From Menstruation to Menace: Time to Tackle Period Pain

Written By Aisha .

Written by: Dr. Aisha Ampah, PT, DPT

For many women, period pain is something that is experienced way too often. Research indicates that up to 91% of menstruating women experience painful periods, and up to 29% of those women have severe pain1, which impacts work, school, and participation in social activities.  It’s so common that we’re often told it’s just “part of being a woman.” But while mild cramping can be expected, severe pain that disrupts your life isn’t something you have to live with.  These symptoms could be signs of an underlying pelvic health issue—one that a pelvic health physical therapist can help address2.

Before we go any further, let's talk about wording, specifically painful periods. There is a medical term for that: dysmenorrhea. dis-men-uh-REE-uh.  Yep, now say that three times! Dysmenorrhea is the medical term used to describe painful periods. Though this term addresses the idea that pain is present, it doesn’t address the potential causes. There are two types of dysmenorrhea: 

  • Primary Dysmenorrhea: This type may begin a few days before your period and last two to three days after the onset of menstruation6.
  • Secondary Dysmenorrhea: This type can cause pain and discomfort for extended periods of time6.

What’s Normal & What’s Not When It Comes to Period Pain?

A little discomfort during your cycle is expected, but pain that interferes with your daily activities is not. Let’s break down what’s considered normal versus what might be a sign of something more profound.


Mild Cramps: Normal

Cramping is a normal part of having your period. It occurs when the body begins to shed the lining of the uterus to prepare for the next cycle and potential implantation. Typical cramps can be bothersome, but they are usually relieved with light exercise such as walking, spinning, or even that DIY project you have been procrastinating on. If exercise during this time isn’t your jam, that is okay. Typically, heating pads or over-the-counter pain meds assist in providing relief. 

  • Caused by uterine contractions as the body sheds the uterine lining

  • Typically mild to moderate and relieved with movement, heat, or over-the-counter pain meds

  • Lasts 1–3 days at the start of your period


Severe Cramping & Chronic Pelvic Pain: NOT Normal

  • Pain so intense that you miss work, school, or activities

  • Cramping that lasts longer than your period

  • Pain that doesn’t improve with common remedies


Painful Urination or Bowel Movements During Your Cycle: NOT Normal

Because of the release of the hormone prostaglandin, increased frequency in bowel movements is normal during your cycle3.  These prostaglandins affect the smooth muscle of the intestines, causing increased motility and more frequent bowel movements. But they should be relatively normal. Nothing should be notably different about your bowel movements during your cycle compared to when you are not menstruating.

  • While hormones can make you more sensitive, burning, stabbing, or deep pelvic pain with urination isn’t typical.

  • If bowel movements cause pelvic pressure or sharp pain, it could be a sign of endometriosis or pelvic floor dysfunction.

Why Does This Happen? The Link Between Hormones & Pelvic Pain

Hormonal changes during the menstrual cycle affect muscle tone, inflammation, and tissue sensitivity3. Estrogen and progesterone fluctuations can heighten pain perception, making pelvic floor dysfunction worse. For some women, conditions like endometriosis, adenomyosis, interstitial cystitis, or past pelvic trauma contribute to ongoing pain. Unfortunately, many are dismissed or told to take painkillers without getting to the root cause4.

How Pelvic Floor Physical Therapy Can Help Reduce Pelvic Pain

Pelvic health physical therapy isn’t just for postpartum recovery—it can be a game-changer for women struggling with chronic pelvic pain5.

Here’s how PT can help:

✔️ Identifying Pelvic Floor Imbalances: If your muscles are too tight or weak, they can contribute to pain. A pelvic PT can assess and create a custom plan. We don’t just throw Kegels at you. 

✔️ Manual Therapy for Pain Relief: Hands-on techniques help release muscle tension, improve blood flow, and reduce inflammation. This can include soft tissue mobilization, cupping, or dry needling.

✔️ Breathwork & Relaxation Strategies: Breathing correctly can reduce pelvic floor tension and ease pain. Breathwork is key!

✔️ Gentle Stretching & Strengthening Exercises: Strengthening weak and relaxing tight muscles helps restore balance and function.

✔️ Guidance on Lifestyle & Movement: Certain postures, stress, or movement habits can worsen pain. A PT will teach you how to modify daily activities to feel better.

The bottom line?

Severe period pain isn’t something you have to accept as normal. Pelvic health physical therapy provides real, science-backed solutions that can help you feel better—without relying solely on medication or invasive procedures.

When to See a Pelvic Health Physical Therapist

If you experience:

✅ Severe cramps that don’t improve with typical pain relief

✅ Pain with urination, bowel movements, or intercourse

✅ Chronic pelvic pain outside of your period

✅ A history of endometriosis, PCOS, or pelvic trauma


It’s time to seek help. Pelvic PT can make a huge difference in your quality of life.


You don’t have to suffer in silence. If you’re struggling with pelvic pain, let’s talk. At Pivot Physio, we help women reclaim their bodies, reduce pain, and move with confidence.


📍 Curious how pelvic health PT can help you manage period pain? Book a consultation today to start feeling better!

References

  1. Ju, H., Jones, M., and G. D. Mishra. "The Prevalence and Risk Factors of Dysmenorrhea." Epidemiologic Reviews, vol. 36, no. 1, 2014, pp. 104–113. https://doi.org/10.1093/epirev/mxt009.
  2. González-Mena, Ángela, Raquel Leirós-Rodríguez, and Pablo Hernandez-Lucas. "Treatment of Women With Primary Dysmenorrhea With Manual Therapy and Electrotherapy Techniques: A Systematic Review and Meta-Analysis." Physical Therapy, vol. 104, no. 5, May 2024, pzae019, https://doi.org/10.1093/ptj/pzae019.
  3. American College of Obstetricians and Gynecologists. "ACOG Practice Bulletin No. 132: Dysmenorrhea and Endometriosis in the Adolescent." Obstetrics & Gynecology, vol. 120, no. 2, pt. 1, 2013, pp. 356–364. https://doi.org/10.1097/AOG.0b013e31829cdbeb.
  4. Bernardi, M., Lazzeri, L., Perelli, F., Reis, F. M., and F. Petraglia. "Dysmenorrhea and Related Disorders." F1000Research, vol. 6, 2017, p. 1645, https://doi.org/10.12688/f1000research.11682.1.
  5. López-Liria, R., Torres-Álamo, L., Vega-Ramírez, F. A., García-Luengo, A. V., Aguilar-Parra, J. M., Trigueros-Ramos, R., and P. Rocamora-Pérez. "Efficacy of Physiotherapy Treatment in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis." International Journal of Environmental Research and Public Health, vol. 18, no. 15, 2021, p. 7832, https://doi.org/10.3390/ijerph18157832.
  6. “Dysmenorrhea.” Yale Medicine, 15 Nov. 2024, https://www.yalemedicine.org/conditions/dysmenorrhea. Accessed 18 Feb. 2024.
Aisha .