Menstrual cramps (period pain): what helps and when to see a doctor

Period pain, or dysmenorrhea, is pain in the lower belly (puson) just before or during your period (regla). Many people call it sakit ng puson or hilab. It can feel like:

• cramps that come and go, or a dull, heavy ache
• pain that spreads to the lower back and thighs
• nausea, loose stools (diarrhea) or a headache at the same time

Period pain is very common: about 8 in 10 people who have periods get it at some point. It often starts a day or two before bleeding and usually lasts up to 3 days.

It is usually normal if it doesn't keep you from your daily life and eases with heat or a pain reliever. Pain that keeps you home from school or work, or gets worse each month, needs a check-up (see When period pain may be something else).

During your period, the womb (matris) tightens to push out its lining, driven by chemicals called prostaglandins. The more of them the body makes, the stronger the cramps.

• Primary dysmenorrhea is the common kind, about 9 in 10 cases. No illness causes it. It usually starts within a year or so after your first period, is most common under age 30, and often gets milder with age.
• Secondary dysmenorrhea is caused by a condition of the womb or pelvis, such as endometriosis, adenomyosis, fibroids (myoma) or pelvic inflammatory disease (PID). It often starts years after your periods began, most often between 30 and 40, and tends to get worse over time. The pain may start before your period and go on after it.

A copper IUD can also make periods more painful, mostly in the first 3 to 6 months. Only a doctor can tell what is behind your pain.

These steps help many people and are safe for most, teens included:

• Use heat. Put a hot water bottle or warm compress on your lower belly. Wrap it in a towel first, and never fall asleep with a heating pad on, so you don't get burned.
• Take a warm bath or shower.
• Move your body. Gentle exercise such as walking, cycling, swimming or yoga helps. For fewer cramps month after month, aim for 45 to 60 minutes of exercise, 3 or more times a week.
• Massage your belly and back gently in small circles with your fingertips.
• Rest in a comfortable position, such as lying on your side with your knees bent, or with your legs raised.
• Drink salabat (ginger tea). Ginger may ease period pain and nausea.
• Eat fish rich in omega-3, such as sardines (sardinas, tamban) and mackerel (hasa-hasa). Studies suggest these foods can lower period pain.
• Relax with slow breathing, meditation or prayer.
• Cut down on alcohol and don't smoke.

Wondering whether this month's pain is normal for you? Tell Joy, our AI symptoms guide how it feels and how long it has lasted.

• Ibuprofen is an anti-inflammatory pain reliever (an NSAID). NSAIDs lower the prostaglandins behind cramps, and they work best when started early, as soon as the pain or bleeding begins.
• Paracetamol can help when cramps are mild. It is also an ingredient in many cough and cold products, so check every label and use only one paracetamol-containing product at a time.
• Mefenamic acid (one brand is Dolfenal) is another NSAID used for menstrual pain. Not every mefenamic acid product can be bought without a prescription here, so check with a doctor or pharmacist before you start it.

Follow the label or ask the pharmacist how much to take. Taking more won't work better and can harm you.

Never take two NSAIDs together, such as ibuprofen with mefenamic acid or aspirin: it raises the risk of stomach ulcers and bleeding. If an NSAID upsets your stomach, take it with a meal. Ask first if you have ever reacted badly to aspirin or another NSAID, or have asthma, a stomach ulcer or bleeding now or in the past, kidney, liver or heart disease, or take blood thinners.

Buy only from an FDA-licensed botika. On 1 September 2026, FDA Philippines warned the public about counterfeit Dolfenal (mefenamic acid) tablets being sold, and reminded everyone to buy medicines only from FDA-licensed outlets.

Pregnant, could be pregnant or breastfeeding, or buying for a girl under 18? Ask a doctor or pharmacist before taking or giving any medicine.

For strong pain that keeps coming back, a doctor may suggest hormonal birth control such as the pill, which makes periods lighter and less painful. Questions about a medicine? Ask our medicines guide.

