Lower-abdominal cramps may occur as the uterus contracts during menstruation, but severe pain should not be dismissed as a normal constitution. Pain that causes repeated absence from work or school, worsens over time, responds poorly to pain relief, or occurs with pain during sex, bowel pain or abnormal bleeding may require assessment for endometriosis, adenomyosis, fibroids or pelvic disease.
TCM care is individualised according to the timing and nature of pain, menstrual flow and the person’s overall presentation. Support may also include regular routines, suitable activity and warmth for comfort. Herbal medicine or acupuncture should be considered only after assessment by a qualified practitioner, especially for people taking other medicines or trying to conceive.
Sudden severe pain, fainting, fever, possible pregnancy or very heavy bleeding requires urgent medical attention.
A diary can record pain before, during and after periods, response to relief and effects on life. Increasing monthly medication needs or pain outside menstruation makes investigation more important.
