Over 90% of women report pain with their periods. In this blog post, I share 10 ways to reduce period pain, without medication.
This post was inspired by the book ‘Healing Pelvic Pain‘ written by gynaecologist Dr Peta Wright. Peta and her team at Vera Wellness have also started a podcast called ‘Women of the Well.’ Take a listen here.
1. Reduce fear
Peta says to reduce period pain, first we need to understand what is happening in our body each month.
Many women believe their menstrual cycle and period are one and the same. But there are actually four phases in the menstrual cycle. Your period is just one phase – the shedding of the uterine lining.
Remember that the purpose of the menstrual cycle is to create a pregnancy.
In the lead up to your period, you will have grown and released an egg and prepared the uterine lining for implantation. But if the egg isn’t fertilised by a sperm, the lining of the uterus sheds and you start to bleed, ready for the next the month.
You can read more about the full menstrual cycle here.
What causes period pain?
A period is an inflammatory event. As the lining of the uterus starts to shed, inflammatory chemicals called prostaglandins are released. Prostaglandins cause the uterus to contract to help expel the lining, kind of like a mini labour.
The uterus contracting and release of prostaglandins is usually what causes pain and cramps just before and during your period. This is a normal process to make way for the new lining and does not mean any damage is occurring.
How pain works
Contrary to popular belief, we don’t have pain receptors that send pain messages to the brain. Instead, there are receptors that send messages to the brain about potentially damaging stimuli.
The brain then decides whether the stimulus is dangerous or safe based on the information it receives from the body and our environment (i.e. our beliefs, emotions and expectations). If the brain interprets the stimulus as dangerous, it will produce pain to protect us.
Period pain and fear
Inflammatory prostaglandins released during a period activate receptors inside our pelvis. If we are really worried or anxious about our period, our brain is more likely to interpret these signals as dangerous and produce more pain.
But, if we understand what is happening in our body, that some discomfort is normal and not causing any harm, it can reduce fear and start to dial down our pain.
2. Make time for your period
Think of the four phases of the menstrual cycle like the seasons. Your period is the winter phase. Hormone levels have fallen and energy is low. Imagine a cold, rainy winter day where all you feel like doing is staying home and curling up on the couch.
But life usually has other plans. We are expected to push through the pain and carry on with work, study, chores and family responsibilities. No wonder we dread the arrival of our period!
Instead, consider your period a monthly reminder from your body to slow down and rest.
To do this takes planning, which is why I recommend tracking your cycle if you don’t already. That way, you can predict when your period is due and plan to keep these days as free as possible. Work or study from home if you can and put off anything that isn’t urgent.
Use this time for self-care. Have a sleep-in. Run a bath. Book a facial or a massage. For other ideas to make the most of your winter phase, click here.
When you plan ahead, listen to your body and take the time to rest, you set yourself up for a much easier and less painful period.
3. Reduce inflammation
Non-steroidal anti-inflammatory steroid drugs (NSAIDS) are an effective treatment for period pain. Think Ibuprofen (e.g. Nurofen). NSAIDs work by stopping the production of the inflammatory chemicals prostaglandins.
Clients often tell me they wait until their period pain is ‘bad enough’ before taking pain relief. But NSAIDS actually work better when they are taken early, before too many prostaglandins are produced. The trick is to take them as soon as your period starts or even the day before if you know when your period is due.
NSAIDS can have side effects and many women prefer not to rely on medication to manage their period pain.
Ginger also has anti-inflammatory properties and is a good alternative.
Studies have shown ginger is just as effective as NSAIDS for reducing period pain without the side effects (2). The recommended dose is 500 mg ginger root capsules 3 times per day on period days (1). Ginger tea is also a great option.
For more herbal remedies and supplements, listen to this podcast episode.
4. Apply heat
Another simple home remedy for period pain is heat. This could be in the form of a heat pack, hot water bottle, warm shower or bath. Heat helps to ease muscle tension and improve blood flow to the pelvis (3).
