Use painkillers such as ibuprofen for period pain instead of just enduring it; if pain disrupts work or school or remains uncontrolled after three months of medication, see a gynecologist

A box of ibuprofen costs a little over ten yuan; take it only during the painful days. If you need to see a gynecologist, registration and an ultrasound cost some money and take about half a day.

A Cochrane systematic review combined 80 randomized controlled trials involving 5820 women with primary dysmenorrhea. Primary dysmenorrhea means period pain without another identifiable disease. Compared with placebo, nonsteroidal anti-inflammatory drugs were more effective for pain relief (OR 4.37, 95% CI 3.76–5.09, the confidence interval). In absolute terms, 18% of those taking placebo had at least moderate relief, compared with 45% to 53% taking these drugs. The trade-off was more side effects (OR 1.29, 1.11–1.51). Side effects occurred in 10% taking placebo and 11% to 14% taking these drugs. The increases were mainly gastrointestinal symptoms (OR 1.58) and nervous system effects (OR 2.74). These drugs were also more effective than acetaminophen for pain relief (OR 1.89, 1.05–3.43), although this comparison involved only 3 trials. No difference was established in which drug in this class works best. The UK NICE guideline (updated in 2024) lists circumstances in which endometriosis should be suspected: chronic pelvic pain, period pain affecting daily activities and quality of life, and deep pain during or after sex. Other symptoms are painful bowel movements during menstruation, blood in the urine or painful urination during menstruation, and infertility accompanied by these symptoms. Girls aged 17 and under are included. The guideline recommends first trying acetaminophen or these drugs, for example for 3 months. If pain relief is inadequate, refer for further investigation. Normal gynecological examination and ultrasound findings do not rule out this disease. One study surveyed 1418 women undergoing laparoscopy at 16 hospitals in 10 countries. From symptom onset to surgical confirmation of endometriosis, the average delay was 6.7 years, mainly during care in primary settings. Women with a confirmed diagnosis lost an average of 10.8 hours of work per week, mostly through reduced productivity while at work. An online survey in the Netherlands asked 32748 women aged 15 to 45. Of them, 13.8% had taken leave because of menstruation, averaging 1.3 days per year. During menstruation, 80.7% were at work but less productive, equivalent to 8.9 days of lost work per year.

Marjoribanks J, Ayeleke RO, Farquhar C, Proctor M (2015). Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database of Systematic Reviews, (7):CD001751. https://doi.org/10.1002/14651858.CD001751.pub3；National Institute for Health and Care Excellence (2017, updated 2024). Endometriosis: diagnosis and management (NG73), recommendations 1.3.1, 1.4.2, 1.4.3, 1.5.4. https://www.nice.org.uk/guidance/ng73/chapter/Recommendations；Nnoaham KE, Hummelshoj L, Webster P, et al.; World Endometriosis Research Foundation Global Study of Women's Health consortium (2011). Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertility and Sterility, 96(2):366-373.e8. https://doi.org/10.1016/j.fertnstert.2011.05.090；Schoep ME, Adang EMM, Maas JWM, De Bie B, Aarts JWM, Nieboer TE (2019). Productivity loss due to menstruation-related symptoms: a nationwide cross-sectional survey among 32 748 women. BMJ Open, 9(6):e026186. https://doi.org/10.1136/bmjopen-2018-026186；Haleon (2026). Advil (ibuprofen capsule, liquid filled), OTC drug label: Warnings. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1f01c10a-9434-91a4-2ee4-352315a6b610

People over 60, those with a history of gastrointestinal bleeding, and those taking anticoagulants or corticosteroids should consult a doctor before using NSAIDs. For details, see Section 34, Item 3 (NSAIDs like ibuprofen). The US ibuprofen package insert notes that it can cause severe allergic reactions, which are more common in people allergic to aspirin and may include asthma attacks; individuals with asthma should also consult a doctor before use. If you may be pregnant, consult a doctor first, and do not take it on your own after 20 weeks of pregnancy; see Section 34, Item 5 (after 20 weeks of pregnancy). Those who cannot take NSAIDs can use acetaminophen instead; for maximum daily limits, see Section 34, Item 1 (acetaminophen). Menstrual cramps require medication only on the painful days of the period. The threshold in Section 34, Item 9 (not taking painkillers 15 or more days a month) addresses headaches, and the number of days medication is taken for menstrual cramps falls well below that limit. Grade A is assigned because the pain-relief efficacy is supported by a large volume of randomized trials. The review authors judged the quality of evidence for most comparisons to be low, primarily because trial methods were poorly reported and 59% of trials were funded by pharmaceutical companies. Benefit is rated moderate as a judgment: the review measured only pain relief rather than days of school or work absence saved. In the Dutch survey, annual lost productivity attributable to menstruation averaged around 10 days, which amounts to a matter of hours on a weekly basis. Furthermore, the endometriosis cohort consisted of patients already undergoing laparoscopy, which does not mean that the majority of women with menstrual cramps have the disease. The primary beneficiary is you.