Period pain sits in an awkward place: common enough to be dismissed, and sometimes severe enough to be the only visible sign of something that needs treating. The useful line is not between pain and no pain. It is between pain you can work around and pain that runs your month.
Why periods hurt
Period pain is driven by prostaglandins, the molecules that trigger the uterine contractions needed to shed the endometrium. An excess of pro-inflammatory prostaglandins — influenced among other things by diet — is associated with more marked pain in some women. The mechanism is ordinary. The intensity is not always.
The line between common and worth investigating
Pain that stays manageable with an ordinary painkiller and does not stop you doing what you normally do sits in a common range. Pain that is intense, that limits your day, that resists usual painkillers, or that shows up outside your period, sits outside it and deserves to be evaluated. Endometriosis in particular takes an average of around seven years to diagnose in France, according to the national endometriosis strategy published by the Ministère de la Santé in 2022 — in part because severe menstrual pain is still so routinely treated as normal.
The approaches that can help
Local heat has trial evidence behind it, and gentle regular activity helps some women. The omega-3 story is weaker than it is usually told: the Cochrane review of dietary supplements for period pain found no high-quality evidence for any of them, so treat it as worth trying rather than as established. Medically, several options exist depending on the cause identified — anti-inflammatories, hormonal contraception, or specific care where endometriosis is confirmed — to discuss with a professional rather than to self-manage indefinitely.
- Do not treat pain that limits your day as something normal to endure — it is a signal to evaluate.
- Record the intensity and location of the pain across several cycles before a consultation.
- Try local heat and gentle activity alongside — not instead of — a medical assessment if the pain is severe.
- See someone if ordinary painkillers no longer cover it, or if the pain continues outside your period.
Reviewed by the OVEA medical committee