What should you know about extremely painful periods?

Period pain can be felt in the lower abdomen, back, or thighs and may come with nausea, diarrhoea, headache, or dizziness. Severe or newly worsening pain can occur with endometriosis, adenomyosis, uterine fibroids, an ovarian endometrioma, or pelvic inflammatory disease. Pain that begins later, continues between periods, occurs with sex, or affects bowel or bladder symptoms deserves particular attention. The symptom does not identify one condition by itself.

Record when pain starts, where it spreads, how long it lasts, bleeding changes, and whether pain affects sex, bowel movements, urination, work, or sleep. Arrange a gynaecology review if pain repeatedly limits your life or self-care is not enough. Depending on your history, treatment may include anti-inflammatory medicine, the combined pill, a hormonal coil, physiotherapy, or treatment directed at an underlying condition. Follow medicine instructions and check suitability if you have other health problems.

Seek urgent help for sudden severe pain, fainting, heavy bleeding with weakness, fever, vomiting, or a possible pregnancy. Prompt assessment is also needed for new pain with unusual discharge, pain after a procedure, or pain that is rapidly getting worse.

Could endometriosis, adenomyosis, fibroids, infection, or an ovarian problem explain this pattern? Would an ultrasound help? Which pain relief or hormonal options fit my health and fertility plans?