Period cramps: why they happen and what actually helps

Every month, the lining of your uterus (the endometrium — the soft inner layer that would hold a pregnancy) builds up. If you don't get pregnant, your body sheds it. To push it out, your uterus releases chemicals called prostaglandins (natural pain-and-inflammation messengers your body makes). These make your uterus squeeze. Stronger squeezes mean stronger cramps.

That's why women with higher prostaglandin levels feel more pain — it's not "in your head", it's chemistry.

When cramps are normal (and when they're not)

Normal period cramps usually:

• Start a day before or on the first day of bleeding
• Feel like a dull ache or throbbing in your lower belly, sometimes lower back or thighs
• Ease within 2–3 days
• Respond to a heat pack or a painkiller

Red flags — talk to a gynaecologist (a doctor who specialises in women's reproductive health) if:

• Pain is getting worse each cycle
• Pain lasts more than 3 days or starts before your period
• Painkillers don't help
• You have pain during sex, or when passing stool during your period
• Bleeding is very heavy (soaking a pad every hour)

These can be signs of endometriosis (a condition where uterine-like tissue grows outside the uterus), adenomyosis (where this tissue grows into the muscle of the uterus), or fibroids (non-cancerous growths in the uterus) — all common, all treatable, but they need diagnosis.

What actually helps — evidence-based

1. Heat. A hot water bottle or heating pad on your lower belly works as well as ibuprofen in some studies. Cheap, safe, effective.
2. Take painkillers early — not late. Ibuprofen and naproxen (NSAIDs — non-steroidal anti-inflammatory drugs) block prostaglandins. Typical over-the-counter doses are ibuprofen 400 mg every 6–8 hours or naproxen 250–500 mg every 12 hours. Take the first dose before pain peaks, ideally when you first notice cramps or spotting. Always check the label and ask a pharmacist or doctor if you have stomach, kidney, or asthma issues.
3. Move gently. Walking, stretching, or light yoga increases blood flow and releases endorphins (your body's natural painkillers). 20 minutes is enough.
4. Stay hydrated and cut back on salt. Water reduces bloating; salt makes it worse.
5. Magnesium, omega-3, and ginger. Small studies suggest these reduce cramp severity over 2–3 cycles. Ginger (about 750–2000 mg/day of ginger powder in the first 3–4 days) has the strongest data. Talk to your doctor before starting supplements.
6. TENS (a small device that sends mild electric pulses through skin patches) — Cochrane reviews suggest high-frequency TENS can meaningfully reduce cramp pain. Ask your gynaecologist or physiotherapist.
7. Sleep on your side with knees up. Takes pressure off the uterus.

What usually doesn't help

• "Sweating it out" with intense exercise during severe cramps
• Skipping meals — low blood sugar makes pain feel worse
• Cold drinks and ice cream aren't harmful, but very cold food can trigger cramps in some people

A note on tracking

Writing down when cramps start, how long they last, and how bad they are (on a 1–10 scale) is one of the most useful things you can do. If you ever need to see a doctor, this record cuts down guesswork and gets you the right diagnosis faster.