Fluctuating hormones, along with high levels of inflammatory compounds, may also contribute to menstrual cramps. And for some women with severe period pain, conditions like , adenomyosis (when the inner lining of the uterus breaks through the muscular uterine wall), or uterine fibroids may play a role. “This is something that many women live with, and for some women it’s quite severe,” says Brett Worly, MD, ob-gyn at The Ohio State University Wexner Medical Center.
If the pain is so bad it makes a major dent in your daily life, talk to your health care provider, Dr. Worly suggests, to rule out a serious underlying cause. If you get an all-clear and need easy cramp relief strategies that really work, give these expert-backed remedies a try. Some may help you feel better temporarily, while others may reduce the level of pain you feel for the long-term.
Eat a low-fat, high-fiber diet
Women who eat more fiber tend to report less menstrual pain than those who eat less, according to a 2005 study in the European Journal of Clinical Nutrition. The connection may have to do with the fact that fiber intake can decrease blood estrogen levels in women, the study authors say, and estrogen seems to be a driving factor behind period-related pain.
In that sense, foods that may help with period cramps include whole grains, fruits, and vegetables (especially leafy greens). Adding more of these foods to your diet can also help improve digestion in the long run, which may help minimize stomach pain and cramping at any time of the month.
Fatty foods, on the other hand, have been shown to increase estrogen levels in women. The 2005 study did not find a significant association between high-fat diets and increased period pain, but the authors say the connection should be studied further. In an earlier study, women who followed a low-fat vegetarian diet (and increased their fiber intake) reported reduced pain duration and intensity.
Take OTC pain meds—even before your period starts
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen (Aleve) act by blocking prostaglandin production, and several studies have shown that they can be very effective in treating menstrual pain. All of the NSAIDs studied seem to work better than acetaminophen (Tylenol), according to a 2015 Cochrane Review of previous research—but it’s not clear which one of the two is the best medicine for severe menstrual cramps.
“Taking Motrin or Tylenol, or a combination of the two, every four to six hours can be helpful,” says Dr. Worly. “Sometimes it can also be helpful to start taking those medicines before your period starts—so if you know it’s going to start on a Friday, start taking those medicines on Thursday.”
Dial back your stress level
Stress may affect the severity and duration of period pain, according to a 2010 Journal of Women’s Health study. When participants experienced high levels of stress in a given month, they were more likely to report more (and worse) menstrual symptoms during their next cycle, compared to months when they had less stress. For women who had two consecutive high-stress months, there seemed to be a cumulative effect: The number of women reporting 8 or more symptoms nearly doubled between the first and second cycle, from 27% to 50%.
Study co-author Audra Gollenberg, PhD, now an associate professor of public health at Shenandoah University, recommends making time on the regular for self-care and stress-busting activities, from meditation to outings with friends. “Stress has been shown to affect reproductive hormones, so it makes sense that it could affect your period, too,” she says. “Stress reduction is very individual, but anything that helps you handle stressful situations may help reduce discomfort at this time of the month."
Keep a heating pad handy
“For some women, using a heating pad or taking a hot bath or shower can provide some relief from period pain,” says Dr. Worly. There’s some science behind this age-old remedy: In 2005, researchers from University College London showed how heat placed on the skin can block pain signals, as well as deactivate painful sensations at a molecular level for up to an hour.
Topical heat can also , which may help reduce the contractions that cause cramping. In a 2001 study in Obstetrics and Gynecology, women who wore a heated abdominal patch during their period reported significant reductions in pain, compared to those who wore a placebo, unheated patch.
Don't skip the gym
Working out may be the last thing you feel like doing when your period starts, but there’s good reason to push through. “High-intensity exercise when you have really bad cramps isn’t necessarily going to make you feel better right away,” says Dr. Worly. “But in the long run, studies show that women who exercise regularly and stay fit tend to have less pelvic pain overall.”
In some cases, getting your heart rate up and your body moving really could have some immediate benefits. “Exercise can release endorphins, which is the body’s natural pain medicine,” says Dr. Worly. If you’re not feeling up something as intense as kickboxing class, try .
Go on hormonal birth control
Taking birth-control pills or using another form of hormonal contraception prevents ovulation, which can make a big difference for women who have endometriosis and suffer from severe cramps every month as a result. (Endometriosis is a condition in which uterine tissue grows outside of the uterus.)
But even women with normal periods may notice that their cramps go away or aren't quite so bad when they start taking hormonal birth control. “Contraception can help regulate hormone levels and decrease extreme fluctuations, which can be helpful,” says Dr. Worly.
The market for supplements that claim to help period pain is full of vitamins, minerals, and herbal remedies—but most have very little or no evidence that they make a difference. One exception: magnesium. At least three small clinical trials have compared the effects of magnesium supplements to a placebo for women with menstrual pain. Overall, women who took magnesium reported less pain, and their need for extra medication was lower.
In 2017, a review in the journal Magnesium Research stated that magnesium deficiency may play a role in a number of gynecological conditions, including premenstrual syndrome (PMS) and dysmenorrhea. Researchers believe that magnesium may inhibit painful contractions by relaxing muscle cells in the uterus.
More research is needed in order to recommend an effective dosage, researchers say, and popping too much of the supplement can cause a dangerous heart arrhythmia. Talk to your doctor before you start taking any new supplement, or aim to get more magnesium from food sources like whole grains, beans, nuts, seeds, and dark, leafy greens.
As if you need one more reason to give up cigarettes: Several studies have found a link between smoking—as well as inhaling secondhand smoke—and an increased risk of menstrual pain. One 2015 report published in Tobacco Control found that the earlier women started smoking, the more likely they were to have chronic period pain as adults.
While kicking the habit may not help you feel better instantly, it can help improve your health overall, says Dr. Worly. It can also make exercise, another period-pain remedy, a little easier.