Period Pain

Cramping lower tummy pain just before or during a period. Common, often worst in the teens and twenties, and very treatable. Pain that stops school, work or life deserves proper help, not grit.

The period pain ladder

Most people get good relief from steps 1 to 3. If you’re climbing past the pill and still in pain, it’s time to look for a cause.

1. Step 1 · Self-careHeat and exerciseHeat pack or patch on the tummy; regular exercise through the month.

   Works

   Exercise lowers pain about 25 points out of 100 (low-quality evidence); heat helps in small trials

   Cost

   About $0–20

   How long

   Heat: as needed. Exercise: about 3 times a week

   Watch for

   Burns from overheated wheat bags. Don’t sleep on a hot pack.

   The hot water bottle has a better evidence base than most period apps.

2. Step 2 · PharmacyAnti-inflammatory tablets (ibuprofen, naproxen, mefenamic acid)Block the prostaglandins that cause the cramping. Better than paracetamol for period pain.

   Works

   About half get moderate to excellent relief, vs about 1 in 5 on a dummy treatment

   Cost

   About $5–15

   How long

   Start at the first sign of the period (or a day before), take regularly for 2–3 days

   Watch for

   Stomach upset; take with food. Avoid with stomach ulcers, some kidney problems, or asthma made worse by these medicines.

   Taking one when the pain is already a 9 out of 10 is playing catch-up. Start early, take regularly.

3. Step 3 · PrescriptionCombined contraceptive pillThins the lining, so less prostaglandin and lighter periods. Can be taken continuously to skip periods.

   Works

   About 4 to 6 in 10 improve, vs about 3 in 10 on a dummy treatment; continuous use may work better

   Cost

   Under $25 on the PBS for some pills; others about $20–40 a month privately

   How long

   Give it 3 months

   Watch for

   Spotting, nausea, headache. Small clot risk: not if you smoke over 35 or get migraine with aura.

   Skipping periods on the pill is safe. The monthly bleed is a 1960s design choice.

4. Step 4 · PrescriptionHormonal IUD (levonorgestrel) or other progestogen optionsA small device in the uterus, or progestogen tablets, implant or injection.

   Works

   Mostly observational evidence; often makes periods much lighter and less painful

   Cost

   IUD: $25 on the PBS ($7.70 concession), plus an insertion fee that varies

   How long

   IUD lasts up to 8 years; judge at 3–6 months

   Watch for

   Irregular spotting for the first few months. Insertion can be uncomfortable: ask about pain relief.

   Five-plus years of set-and-forget. Hard to beat for low effort.

5. Step 5 · Allied healthPelvic health physioFor ongoing pelvic pain, muscle tension and pain flare strategies, including TENS.

   Works

   Evidence limited (small trials); helps some people, especially with persistent pelvic pain

   Cost

   About $90–150 a session; Medicare rebates with a GP care plan

   How long

   A few sessions plus home practice

   Watch for

   Make sure underlying causes have been looked for.

   Pain changes the muscles too. Physios undo that.

6. Step 6 · SpecialistGynaecologistFor pain that’s not controlled, or suspected endometriosis, adenomyosis or fibroids. May include ultrasound or keyhole surgery (laparoscopy).

   Works

   Finds and treats causes; surgery helps endometriosis pain for some, but trial evidence is low quality

   Cost

   Medicare rebates with a GP referral; specialist and surgery gaps vary

   How long

   Depends on findings

   Watch for

   Wait times can be long, so start the referral early.

   “It’s just bad periods” is a diagnosis that should come with an expiry date.

Costs are rough Australian prices in October 2026 and vary by pharmacy and provider. PBS co-payment: $25, or $7.70 with a concession card. Results are typical figures from trials, not promises.

Save your money

Popular, heavily marketed or often asked about, but the evidence is weak or says no.

• Spinal manipulation (chiropractic)No better than sham treatment in trials.
• Supplements (magnesium, fish oil, vitamin B1, ginger)Low-quality studies. Some may help a little, but none is proven.
• AcupunctureSmall, low-quality trials with mixed results. May help some people, but the evidence is shaky.
• CBD and cannabis productsNo good trials for period pain, and they cost a lot.
• Uterine nerve ablation (LUNA)A large trial found cutting the nerves during keyhole surgery didn’t reduce pain.

What you can do

• Start the anti-inflammatory at the first twinge, with food, and keep it regular for 2–3 days.
• Heat pack plus a gentle walk beats lying very still.
• Track your periods and pain for 3 months: it makes the GP visit far more useful.
• Don’t just tough it out. Missing school or work every month is a reason to see a GP.

See your GP if

• Pain isn’t controlled by anti-inflammatories and the pill
• Pain started or got worse after age 25, or is changing
• Pain with sex, between periods, or with bowel or bladder symptoms
• Very heavy bleeding, bleeding after sex, or unusual discharge or fever

Get urgent help for sudden severe pelvic pain, fainting or shoulder-tip pain if you could be pregnant: call 000 (Australia) or your local emergency number. From a mobile, 112 works in most countries.

Helpful resources

• Jean Hailes: Types of period painWhat’s common, what might mean endometriosis, and when to see a doctor. Free, Australia.
• Pelvic Pain Foundation of AustraliaInformation and tools for people living with pelvic pain, and the PPEP Talk schools program. Australia.
• Endometriosis AustraliaSymptoms, diagnosis and treatment of endometriosis explained. Free, Australia.

Evidence and more information

• Healthdirect: Painful periods
• Cochrane: Anti-inflammatories for period pain
• Cochrane: The pill for period pain
• Cochrane: Exercise for period pain

Reviewed 28 October 2026. General education, not personal medical advice. Treatment depends on your situation, so talk to your GP or pharmacist.

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