Period Pain — OTC Treatment Options Your Pharmacist Recommends

Why does period pain happen?

Period pain — medically known as dysmenorrhoea — is one of the most common gynaecological complaints, affecting up to 80% of women at some point during their reproductive years. Understanding why it happens is the first step to treating it effectively, and it is something our pharmacists at Medway Pharmacy in Gillingham are asked about regularly.

Primary dysmenorrhoea refers to period pain with no underlying medical cause. It occurs because the uterus contracts to shed its lining each month, and these contractions are driven by hormone-like chemicals called prostaglandins. Women who experience more severe period pain typically have higher levels of prostaglandins in their uterine lining. Elevated prostaglandin levels cause stronger, more intense contractions that can temporarily reduce blood flow to the uterine muscle, producing cramping pain. The same prostaglandins can also cause systemic symptoms such as nausea, diarrhoea, and headaches, which many women experience alongside cramping during their period.

Secondary dysmenorrhoea is pain caused by an identifiable underlying condition, most commonly endometriosis, uterine fibroids, or adenomyosis. Unlike primary dysmenorrhoea — which often improves with age or after pregnancy — secondary dysmenorrhoea tends to worsen over time and may be associated with pain at other points in the cycle, heavy bleeding, or pain during sex. If your period pain has been getting progressively worse, is not adequately controlled by standard painkillers, or is accompanied by other symptoms, it is important to speak to your GP rather than simply managing it with over-the-counter medication alone.

What is the best over-the-counter medicine for period pain?

For most women with primary dysmenorrhoea, non-steroidal anti-inflammatory drugs (NSAIDs) are the most effective over-the-counter option for period pain treatment medway residents can access without a prescription. NSAIDs include ibuprofen (available in 200 mg and 400 mg tablets) and naproxen sodium (250 mg tablets, sold as Feminax Ultra and other brands). Unlike paracetamol, which only relieves pain, NSAIDs actively block the production of prostaglandins — addressing the underlying mechanism of period cramping rather than just masking the discomfort. This dual analgesic and anti-spasmodic action makes them significantly more effective than paracetamol for most women.

Timing matters with NSAIDs. Starting ibuprofen or naproxen one to two days before your period is expected — rather than waiting until cramps begin — allows prostaglandin levels to be suppressed before the contractions intensify. If you know your cycle is regular, this preemptive approach can substantially reduce the severity of pain on the first day or two, which are typically the worst.

Paracetamol is a reasonable second-line option for women who cannot take NSAIDs — for example, those with asthma triggered by ibuprofen, a history of peptic ulcer disease, or certain kidney conditions. Paracetamol 500–1000 mg every four to six hours (up to four grams in 24 hours) provides useful pain relief, though it will not reduce cramping to the same degree as an NSAID. Combined products containing paracetamol and low-dose codeine are available over the counter, but our pharmacists generally advise caution with these — codeine carries a real risk of dependence with regular use, and for most women with period pain, an NSAID alone is more effective and safer for ongoing monthly use.

Does heat help with period pain?

Heat therapy is one of the most well-evidenced non-pharmacological options for period pain, and it can be used alongside NSAIDs for additional relief. Applying heat to the lower abdomen works by promoting muscle relaxation in the uterine wall, improving local blood flow, and interrupting pain signals. A hot water bottle wrapped in a cloth or towel is the simplest method, and many women find that sustained heat applied over one to two hours provides significant comfort during the first days of their period.

For a more practical solution during the day, adhesive heat patches — such as Cura-Heat Period Pain patches — can be worn discreetly under clothing and maintain a therapeutic temperature of around 38 to 39°C for up to eight hours. Clinical research has shown that continuous low-level heat at this temperature can be as effective as ibuprofen for some women with primary dysmenorrhoea, particularly when applied consistently from the start of cramping. Medway Pharmacy stocks a range of heat therapy products and our team can advise on which options suit your lifestyle.

Transcutaneous electrical nerve stimulation (TENS) machines are another drug-free option worth considering. TENS devices deliver small electrical impulses through electrode pads placed on the lower abdomen or back, which are thought to disrupt pain signals travelling to the brain and stimulate the release of endorphins. Several consumer TENS devices are designed specifically for period pain — including the Livia and TensCare itouch Sure — and can be purchased over the counter. TENS is safe to use alongside medication and heat therapy, making it a useful addition for women who prefer to minimise their reliance on painkillers.

When should period pain prompt a GP visit?

While most period pain is primary dysmenorrhoea and responds well to NSAIDs and self-care, there are specific warning signs that suggest an underlying condition requiring medical investigation. It is important that women in Medway and Gillingham are aware of these, as conditions like endometriosis are notoriously underdiagnosed — the average time from first symptoms to diagnosis in the UK is around eight years.

You should speak to your GP if your period pain has been getting progressively worse over successive cycles rather than staying consistent. Pain that is not adequately controlled by NSAIDs taken at the correct dose and timing is also a red flag for secondary dysmenorrhoea. Other symptoms that warrant investigation include pain between periods (not just during menstruation), unusually heavy or prolonged periods, pain during or after sex (deep dyspareunia), and pain or discomfort when using your bowels or bladder around the time of your period. Any of these, particularly in combination, should prompt a conversation with your GP rather than simply increasing your painkiller dose.

If you are unsure whether your symptoms warrant a GP visit, our pharmacists at Medway Pharmacy on Canterbury Street in Gillingham are a good first port of call. We can help you assess whether your pain pattern suggests primary or secondary dysmenorrhoea, advise on optimising your current pain relief, and help you decide whether and how urgently to seek a GP appointment. We are usually open 7:30am to 10pm Monday to Sunday, excluding bank holidays, making it easy to get advice without waiting.

Other tips to reduce period pain

Beyond medication and heat, there are several lifestyle approaches that can reduce the severity of period pain over time. Regular low-impact aerobic exercise — such as cycling, brisk walking, or yoga — has consistent evidence behind it. Exercise is thought to reduce period pain by lowering prostaglandin levels, improving pelvic blood flow, and triggering the release of endorphins. Even gentle movement during your period, when it feels counterintuitive, can noticeably reduce cramping for many women.

Dietary supplements with some supporting evidence include omega-3 fatty acids (found in oily fish and available as capsules) and magnesium glycinate. Omega-3s may reduce prostaglandin production, while magnesium helps to relax smooth muscle. Neither supplement will replace NSAIDs for acute pain, but regular use across the cycle may reduce baseline cramp severity over time. It is worth giving any supplement at least two to three cycles before assessing whether it is helping.

Reducing caffeine and high-salt foods in the days leading up to and during your period can also help by minimising bloating, fluid retention, and vascular tension that can worsen cramping. Adequate sleep and stress management are important too — cortisol and other stress hormones can amplify pain perception and may influence menstrual symptoms. If your period pain is part of a broader pattern of premenstrual symptoms affecting your quality of life, speak to your GP about options that address the hormonal root causes, including the combined oral contraceptive pill, which can significantly reduce dysmenorrhoea by suppressing ovulation and thinning the uterine lining.

Period pain FAQ