Painful Periods: What Your Body Is Telling You

You've been told painful periods are normal. You've been told to take ibuprofen and push through. You've been told this is just what having a uterus means.

We're here to tell you something different: painful periods are common, but they're not normal. Pain is a signal. Your body is trying to tell you something.

When we listen to that signal instead of just suppressing it, we can often find and address what's actually causing the pain. And that changes everything.

What Causes Painful Periods?

Menstrual cramps, or dysmenorrhea, occur when the uterus contracts to shed its lining. These contractions are triggered by hormone-like compounds called prostaglandins. The more prostaglandins, the stronger the contractions, and the more pain.

Research published in the Journal of Pain Research found that women with severe menstrual pain have significantly higher prostaglandin levels than women with mild or no pain. But here's what's important: prostaglandin levels aren't fixed. They're influenced by inflammation, hormonal balance, and other factors in your body. High prostaglandins are a downstream effect, not an inevitable reality.

This means painful periods aren't just something to manage. They're something to understand.

Primary dysmenorrhea refers to menstrual pain without an underlying condition. Secondary dysmenorrhea is pain caused by conditions like endometriosis, adenomyosis, or fibroids. Both are treatable, but they require different approaches.

When Does Period Pain Signal Something More Serious?

Mild cramping on the first day or two of your period is within the range of normal. But there's a difference between mild discomfort and debilitating pain.

If you're missing work or school because of period pain, if you need prescription painkillers or multiple over-the-counter medications to function, if the pain makes you nauseous or causes vomiting, if you're curled up with a heating pad unable to move, if your pain seems to be getting worse over time... this is your body telling you something needs attention.

Severe menstrual pain can indicate underlying conditions like endometriosis, adenomyosis, fibroids, or pelvic inflammatory disease. Research in the American Journal of Obstetrics and Gynecology found that up to 70% of women with severe dysmenorrhea have endometriosis. Pain can also occur without a diagnosed condition when there's significant inflammation, hormonal imbalance, or what Chinese medicine calls stagnation.

Warning signs that warrant medical evaluation include pain that doesn't respond to over-the-counter medications, pain that occurs outside of your period, pain during intercourse, very heavy bleeding, and symptoms that are progressively worsening.

Either way, you don't have to accept it as your fate.

How Does Chinese Medicine View Period Pain?

In Chinese medicine, we say that pain indicates stagnation. Where there is free flow, there is no pain. Where there is pain, there is no free flow.

Menstruation should involve the smooth movement of blood and energy downward and out. When this flow is obstructed, pain results. The obstruction can come from:

Cold causes the blood to congeal and move sluggishly, like how cold weather makes you want to curl up and contract. Many women notice cramps are worse in winter or when they eat cold foods. This type of pain is often relieved by heat, and the blood may be darker with clots.

Emotional constraint creates tension that obstructs flow. Chronic stress, suppressed emotions, frustration, and resentment all contribute to what we call liver qi stagnation. This type of pain often comes with irritability, breast tenderness, and mood changes before the period.

Blood deficiency leaves the body without enough resources to move blood efficiently. This pattern often shows up as dull, achy pain that may be worse at the end of the period, accompanied by fatigue, scanty flow, and dizziness.

Heat and inflammation thicken the blood and create a kind of internal friction. This pattern often involves sharp, intense pain with heavy, bright red flow and clots.

Different patterns require different treatments. A woman whose cramps are relieved by warmth needs different support than a woman whose pain is accompanied by heavy, clotted flow. A woman with dull, achy pain has a different pattern than one with sharp, stabbing cramps.

This individualized assessment guides our treatment. We're not just treating "painful periods." We're treating your painful periods, based on your specific pattern.

What Questions Do We Ask About Period Pain?

When a woman comes to us with painful periods, we want to understand the full picture.

We ask about the pain itself. When does it start? How long does it last? Where exactly is it located? What makes it better or worse? Is it sharp, dull, cramping, or aching? Does heat help or make it worse?

We ask about your flow. Is it heavy or light? Are there clots? What color is the blood? How many days do you bleed?

We ask about the rest of your cycle. Do you have PMS? Breast tenderness? Mood changes? How long is your cycle? Do you have pain during ovulation?

We look at your overall health. How is your digestion? Your sleep? Your stress levels? Your energy?

We also consider whether conditions like endometriosis might be present. Research in Human Reproduction found that the average delay in endometriosis diagnosis is 7-10 years, meaning many women with severe period pain have undiagnosed endo. If we suspect this, we'll recommend appropriate evaluation. For more on this, see our article on endometriosis and fertility.

How Does Acupuncture Help Painful Periods?

Acupuncture is remarkably effective for menstrual pain. A Cochrane systematic review found that acupuncture was associated with reduced menstrual pain compared to no treatment, NSAIDs, and other interventions. Research in the Journal of Alternative and Complementary Medicine found that acupuncture reduced pain intensity by an average of 50%.

