Dr Sherene Kalloo

Spe­cial­ist Ob­ste­tri­cian and Gy­nae­col­o­gist.

For many women, painful pe­ri­ods have been con­sid­ered a nor­mal part of life. Young girls are of­ten told to “bear with it,” while old­er women silent­ly tol­er­ate dis­com­fort month af­ter month. But as a gy­nae­col­o­gist, I want to make one thing very clear: se­vere or dis­abling pe­ri­od pain is not nor­mal and should nev­er be ig­nored.

Mild cramps or oc­ca­sion­al dis­com­fort dur­ing men­stru­a­tion are com­mon. This is caused by the uterus con­tract­ing to shed its lin­ing, com­pound­ed by the pro­duc­tion of prostaglandins, which caus­es cramps. How­ev­er, when pain in­ter­feres with dai­ly ac­tiv­i­ties, caus­es missed school or work, or re­quires fre­quent painkillers, it is a warn­ing sign. Un­for­tu­nate­ly, many women ac­cept chron­ic pain as part of be­ing a woman, un­aware that it may sig­nal an un­der­ly­ing med­ical con­di­tion.

One of the most com­mon caus­es of se­vere men­stru­al pain is en­dometrio­sis. In this con­di­tion, tis­sue sim­i­lar to the lin­ing of the uterus grows out­side the uterus, caus­ing in­tense cramps, chron­ic pelvic pain, painful in­ter­course, and even fer­til­i­ty prob­lems. En­dometrio­sis is of­ten un­der­diag­nosed be­cause its symp­toms are dis­missed as “nor­mal” men­stru­al dis­com­fort. Ear­ly recog­ni­tion and treat­ment can dra­mat­i­cal­ly im­prove qual­i­ty of life and fer­til­i­ty out­comes.

An­oth­er fre­quent cause of painful pe­ri­ods is fi­broids, non-can­cer­ous growths in the uterus. Fi­broids can lead to heavy bleed­ing, painful sex­u­al in­ter­course, bleed­ing af­ter sex, fre­quen­cy of uri­na­tion, pres­sure in the low­er ab­domen, and in­tense cramps. Oth­er pos­si­ble caus­es in­clude ade­no­myosis (when the uter­ine lin­ing grows in­to the uter­ine wall), pelvic in­fec­tions, and hor­mon­al im­bal­ances. Each of these con­di­tions is treat­able—es­pe­cial­ly when iden­ti­fied ear­ly.

Why ig­nor­ing pain can be harm­ful: Chron­ic men­stru­al pain af­fects not on­ly phys­i­cal health but al­so emo­tion­al well-be­ing. Women of­ten ex­pe­ri­ence fa­tigue, dis­rupt­ed sleep, anx­i­ety, and de­pres­sion. Miss­ing work or school can im­pact aca­d­e­m­ic or ca­reer per­for­mance, while so­cial iso­la­tion can af­fect re­la­tion­ships and con­fi­dence. More im­por­tant­ly, un­treat­ed con­di­tions can wors­en over time, mak­ing treat­ment more com­plex and re­duc­ing the like­li­hood of symp­tom re­lief.

The good news is that ef­fec­tive treat­ments ex­ist. De­pend­ing on the cause, man­age­ment may in­clude lifestyle changes, ex­er­cise and prop­er di­et, pain med­ica­tions, hor­mon­al ther­a­py, min­i­mal­ly in­va­sive pro­ce­dures, or surgery in se­lect­ed cas­es. Keep­ing a pe­ri­od di­ary—track­ing the sever­i­ty, du­ra­tion, and pat­terns of pain—can help your doc­tor iden­ti­fy the un­der­ly­ing cause more quick­ly and choose the best treat­ment.

When should you see a doc­tor?

• Pain that wors­ens over time

• Pain not re­lieved by over-the-counter med­ica­tions

• Very heavy bleed­ing or large clots

• Painful in­ter­course

• Dif­fi­cul­ty get­ting preg­nant

Prac­ti­cal self-care tips:

• Ap­ply heat to the low­er ab­domen or low­er back

• En­gage in gen­tle ex­er­cise, yo­ga, or stretch­ing to re­duce cramps

• Main­tain a bal­anced di­et rich in iron and mag­ne­sium

• Get ad­e­quate sleep and man­age stress

• Stay hy­drat­ed to help re­duce bloat­ing and dis­com­fort

A mes­sage to fam­i­lies:

Pe­ri­od pain should nev­er be min­imised. Sup­port women in seek­ing care, en­cour­age open con­ver­sa­tions, and help break the taboo around men­stru­al health. Aware­ness and em­pa­thy from fam­i­ly mem­bers can make it eas­i­er for women to seek time­ly med­ical ad­vice.

Take-home mes­sage:

Men­stru­a­tion should not be a month­ly or­deal. Pain is your body’s way of send­ing a mes­sage—lis­ten, seek help, and take con­trol of your health. With ear­ly eval­u­a­tion and prop­er care, what once felt like an un­avoid­able bur­den can be man­aged ef­fec­tive­ly, im­prov­ing both qual­i­ty of life and long-term health.

Dr Sherene Kalloo

MBBS, DGO, DM, FACOG, MDW

Spe­cial­ist Ob­ste­tri­cian & Gy­nae­col­o­gist