Menstrual Health Through the Years: From Period Pain to Menopause
Author : Annette Davis | Published On : 15 Oct 2026
Period pain in your teens and 20s: why it happens
Period pain, known medically as dysmenorrhoea, happens when the womb lining releases chemicals called prostaglandins that make the womb muscle contract. The stronger the contractions, the stronger the cramps.
Most people first notice it within a year or two of their periods starting. This is called primary dysmenorrhoea. It typically shows up as:
• cramping or aching in the lower tummy, starting just before or as bleeding begins
• pain that spreads to the lower back or thighs
• pain that lasts one to three days and often eases with age or after childbirth
It is very common, and it is not something you simply have to put up with. When pain keeps you from school, work or normal activities, it deserves proper treatment and, if needed, a medical check.
Easing period pain: self-care, over-the-counter and prescription options
The best treatment for period pain is usually the one that matches how strong the pain is. Most people start simple and step up only if they need to.
Self-care that helps
• A hot water bottle or heat patch on the lower tummy
• A warm bath or shower
• Gentle exercise such as walking or stretching
• Rest, and tracking your cycle so you can start treatment early
Over-the-counter pain relief
Anti-inflammatory painkillers work well for period pain because they reduce prostaglandin activity, and they tend to work best when taken as soon as the pain starts. Feminax Express is a tablet made specifically for period pain, and its active ingredient is ibuprofen lysine. Always read the leaflet first. Ibuprofen-type medicines are not suitable for everyone, including some people with asthma, stomach ulcers, kidney problems or certain heart conditions, so ask a pharmacist if you are unsure. Paracetamol is another common option if ibuprofen is not suitable for you.
Prescription treatment for stronger pain
If over-the-counter options are not enough, prescription medicine may help. Mefenamic Acid is a prescription-only anti-inflammatory used for period pain. It is taken with food, and the dose and duration should always follow your prescriber’s instructions and the patient leaflet.
Sphere Pharmacy’s period pain treatment service lets you request treatment online, where your answers are assessed by a prescriber before anything is supplied. You can also speak to your GP, who may discuss hormonal options such as the contraceptive pill or a hormonal coil.
Your 30s and 40s: heavy periods, PMS and conditions behind severe pain
For many women, period pain settles in their 20s. For others, it changes or gets worse. Pain that starts later in life, or keeps building over time, is called secondary dysmenorrhoea, and it can point to an underlying condition.
Common causes include:
• Endometriosis: tissue similar to the womb lining grows elsewhere in the pelvis, often causing severe pain, pain during sex and heavy bleeding
• Adenomyosis: the womb lining grows into the womb wall, leading to heavy, painful periods
• Fibroids: non-cancerous growths in or around the womb that can cause heavy bleeding and pressure
• Pelvic inflammatory disease: an infection of the reproductive organs that can cause ongoing pelvic pain
Premenstrual syndrome (PMS) also becomes more noticeable for some women in this decade, with mood changes, bloating, breast tenderness and tiredness in the days before a period.
A useful rule: if your pain no longer responds to usual painkillers, is getting worse, or comes with very heavy bleeding, it is time to get it checked rather than manage it alone.
Perimenopause: when periods start to change
Perimenopause is the transition before menopause, when oestrogen and progesterone levels begin to fluctuate. It often starts in the 40s, sometimes earlier, and can last several years.
Periods are usually the first thing to change. They may become shorter or longer, lighter or heavier, and further apart or closer together. Some women find period pain gets worse for a while, because heavier bleeding and hormone swings can make cramps more intense.
Other common symptoms include:
• hot flushes and night sweats
• trouble sleeping
• low mood, anxiety or irritability
• brain fog and poor concentration
• vaginal dryness and changes in sex drive
Because ovulation can still happen during perimenopause, pregnancy is still possible. NHS advice is to keep using contraception for two years after your last period if you are 40 to 49, or one year if you are 50 or over.
Women’s menopause: what to expect and where to get help
Women’s menopause is confirmed once you have gone 12 months in a row without a period. Most women reach it between 45 and 55, but it can happen earlier. Menopause before 45 is considered early, and before 40 it is called premature ovarian insufficiency, which needs medical advice.
After menopause, the cramping side of period pain stops because periods stop, but other symptoms can continue for years, including hot flushes, sleep problems, joint aches, mood changes and vaginal dryness.
Treatment options are broader than many women realise:
• Hormone replacement therapy (HRT): replaces the oestrogen your body no longer makes and is the most effective treatment for many symptoms. Your doctor will weigh benefits and risks for you.
• Local vaginal oestrogen: targets dryness and discomfort with very little absorbed into the body.
• Non-hormonal options: some prescription medicines, cognitive behavioural therapy (CBT) and lifestyle changes can help if HRT is not suitable.
• Lifestyle support: regular exercise, a balanced diet, cutting back on alcohol and caffeine, and a cool bedroom can ease symptoms.
Any vaginal bleeding after menopause should be checked by a GP promptly, even if it is light.
When to see a doctor
Book a GP appointment if you notice any of the following:
• period pain that interferes with daily life or does not improve with painkillers
• very heavy bleeding, such as soaking through protection every hour or two, or passing large clots
• bleeding between periods or after sex
• pain during sex or when using the toilet around your period
• pain that is new or getting worse, especially after years of manageable periods
• menopause symptoms before the age of 45
• any bleeding after menopause
Seek urgent help through NHS 111 or 999 if you have sudden severe pelvic pain, a high temperature with pelvic pain, or feel faint with heavy bleeding.
For straightforward period pain, you can also start with Sphere Pharmacy’s online period pain service or ask a pharmacist for advice on suitable treatment.
FAQs about period pain and menopause
What causes period pain?
Period pain is caused by prostaglandins, chemicals released by the womb lining that make the womb muscle contract. Conditions such as endometriosis, adenomyosis and fibroids can also cause or worsen it.
What is the best medicine for period pain?
Anti-inflammatory painkillers such as ibuprofen are often effective when taken at the first sign of pain. Feminax Express is made for period pain, and stronger prescription options such as Mefenamic Acid are available after assessment by a prescriber.
Can period pain get worse during perimenopause?
Yes. Hormone fluctuations can make periods heavier and cramps stronger for a time before periods eventually stop.
What are the first signs of menopause?
Changes to your periods are usually the first sign, followed by hot flushes, night sweats, sleep problems and mood changes.
Does period pain stop after menopause?
Period cramps stop once periods stop, but other menopause symptoms may continue. Any bleeding after menopause should be checked by a GP.
Do I need a prescription for mefenamic acid in the UK?
Yes. Mefenamic acid is a prescription-only medicine in the UK, so it must be supplied after a prescriber has reviewed your health information.