Acupuncture works through several mechanisms:

Reducing inflammation. Research in Evidence-Based Complementary and Alternative Medicine has shown that acupuncture decreases inflammatory markers, which helps reduce prostaglandin production.

Improving blood flow to the pelvis. Studies using Doppler ultrasound have demonstrated increased uterine blood flow following acupuncture treatment, which supports the smooth shedding of the uterine lining.

Relaxing uterine smooth muscle. Acupuncture has been shown to reduce uterine contractions, directly addressing the mechanism of cramping.

Regulating the nervous system's pain response. Acupuncture activates the parasympathetic nervous system and affects pain processing in the brain, changing how pain signals are perceived.

We typically recommend treatment in the week before your period, when we can influence the conditions that will determine how painful menstruation is. Many women also find treatment during their period helpful for acute pain relief. Over time, with consistent treatment, the underlying pattern shifts and pain decreases.

Chinese herbs can also be very effective for menstrual pain. Formulas are customized based on your specific pattern and can address the root cause of pain rather than just suppressing symptoms. Some women use herbs daily throughout their cycle; others use them just in the week before and during their period.

What Lifestyle Changes Help Period Pain?

Several factors consistently influence menstrual pain, and addressing them can make a significant difference.

Diet matters. Research in Obstetrics and Gynecology found that a low-fat, plant-based diet reduced menstrual pain duration and intensity. Reducing inflammatory foods (processed foods, refined sugar, excessive dairy, and alcohol) and increasing anti-inflammatory ones (omega-3 fatty acids, vegetables, ginger, turmeric) can lower prostaglandin levels.

Stress matters. Chronic stress creates tension and affects hormonal balance. Research has shown that women with higher stress levels report more severe menstrual pain. Nervous system regulation work can help break this pattern.

Movement matters. Gentle exercise can help, while exhausting yourself can make things worse. Research in the Journal of Alternative and Complementary Medicine found that yoga significantly reduced menstrual pain and distress.

Heat helps. Using a heating pad or hot water bottle on your lower abdomen is one of the most effective immediate pain relief strategies. Research in Evidence-Based Nursing found that continuous low-level topical heat was as effective as ibuprofen for menstrual pain.

Does Period Pain Affect Fertility?

If you're trying to conceive, painful periods are worth addressing for reasons beyond your comfort.

Severe menstrual pain can indicate conditions like endometriosis that directly affect fertility. Research in Fertility and Sterility has shown that even without a diagnosed condition, the inflammation, poor circulation, and hormonal imbalance that cause period pain can also affect egg quality, ovulation, and implantation.

The same treatment that reduces menstrual pain often improves fertility. When blood flows freely to the reproductive organs, when inflammation decreases, when hormonal balance is restored, both pain and fertility improve.

Many women come to us for fertility support and find their period pain improves as a side effect. Others come specifically for period pain and later return when they're ready to conceive, already having laid the groundwork.

What Does Treatment Look Like?

A 32-year-old patient came to us not trying to conceive yet but wanting to address her periods before pregnancy. She was recently engaged and knew she wanted to start a family in about a year. She'd had painful periods since her teens, and they'd gotten progressively worse. By her late twenties, she was taking four to six ibuprofen on her first day and still sometimes couldn't function. Her doctor had offered birth control, which she'd tried but couldn't tolerate.

When we assessed her, several things stood out. Her periods were heavy with dark clots. The pain was sharp and stabbing, the worst on the first day. She had significant PMS with irritability, breast tenderness, and headaches. She was stressed, working long hours, not sleeping well. She craved sugar and ate quickly on the go.

In Chinese medicine terms, she had liver qi stagnation creating heat and blood stasis. Her stress was creating tension that obstructed flow. Her diet was contributing to inflammation.

We started with weekly acupuncture, timed around her cycle, with extra sessions during her period initially. We prescribed Chinese herbs to move blood and clear heat. We addressed her diet, reducing sugar and inflammatory foods. We worked on her stress, though this was harder to change than her diet.

Her first period after starting treatment was slightly better. By her third cycle, she noticed a real difference. Less clotting, less sharp pain, able to manage with just one or two ibuprofen. By her sixth cycle, she described her periods as "uncomfortable but manageable." She no longer dreaded that time of month.

A year later, she was ready to start trying. She'd continued with monthly acupuncture to maintain her progress, and her periods had remained manageable. She conceived her first month trying.

Your Next Step

Painful periods have been normalized for too long. Generations of women have been told to just deal with it. But pain is information. When we listen to it, we can often change it.

If you've been suffering through your periods every month, there's another way. Treatment can reduce your pain and improve your overall health at the same time.

If painful periods are affecting your quality of life, we can help. We'll assess your specific pattern and create a treatment plan to address the root cause of your pain.

Learn more about our Fertility & Health path or contact us at 212.432.1110 or info@fafwellness.com.