Period pain and menstrual health

For many students who have periods, managing them without family nearby is a new responsibility. This lesson gives factual, practical information so you know what is normal, what helps and when to see a doctor. Everyone can benefit from understanding it, including to support friends and flatmates.

What is typical

• The NHS says periods usually come about every 28 days, but anywhere from every 21 to 35 days is common.
• A period usually lasts about 5 days, within a range of 2 to 7 days, and bleeding is heaviest in the first 2 days.
• Typical blood loss is about 20 to 90ml (roughly 1 to 5 tablespoons), though some people bleed more.
• Cycles can change with stress, travel, illness and big life changes, such as moving abroad; tracking them helps you notice patterns.
• Premenstrual syndrome (PMS) can cause bloating, tender breasts, mood swings, irritability, spots and headaches before a period; it usually eases when the period starts.

Period pain: what helps

• The NHS describes period pain as cramps in the tummy that can spread to the back and thighs, usually lasting up to 3 days.
• Self-help suggested by the NHS: a warm bath or shower, a heat pad or hot water bottle wrapped in a tea towel on your tummy, and massaging your tummy and back.
• Gentle exercise such as walking, swimming, yoga or cycling can help.
• Paracetamol or ibuprofen can ease pain; follow the label and the safe-use lesson in this module.
• Keep a heat pad and painkillers in your kit and a spare product in your bag, so a lecture day is manageable.

Products and hygiene

• Options include pads (disposable or reusable), tampons, menstrual cups and period underwear; choose what suits you, your comfort and your values.
• Follow the product instructions, wash your hands before and after, and do not leave tampons or cups in longer than recommended; the NHS links this to preventing toxic shock syndrome.
• Toxic shock syndrome is rare but serious. Symptoms include a high temperature, flu-like aches and a sandpaper-like rash; if you have these while using a tampon or cup, remove it and get urgent advice, saying you were using one.
• Find out where to buy products near your accommodation in your first week, and keep a small stock so you are never caught out.

When to see a doctor

• See a GP if periods become more painful, heavier or irregular, or if pain stops you doing your usual daily activities (NHS).
• Signs of heavy periods include changing a pad or tampon every 1 to 2 hours, needing two types of product at once, periods lasting more than 7 days, clots larger than about 2.5cm, or feeling tired or short of breath a lot.
• See a GP about bleeding between periods.
• Get an urgent GP appointment or call NHS 111 if pelvic or period pain is severe or worse than usual and painkillers have not helped.
• Severe period pain is sometimes caused by a condition such as endometriosis or fibroids, so it is worth getting checked rather than putting up with it.

Talking about it

• Doctors and pharmacists discuss periods every day; you can say simply: 'My periods have become very painful and painkillers aren't helping.'
• You can ask to see a female doctor or nurse if that makes you more comfortable; many practices will try to arrange this.
• If severe period pain affects an exam or deadline, it may count under your university's mitigating circumstances rules; see the last lesson in this module.
• Friends of any gender can help by keeping a spare product, being discreet and never making jokes about it.