cold and damp in the uterus: cramping eased by warmth and pressure, with a feeling of coldness.
Deficiency patterns: a dull, dragging ache during or after the period, often with tiredness.

Treatment combines herbal medicine and acupuncture matched to your pattern, with advice on diet, exercise and warmth. There is some evidence that acupuncture and certain herbal formulas reduce period pain, though more high-quality research is needed.

Frequently asked questions

Is it normal for periods to be very painful?

Some discomfort is common, but pain that stops you working, studying or sleeping is not something you have to put up with. It is worth seeking help, particularly if it is getting worse.

Could my period pain be endometriosis?

It could, especially if pain has worsened over time or you also have pain during sex or between periods. A transvaginal ultrasound is a good first step.

When should I take painkillers for period pain?

Anti-inflammatory painkillers work best taken regularly from the first sign of pain, or a day before your period is due if your cycle is regular. Always follow the packet instructions or a pharmacist’s advice.

Can acupuncture help period pain?

Some studies suggest acupuncture can reduce period pain, and many of our patients find it helpful alongside herbal medicine. We will discuss what to expect at your consultation.

Book a consultation

To book, book an appointment online or call 020 3811 8778. Initial consultations last up to one hour at our clinic at 16 Bridle Lane, St Margaret’s, Twickenham TW1 3EE.