What’s Actually Causing Your Period Pain (Primary Dysmenorrhea)?

A Clear Guide to Primary Dysmenorrhea

Most of us are told from a young age that period pain is “just part of life.” But when the pain becomes a monthly obstacle, interrupting your work, your sleep, your social life, it’s natural to wonder: Why is this happening? Is this normal? And more importantly, is there anything that can actually help?

This guide explains the most common type of period pain, primary dysmenorrhea, in straightforward terms.

So, What is Primary Dysmenorrhea?

Primary dysmenorrhea is the medical term for period pain that isn’t caused by an underlying condition. It typically begins in adolescence, often within a year or two of starting menstruation, and can continue well into adulthood.

This type of period pain:

• Usually starts 1–2 days before your period or with the first day of bleeding

• Peaks within the first 24–48 hours

• Often improves with age or after childbirth

Importantly, this pain isn’t “imagined” or exaggerated — it’s a real, physical process happening in the body.

Further Reading: The Menstrual Cycle Explained

What’s Causing the Pain?

During your menstrual cycle, the lining of the uterus thickens in preparation for a possible pregnancy. If pregnancy doesn’t occur, the body sheds this lining — and that’s your period.

Here’s where the pain comes in:

• To help the uterus contract and expel the lining, your body produces hormone-like substances called prostaglandins.

• High levels of prostaglandins cause the uterine muscles to contract more strongly — and sometimes painfully.

• These contractions can reduce blood flow to the uterus temporarily, which adds to the pain.

Think of it as the uterus working hard, too hard, sometimes, to do its job.

What Does it Feel Like?

Everyone’s experience is different, but common symptoms of primary dysmenorrhea include:

• Cramping or aching pain in the lower abdomen or pelvis

• Pain that may radiate to the lower back or thighs

• Nausea or digestive upset (like diarrhoea)

• Headaches or lightheadedness

• Fatigue and irritability

Some people describe the pain as dull and constant; others feel sharp spasms that come and go.

Read More: Period Pain and Productivity

Is it Normal, or Something Else?

This is a common and important question.

If your period pain began in your teens, follows a predictable pattern each month, and isn’t getting worse over time, it’s likely primary dysmenorrhea.

But sometimes period pain is caused by an underlying condition — this is called secondary dysmenorrhea. Red flags to look out for include:

• Pain that starts later in life (e.g. mid-20s or 30s)

• Periods that are getting heavier or more painful over time

• Pain during sex or between periods

• No relief from over-the-counter painkillers

If any of this sounds familiar, it’s worth talking to your GP. Conditions like endometriosis, adenomyosis, or fibroids (common causes of secondary dysmenorrhea) are treatable — but often underdiagnosed.

Can You Treat Primary Dysmenorrhea?

Yes, and you don’t need to “just deal with it.” Treatment depends on your symptoms and personal preferences. Options include:

1. Pain Relief

NSAIDs like ibuprofen or naproxen work by reducing prostaglandin production. They're often most effective when taken before the pain begins or as early as possible.

2. Hormonal Contraceptives

The combined pill, patch, ring, or hormonal IUD can help regulate or even suppress menstruation, which may reduce or eliminate period pain altogether.

3. Lifestyle Support

Regular movement (even gentle walking or yoga), heat therapy (like a hot water bottle), and balanced nutrition can all help reduce symptoms over time.

4. Alternative Approaches

Some find relief through acupuncture, magnesium supplements, or omega-3 fatty acids — though evidence varies, and results can be personal.

When to Speak to a Doctor

You don’t need to wait until the pain becomes unbearable. It’s a good idea to talk to your GP if:

• The pain regularly disrupts your daily life

• Over-the-counter medication doesn’t help

• You’re unsure if your symptoms are normal

• You’ve noticed any changes in your cycle or pain pattern

Even if you’ve had painful periods for years, support is available. You don’t have to prove that it’s “bad enough”, if it’s affecting your life, it matters.

Primary dysmenorrhea is incredibly common, but that doesn’t mean it should be brushed off. You deserve care, clarity, and comfort when managing your cycle. Understanding what’s happening in your body is the first step toward getting the support that works for you.