Her Period Pain — When to Worry, When to Help

Some period pain is a normal part of menstruation. During her period, the uterus contracts to shed its lining, and these contractions are driven by chemicals called prostaglandins. Higher prostaglandin levels mean stronger contractions and more pain. This is called primary dysmenorrhea — pain without an underlying disease.

Normal period pain typically starts on the first day of her period or just before, peaks within the first 48 hours, and fades by day 2-3. It usually responds to over-the-counter pain relief like ibuprofen or naproxen. She can still go about her daily life, even if she's uncomfortable.

Here's the line: if her pain regularly causes her to miss work or school, if she's doubled over and can't function, if pain medication doesn't touch it, or if the pain is getting worse over time — that's not normal. That's a signal that something else may be going on, and she deserves medical attention, not a lecture about toughening up.

Studies show that period pain is systematically undertreated and dismissed in medical settings. Women wait an average of 7-10 years for an endometriosis diagnosis. As her partner, taking her pain seriously isn't coddling — it's advocacy.

When period pain goes beyond typical cramping, it's called secondary dysmenorrhea — meaning there's an underlying condition causing the pain. Several conditions can be responsible, and they're more common than most people realize.

Endometriosis affects roughly 1 in 10 women. Tissue similar to the uterine lining grows outside the uterus — on ovaries, fallopian tubes, bowel, and other pelvic organs. This tissue responds to hormonal cycles, causing inflammation, scarring, and intense pain that often extends beyond just her period.

Adenomyosis occurs when endometrial tissue grows into the muscular wall of the uterus itself. It causes heavy, painful periods and a feeling of constant pressure or aching in the pelvis.

Uterine fibroids are noncancerous growths in or on the uterus. They can cause heavy bleeding, prolonged periods, and significant cramping.

Ovarian cysts — while often harmless and self-resolving — can cause sharp pain, especially if they rupture or twist.

Pelvic inflammatory disease (PID), usually caused by untreated STIs, can cause chronic pelvic pain and painful periods.

The common thread: all of these are real medical conditions that require diagnosis and treatment. None of them are 'just bad periods.' If she's describing pain that sounds like more than cramps, trust her instinct and support her in getting answers.

Practical support during period pain is about reducing her burden and increasing her comfort. Most of this isn't complicated, but consistency matters more than grand gestures.

Heat is one of the most effective non-medication pain relievers for cramps. A heating pad on her lower abdomen or lower back can relax uterine muscles and reduce pain. Some women prefer warm baths. Keep a heating pad charged and accessible — don't make her hunt for it when she's hurting.

Medication timing matters. Ibuprofen and naproxen are the best OTC options because they reduce prostaglandin production. The key is taking them before pain peaks — ideally at the first sign of cramps or even preemptively if she knows when her period is coming. Acetaminophen is less effective for cramps specifically.

Physical comfort: loose clothing, comfortable bedding, her preferred snacks and drinks. Some women find gentle movement like walking or stretching helps; others need to lie still. Follow her lead.

Emotional presence matters too. Don't disappear when she's in pain. You don't need to hover, but checking in, bringing her things without being asked, and being physically available for comfort (gentle back rubs, lying together) makes a real difference.

The overarching principle: make it easy for her to rest and recover. Handle dinner, manage the household logistics, and create a low-demand environment. Period pain is exhausting, and knowing she doesn't have to push through everything alone is genuinely therapeutic.

There's a line between supportive encouragement and pressure, and it's important to get this right. Many women have been told their period pain is normal for so long that they've internalized it — even when their pain is objectively severe. Your outside perspective can be genuinely valuable here.

Signs she should see a doctor: pain that causes her to miss work, school, or social activities regularly; pain that gets worse cycle after cycle; pain that doesn't respond to standard doses of ibuprofen or naproxen; pain that occurs outside her period (during ovulation, during sex, with bowel movements); extremely heavy bleeding (soaking through a pad or tampon every hour for several consecutive hours); and any new or sudden change in her pain pattern.

How to bring it up: timing matters. Don't suggest a doctor visit while she's actively in pain and miserable — that feels like criticism when she's vulnerable. Wait until she's feeling okay, and frame it around care, not complaint. 'I notice you're really struggling every month, and I hate seeing you in that much pain. Would you be open to talking to your doctor about it? I'll go with you if you want.'

If she's resistant, don't push. But do revisit it gently. Some women have had bad experiences with doctors dismissing their pain, and they've given up. Acknowledging that — 'I know doctors haven't always listened, but you deserve someone who does' — can help.

Chronic pain of any kind takes a psychological toll, and period pain is no exception — especially because it's cyclical and predictable. She knows it's coming, and that anticipatory dread is its own form of suffering.

Women with severe period pain report higher rates of anxiety and depression. The monthly cycle of pain creates a pattern: dread in the days before, suffering during, and recovery after — leaving a narrower window of feeling genuinely well. Over time, this erodes quality of life, self-confidence, and willingness to make plans or commitments during vulnerable windows.

There's also the invalidation factor. When pain is dismissed by doctors, employers, friends, or partners, it creates a secondary layer of distress. She's not just in pain — she's in pain and being told it's not a big deal. This combination breeds frustration, isolation, and a deep sense of not being believed.

Relationship impact is real too. She may avoid sex because of pain, cancel plans repeatedly, or be less emotionally available during pain episodes. If these patterns aren't understood as pain-related, they can breed resentment on both sides.

The most powerful thing you can do is break the invalidation cycle. When you consistently believe her, accommodate her needs, and treat her pain as legitimate, you become a source of safety rather than another person she has to convince. That psychological safety has a measurable effect on how she copes with pain.