When Period Pain Isn't Normal: Could It Be Endometriosis?

Medically reviewed and fact-checked by Prof. Dr. Kristina Jariene, MD, PhD, Consultant Obstetrician and Gynaecologist.

Endometriosis is still discussed far too little, and its symptoms are often dismissed as simply “part of being a woman.” The truth is different: pain that prevents you from living your life is never normal.

Is It Just Normal Period Pain?

Not all menstrual pain is the same. It is important to understand the difference between primary dysmenorrhea, or common period cramps, and pain caused by endometriosis.

Primary Dysmenorrhea (Common Period Pain)

• Usually begins shortly after the first menstrual periods during adolescence.
• Is caused by prostaglandins, natural substances that trigger uterine contractions.
• Pain typically lasts one to two days.
• Usually responds well to nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, and heat therapy.

During the teenage years, period pain may be more intense as the body is still adjusting to hormonal cycles. However, it should not interfere with school, work or everyday activities.

Endometriosis May Be More Likely If:

• The pain becomes worse over time.
• The pain lasts longer than two to three days.
• Pelvic pain begins before your period or continues between periods.
• Regular painkillers such as NSAIDs provide little or no relief.

Additional Warning Signs

• Pain during sexual intercourse.
• Pain during bowel movements or urination.
• Persistent fatigue and characteristic bloating, sometimes called “endo belly.”
• Difficulty conceiving or infertility.

Why Can Endometriosis Take Years to Diagnose?

Around one in ten women may have endometriosis, yet many remain undiagnosed. Diagnosis often takes years because symptoms vary greatly from person to person, and severe menstrual pain is still too often considered “normal.” In some cases, surgery may be required to confirm the diagnosis. Limited research funding has also contributed to delays in improving diagnostic methods.

How Can You Help Manage the Symptoms?

If you experience menstrual pain, particularly primary dysmenorrhea, or want to reduce symptoms, the following strategies may help:

• Take NSAIDs early: Do not wait until the pain becomes severe. Always follow the instructions provided by your healthcare professional or on the medicine label.
• Use heat therapy: Applying warmth to the lower abdomen may help relax the muscles and ease cramps.
• Support your overall well-being: Regular physical activity, quality sleep and relaxation practices such as yoga or breathing exercises may help.
• Consider nutrition: A balanced diet and limiting caffeine before your period may help some people manage symptoms.
• Discuss supplements with a healthcare professional: Magnesium and omega-3 fatty acids may be helpful for some people, but supplements are not suitable for everyone.

You may also be interested in: How Insulin Resistance and Anti-Inflammatory Nutrition Shape Women’s Health.

Herbal Support

According to recommendations from Dr. Gabriele Balciunaite-Murziene, certain medicinal plants may help support comfort, particularly when used before menstruation. Speak with a healthcare professional before using herbal products, especially if you take medication, are pregnant or are breastfeeding.

• Ginger: May help reduce menstrual pain and inflammation.
• Fennel and peppermint: May help relieve menstrual cramps and bloating.
• Yarrow: Has traditionally been used to support menstrual comfort.
• Milk thistle and dandelion: Are traditionally used to support digestive and liver function.

Listen to Your Body

Pay attention to how long your pain lasts, whether it becomes more severe over time and whether it affects your quality of life. If it does, seek advice from a healthcare professional.

Remember: If Period Pain Is Stopping You from Living Your Life, It Is Not Normal.

Gentle Products for Difficult Days

If you experience heavy or painful periods, choosing suitable period care can help support your comfort:

Heavy Flow Period Care – products selected for heavier-flow days.

All Pads and Liners – gentle, certified options suitable for sensitive skin.