• "Bawal maligo kapag may regla" (don't bathe during your period). Bathing is safe, and a warm bath or shower can ease cramps.
• "Bawal ang malamig at maasim" (no cold drinks or sour food). We found no good evidence that these cause cramps. Skip them if they seem to bother you, but you don't need to.
• "Normal lang 'yan, tiisin mo" (it's normal, just bear it). Mild cramps are normal. Pain that stops you from going to school or work is not. WHO warns that beliefs that downplay period pain make life harder for people with endometriosis, a condition that already takes years to find.
• "Mawawala 'yan pag nanganak ka na" (it goes away after you give birth). It sometimes gets better after childbirth, but not for everyone. Don't wait if your pain is severe.
• Hilot. Gentle rubbing of your own belly and back is fine. Don't let anyone press hard on your belly if the pain is new or severe, or if you might be pregnant.

• Endometriosis: tissue like the womb lining grows outside the womb, for example on the ovaries. WHO estimates it affects about 1 in 10 women of reproductive age. Signs include severe period pain, heavy periods, pelvic pain at other times, pain during sex or when peeing or pooing, and trouble getting pregnant. Finding it often takes years, so speak up if your pain is severe.
• Adenomyosis: the lining grows into the muscle wall of the womb, usually after age 35, with painful, heavy periods and a bloated, heavy belly.
• Fibroids (myoma): common growths in or around the womb that are not cancer. They can cause heavy or painful periods, needing to pee often, bloating or trouble pooing, and pain during sex.
• Pelvic inflammatory disease (PID): an infection, usually from a sexually transmitted infection such as chlamydia or gonorrhea (tulo). Signs include lower belly or pelvic pain, pain deep inside during sex, bleeding between periods or after sex, and discharge that looks or smells unusual; severe cases bring fever. Found early, it is usually easy to treat with antibiotics. Left untreated, it can make it harder to get pregnant and raise the chance of an ectopic pregnancy.
• Polycystic ovary syndrome (PCOS): mostly irregular or missed periods, acne and extra hair, sometimes with heavy, painful periods.
• Ectopic pregnancy: a pregnancy growing outside the womb, usually in a tube. Its bleeding can look like a period. Signs are pain low on one side, often with a missed period, bleeding that may be watery and dark brown, or pain at the tip of the shoulder. Sudden, severe belly pain with dizziness or fainting is an emergency: go to the nearest emergency room or call 911. See early signs of pregnancy.

Lower belly pain can also come from the bladder or bowel: see our guides to UTI symptoms and stomach pain.

Before your visit, keep notes for a few periods:

• the dates your period starts and ends
• how heavy it is (how often you change your pad or napkin)
• when the pain starts and stops, and how bad it is
• what you tried and whether it helped
• whether you miss school or work

The doctor will ask about your periods and may feel your belly. A pelvic (internal) exam, an ultrasound or tests for infections may follow. You can ask for a female doctor, bring someone you trust into the room, and ask to stop at any time.

Long-term pelvic pain can bring low mood or worry: tell your doctor. If you ever have thoughts of harming yourself, call 1553, the National Center for Mental Health crisis line, or go to the nearest emergency room.

• Your barangay health station, rural health unit (RHU) or city health center can check period pain that worries you and refer you if needed. Search for one near you.
• PhilHealth YAKAP. Under PhilHealth's YAKAP rules as of July 2025, your YAKAP clinic's consultations are free. Lab tests your YAKAP doctor requests are covered, and medicines they prescribe from the GAMOT list are free at accredited pharmacies, up to ₱20,000 worth each year. Public YAKAP clinics charge nothing; a private one may ask a co-payment of no more than ₱900 for the whole year. Details are in our PhilHealth YAKAP guide.
• A gynecologist (OB-GYN) can be seen for severe or worsening pain, a possible myoma or endometriosis, or tests like an ultrasound. At private clinics, ask the price of the visit and any ultrasound first.
• Emergencies such as sudden, severe belly pain or fainting need a hospital emergency room. If you are worried about the hospital bill, our Malasakit Center guide explains how to ask for help at a public hospital.

More on women's health is in our pregnancy and women's health guides. Want to talk it through? Book a call with a nurse.