If you use a heat pack or hot water bottle, just make sure you have a layer in between so you don’t burn your skin.
These days, you can purchase heat packs which wrap around your lower back for heat on-the-go! Check them out here.
5. Keep moving
Our natural instinct when we have period pain is to curl up in a ball. We are afraid if we move, we will make our pain worse. Makes sense right?
But think about a time when you hurt your back or neck. It is likely the muscles in that area went into spasm. The same thing happens during our period. The muscles inside and around the pelvis tense up in a protective response. When we stay still, the muscles can become even tighter and contribute to the pain.
Avoiding movement when we have our period also sends the message that something is wrong and the brain will ramp up the pain in response.
So while it may be the last thing you feel like doing, try to keep moving while you are on your period. Even if that is simply going for a 10 minute walk or doing a few gentle stretches like the ones in this handout.
Not only does movement reassure our brain we are safe and ease muscle tension, it also releases endorphins, our body’s natural painkillers.
6. Invest in a TENS machine
TENS stands for transcutaneous electrical nerve stimulation. A TENS machine is a small, battery operated device with pads (electrodes) that you stick on your skin over the area of pain. The machine delivers small electrical impulses which feel like a tingling or pins and needles sensation.
You may have heard of using a TENS machine in labour but studies have shown TENS is also highly effective at reducing period pain (4).
How does TENS work?
Websites often say TENS works by blocking pain signals from nerves to the brain but this is not quite true. As I mentioned before, there are no pain messages.
Despite what we may think, our brain isn’t actually very good at focusing on two things at once. When we use TENS, we distract our brain with a competing stimulus, dampening down the messages coming from the pelvis.
Which TENS machine do I choose?
There are a number of wearable TENS devices available specifically designed for period pain. You need to choose carefully because they often come with pre-set settings which aren’t evidence based. Pelvic health physio and electrical stimulation expert Fiona Rogers recommends Tap 2.0 which you can purchase here.
Alternatively, you can use a conventional TENS machine which allows you to customise the settings and find what works best for you.
The recommended settings are:
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- High frequency (50-120 Hz)
- 100uS (pulse width)
- Continuous mode
How do you use a TENS machine?
Simply apply the electrodes when your period pain starts, where your pain starts. In this video, Fiona takes you through some different options. Increase the intensity (mA) until you feel a strong but comfortable sensation. If you feel the sensation start to subside, you can increase the intensity back up.
When shouldn’t you use TENS?
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- If you have an implanted device
- Over infected, inflamed or broken skin or unhealed scars
- In water
- When driving or operating machinery
If you find these simple strategies don’t quite cut it, then we need to dig a little deeper.
Lara Briden, naturopath and author of the ‘Period Repair Manual,’ encourages us to think of our period as a monthly health report card. An abnormally painful period is a sign that something is amiss.
You may need to consider your lifestyle throughout the month and make some changes to your diet, sleep and stress levels.
7. Eat an anti-inflammatory diet
Eating inflammatory foods can contribute to more painful periods. I’ve heard first hand from clients that changing their diet has made a huge difference to their pain.
No one diet has been proven to be the best for period pain but an anti-inflammatory, Mediterranean style diet shows the most promise. This means reducing intake of:
- processed foods
- refined sugar
- red meat
- saturated fats
And increasing intake of:
- wholegrains
- fibre
- healthy fats (e.g. fish, nuts, seeds, olive oil)
- fruits and vegetables in a variety of colours.
There is no one-size-fits-all approach so for more personalised advice, see a dietician or naturopath.
8. Manage stress
Have you noticed your period pain is worse when you are stressed? That’s because stress activates our sympathetic nervous system and we go into ‘fight or flight’ mode. Our brain, on high alert for potential threats, will perceive any incoming signals from the pelvis as dangerous and ramp up our pain.
