How to stop extreme period cramps

Strong uterine contractions can cause period pain, but extreme or changing pain may indicate a condition that needs treatment. [Endometriosis](/conditions/endometriosis/), [Adenomyosis](/conditions/adenomyosis/), [Uterine Fibroids](/conditions/uterine-fibroids/), [Ovarian Endometrioma](/conditions/ovarian-endometrioma/), and [Pelvic Inflammatory Disease](/conditions/pelvic-inflammatory-disease/) can all present with pelvic or period pain. Pain alone cannot distinguish among these causes.

Tell a clinician whether the pain is one-sided, begins before bleeding, continues after the period, or comes with heavy bleeding, fever, vomiting, painful sex, bowel or bladder symptoms, or difficulty becoming pregnant. This pattern guides the examination and any testing.

Use a heat pack on the lower abdomen or back and rest in a position that feels comfortable. Gentle walking or stretching is acceptable only if it does not worsen the pain. Ask a pharmacist or clinician about anti-inflammatory medicine before taking it, especially with stomach ulcers, kidney disease, bleeding problems, allergies, or possible pregnancy. Do not combine products containing the same medicine. A clinician may discuss options such as the [Combined Pill](/treatments/contraception-and-family-planning/combined-pill/) or [Hormonal Coil](/treatments/contraception-and-family-planning/hormonal-coil/), depending on your health and goals.

Seek emergency help for sudden or unbearable pain, fainting, a rigid or swollen abdomen, fever with pelvic pain, repeated vomiting, heavy bleeding, or pain when pregnancy is possible. Contact a clinician promptly if severe cramps repeatedly stop you functioning, are getting worse, or are accompanied by unusual discharge, bleeding between periods, or pain during sex. Do not wait for the next cycle if the symptoms feel significantly different.

What could explain the severity and timing of my cramps? Do I need an examination, pregnancy test, infection testing, or imaging? Which treatment can reduce future episodes, and what warning signs should prompt urgent care?