What is Primary Dysmenorrhea?

Understanding Period Pain That Doesn’t Feel “Normal”

Most people who menstruate are familiar with cramps, it’s often seen as just part of the deal. But if your period pain consistently feels more intense than what others describe, or it starts to interfere with your day-to-day life, it could be a sign of something more specific: a condition called primary dysmenorrhea.

Let’s talk about what it is, why it happens, and how you can manage it, without getting overwhelmed by medical jargon.

What is Primary Dysmenorrhea?

The term sounds a bit clinical, but it simply means painful periods that aren’t caused by an underlying condition.

This type of period pain is extremely common, especially in teens and young adults. It typically starts within a year or two of your first period and can stick around well into your twenties and thirties. For some, it often eases over time or after having children, but not always.

Read More: The Menstrual Cycle Explained

How is it different from secondary dysmenorrhea?

Secondary dysmenorrhea happens because of something else going on in the body, like endometriosis or fibroids. The cramps you get with primary dysmenorrhea aren’t linked to a structural problem, they’re just your body reacting to hormonal changes during your cycle.

With secondary dysmenorrhea, the pain is often more intense, can last longer, and may not respond as well to typical pain relief. It might also come with other symptoms like pelvic pain between periods or discomfort during sex, which usually aren't part of primary dysmenorrhea.

What Causes the Pain?

During your period, your uterus contracts to help shed its lining. It does this by releasing hormone-like chemicals called prostaglandins. These trigger those muscle contractions, and sometimes, they become more forceful than normal.

Some people naturally produce higher levels of prostaglandins, or their bodies are more sensitive to them, which can make the pain feel especially intense, even if everything else looks “normal” on paper.

When prostaglandin levels are high, the uterus cramps more intensely, and blood flow can be restricted. This is what causes the sharp, throbbing pain many people feel in their lower abdomen. You might also feel the pain spreading to your back or thighs.

High prostaglandins can lead to other symptoms like:

• Nausea

• Diarrhoea

• Dizziness

• Headaches

That’s because prostaglandins don’t just act on the uterus, they can affect other smooth muscles in the body too, like those in your digestive system and blood vessels.

This can cause your stomach to feel unsettled, your bowels to speed up, and even trigger headaches or light-headedness due to changes in blood pressure.

What Does It Feel Like?

Everyone’s experience is slightly different, but common descriptions include:

• A tight, squeezing feeling in the lower stomach

• Sharp, stabbing pain that comes in waves

• Constant dull ache that doesn't let up for hours

• Lower back pain or leg aches around the same time

The pain usually starts a day or two before bleeding begins and can last up to three days. For many, it’s uncomfortable but manageable, like a dull ache or sharp cramp that comes and goes. But if your pain is so severe it regularly disrupts your daily life, that could be a sign of something else, like secondary dysmenorrhea, which is often linked to an underlying condition.

How Do You Know If It’s Just Primary Dysmenorrhea?

This is where things can get confusing. Because period pain is so normalised, many people go years before realising their experience isn’t actually typical.

Here’s when it might be time to speak to your GP:

• Pain doesn’t improve with standard painkillers

• Cramps interfere with school, work, or social life

• You also experience pain during sex, between periods, or when using the toilet

• Your symptoms have worsened over time

These could be signs of something like endometriosis or adenomyosis, causing a more severe secondary dysmenorrhea.

Further Reading: What to Pack in a Period Pain Care Kit

Managing the Pain: What Actually Helps?

The good news? There are ways to make primary dysmenorrhea more manageable. What works can vary, but here are some tried-and-tested options:

1. Pain Relief

Over-the-counter painkillers like ibuprofen or naproxen are usually the first choice. They help reduce inflammation and lower prostaglandin levels, which tackles the problem at its source.Start taking them a day before your period begins, if you can predict it. That gives you a bit of a head start.

2. Heat

It might sound too simple, but a hot water bottle or heat patch can do wonders. Heat helps relax the muscles in your uterus, easing cramping and dulling the ache.

3. Exercise

Okay, we know. When you're doubled over in pain, a jog sounds ridiculous. But even gentle movement, like walking, stretching, or light yoga, can increase blood flow and help release natural painkillers in your body.

4. Hormonal Contraceptives

The pill, the patch, or hormonal IUDs can all help by thinning the uterine lining and reducing prostaglandin production. Less lining means fewer contractions, which usually means less pain.

Not everyone wants to go down the hormonal route, but it can be life-changing for some.

5. Dietary Tweaks

There’s growing evidence that what you eat might influence your symptoms. Some people find that:

• Cutting back on processed foods and excess sugar helps

• Adding omega-3s (from oily fish or flaxseeds) reduces inflammation

• Staying hydrated makes bloating and cramping easier to manage

You don’t need a complete overhaul, just gentle changes that support your body rather than fight it.

It’s easy to feel like you’re the only one struggling when people around you seem to breeze through their periods. But around 70 to 80% of women under 25 experience primary dysmenorrhea to some degree. That’s a lot of people quietly suffering.

Just because period pain is common doesn’t mean it’s normal to be in agony every month. You deserve care and comfort, not just vague advice to “take a hot bath and get on with it.”

When to Get Help

If your symptoms are getting worse, don’t improve with over-the-counter treatments, or start interfering with your everyday life, don’t wait. Talk to your GP. Keeping a pain diary for a couple of cycles can help them get a clearer picture of what’s going on.

Your pain is valid.

And there are ways to make it easier.

A Quick Recap

• Primary dysmenorrhea is period pain without an underlying medical condition

• It’s caused by high levels of prostaglandins, which lead to intense cramping

• Symptoms can start before your period and last up to 2–3 days

• You can manage it with pain relief, heat, movement, hormonal contraception, and dietary changes

• If your pain is severe or affecting your quality of life, it’s time to see a doctor

Painful periods shouldn’t be a monthly punishment. Whether it’s primary dysmenorrhea or something else entirely, getting the right support can make a massive difference. You’re not alone. And there’s no reason to suffer in silence.