Some simple ways to calm your nervous system include:
-
- Taking deep breaths into your belly and making your exhales longer than your inhales
- Journaling
- Movement and exercise you enjoy
- Spending time in nature
- Talking to your partner, friend or family member who helps you feel safe
To learn more about the role of stress and period pain, listen to this podcast episode.
9. Get enough sleep
Lack of sleep can worsen period pain by exacerbating stress, promoting inflammation and lowering our pain threshold. Try to aim for 7-8 hours per night. Some tips to improve sleep include:
- Going to sleep and waking up at the same time each day
- Creating a relaxing wind down routine
- Limiting screen time 45 minutes to an hour before bed
- Avoiding alcohol and caffeine
- Optimising your sleep environment by keeping your bedroom dark, quiet and cool (especially in Queensland summer!)
- Using a meditation app such as Smiling Mind, Calm or Laughscape
If despite addressing all of these factors, you still experience distressing period pain, then it is time to see your GP. The longer you have recurrent period pain, the more likely it is to become persistent.
Make sure to see a GP or gynaecologist who listens to your symptoms and offers you a range of treatment options, not just the Pill.
10. See a Pelvic health physiotherapist
Your GP or gynaecologist may recommend seeing a pelvic health physiotherapist. How can a pelvic health physio possibly help with period pain?
Remember that the muscles around the pelvis, including the pelvic floor muscles, tense up in a protective response to period pain and inflammation. With repeated episodes of period pain, these muscles can become overprotective, always in a state of contraction and have difficulty relaxing.
Tight, tender points can develop in the pelvic floor muscles which can refer pain to other areas including the lower back and abdominals. This can be another potential source of period pain (5).
Signs you may have a tight pelvic floor include:
- pain or difficulty inserting tampons
- pain with sex
- difficulty emptying your bladder or bowel
If this sounds like you, then it would be beneficial finding a pelvic health physiotherapist who can teach you how to relax your pelvic floor muscles. They can also assist with the other strategies we have talked about including setting you up with stretches and a TENS machine that’s right for you.
Book here to see a pelvic health physiotherapist or go to https://choose.physio/find-a-physio and refine your search to Women’s, Men’s and Pelvic Health.
I hope you enjoyed this post and feel empowered with more ‘tools in your toolbox’ to reduce period pain.
If you continue to experience painful periods, however, it is important that you see a women’s health GP. Getting on top of the pain early will prevent it from becoming chronic.
Courtney x
P.S. Comment below which strategies have worked for managing your own period pain!
*The information provided is intended as general information only and should not be substituted for medical advice.
References
- Wright, Peta. (2023). Healing Pelvic Pain. Macmillan Australia.
- Moshfeghinia, R., Salmanpour, N., Ghoshouni, H., Gharedaghi, H., Zare, R., Cramer, H., Heydarirad, G., & Pasalar, M. (2024). Ginger for Pain Management in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis. Journal of integrative and complementary medicine, 30(11), 1016–1030. https://doi.org/10.1089/jicm.2023.0799
- Jo, J., & Lee, S. H. (2018). Heat therapy for primary dysmenorrhea: A systematic review and meta-analysis of its effects on pain relief and quality of life. Scientific reports, 8(1), 16252. https://doi.org/10.1038/s41598-018-34303-z
- Han, S., Park, K. S., Lee, H., Kim, E., Zhu, X., Lee, J. M., & Suh, H. S. (2024). Transcutaneous electrical nerve stimulation (TENS) for pain control in women with primary dysmenorrhoea. The Cochrane database of systematic reviews, 7(7), CD013331. https://doi.org/10.1002/14651858.CD013331.pub2
- Serrano-Imedio, A., Calvo-Lobo, C., Casañas-Martin, C., Garrido-Marin, A., & Pecos-Martin, D. (2022). Myofascial Pain Syndrome in Women with Primary Dysmenorrhea: A Case-Control Study. Diagnostics (Basel, Switzerland), 12(11), 2723. https://doi.org/10.3390/diagnostics12112723
