Cramps without another condition
Primary dysmenorrhoea is period pain without an underlying pelvic condition. It often starts in the early years after periods begin. The pain can still be disruptive and deserves treatment.
PATIENT GUIDE
Painful periods
Period pain that interrupts school, work, sleep or exercise is a reason to seek help. We can discuss ways to ease it and whether an underlying condition needs investigation.
UNDERSTANDING YOUR SYMPTOMS
Why do periods hurt?
During a period, natural chemicals called prostaglandins trigger contractions of the womb, which can cause cramps. The medical name for painful periods is dysmenorrhoea.
Pain linked to a condition
Secondary dysmenorrhoea is pain associated with a condition such as endometriosis or adenomyosis. New, changing or persistent symptoms may need further investigation.
When to arrange a consultation
- Pain interrupts everyday activities, is getting worse or is not improving with treatment.
- Pain continues beyond your period, or occurs with sex, passing urine or opening your bowels.
- Periods are also heavy or irregular, or bleeding occurs between periods.
Mention pain dating from your very first periods or a family history of endometriosis. You do not need to work out the cause before asking for help.
YOUR CONSULTATION
How I assess painful periods.
Understand your symptoms
We discuss when pain occurs, the bleeding pattern, its effect on daily life and what you have tried. Bring previous results and a medicine list if available.
Choose useful tests
Typical period cramps do not always need a scan. Other symptoms may call for examination, pregnancy or infection tests, or pelvic ultrasound. If endometriosis is suspected, investigation and initial treatment can proceed together. A normal scan does not exclude every form of endometriosis.
Agree your priorities
We choose a plan around your health and preferences, including pain relief, contraception, avoiding hormones or pregnancy plans. We also agree how to judge whether treatment is helping.
We explain any proposed examination and ask for your consent. You can ask to pause or stop. Tell me about previous difficult examinations or concerns so we can plan together.
YOUR OPTIONS
Treatment options for painful periods
Treatment can often begin while we assess the pattern. Your health, medicines, preferences and pregnancy plans guide the choice.
Review how treatment is working
We usually plan a review around three months after starting, adjusted to your needs. We look at pain, daily activities, medicine use and side effects. Contact the practice earlier if pain remains disabling, symptoms worsen or side effects are unacceptable; follow the urgent advice above when needed.
IF PAIN CONTINUES
If treatment is not helping.
Persistent symptoms may lead to further assessment for endometriosis, adenomyosis or another cause. More than one contributor can be present, including pelvic-floor muscle pain.
Laparoscopy may be useful in selected situations, but it is not required before every trial of treatment. The decision should answer a clear question and take account of your priorities.
OPTIONAL SYMPTOM DIARY
Track your symptoms before your appointment.
Record pain, bleeding, other symptoms and what helps. The printable diary includes an appointment summary to bring to your visit.
No endometriosis diagnosis is needed to use it. Complete only the pages you find useful; you can book without a diary or a full cycle of records.
Endometriosis & menstrual symptom diary
Printable PDF · 8 pages · 41 KB
COMMON QUESTIONS
Common questions about painful periods
Does severe period pain always mean endometriosis?
No. Primary period cramps and several conditions can cause significant pain. Symptoms, examination where appropriate and investigations guide the assessment. Pain severity alone does not establish the cause.
Will I need a scan or an internal examination?
Not everyone does. Your symptoms, age, previous treatment and preferences guide the assessment. If a scan or examination would help, we explain why, discuss alternatives and ask for your consent. You can ask to pause or stop.
Can treatment reduce or stop my periods?
Some hormonal treatments reduce bleeding or stop it, although spotting can occur and complete suppression is not guaranteed. With a suitable combined-pill regimen, a monthly withdrawal bleed is not medically necessary. Discuss the right medicine and schedule before changing how you take it.
Can I use treatment if I want a pregnancy later?
Yes. We can choose symptom treatment now with your future plans in mind. Hormonal treatment for suspected or confirmed endometriosis does not permanently harm later fertility, although return to fertility varies with the method.
If you are trying to conceive now, tell me so we can choose suitable pain relief and discuss whether fertility assessment is needed. Hormonal suppression does not improve the chance of pregnancy while you are trying.
YOUR NEXT STEP
Discuss your symptoms and options.
Consultations in Claremont, with additional appointments in Simon’s Town on selected Mondays. Reception will confirm your date, time and venue.
General information to support your consultation. Your assessment and treatment plan are individual.
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Sources & further reading: ACOG: painful periods · RCH: dysmenorrhoea · NHS: period pain · NICE: endometriosis · ACOG: menstrual suppression · NHS: urgent pelvic pain advice · RCOG: consent