What Helps Period Pain? Supplements, Heat and the Evidence

The two things with the strongest evidence for period pain are anti-inflammatory painkillers from a pharmacist and heat: across 80 trials of 5,820 women, 45 to 53% taking an anti-inflammatory got good relief against 18% on placebo, and heat pads beat painkillers in two trials of 274 women.^{1, 2} Regular exercise cut pain by about 25 mm on a 100 mm scale in nine trials.³ Among supplements, ginger matched anti-inflammatory painkillers across 12 trials, vitamin B1 at 100 mg a day relieved pain in 87% of 556 girls, and zinc, vitamin D, omega-3 and magnesium each have smaller, lower-quality trials; raspberry leaf has none.^{5, 6, 7, 8, 9, 10, 11, 14} Pain that worsens with age, arrives days before bleeding or comes with pain during sex is not ordinary period pain and needs a GP.^{17, 18}

What actually helps period pain first?

Period pain comes from prostaglandins, released by the womb lining as it sheds; they make the muscle contract hard and briefly cut its blood supply. Anti-inflammatory painkillers block prostaglandin production, which is why they beat paracetamol (odds ratio 1.89 in three trials) and work best taken as the pain starts.¹ A pharmacist can say which suits you; anyone with asthma, stomach ulcers or kidney problems asks first. Heat is the other proven tool: a hot-water bottle or heat patch on the lower abdomen outperformed painkillers in two trials and no treatment in a third, a 4-point fall on a 10-point scale.² High-frequency TENS beat sham TENS in small trials.⁴ Exercise, 45 to 60 minutes three times a week through the month, gave the 25 mm reduction above.³ If those fail, a GP can prescribe a stronger anti-inflammatory or hormonal contraception, which thins the lining and so the prostaglandin load.¹⁶

Why do periods hurt, and how much pain is normal?

Pain that starts with or just before bleeding, peaks on the first day or two, eases within 48 to 72 hours and responds to painkillers and heat is primary dysmenorrhoea: no underlying disease, just a prostaglandin-rich lining. It is worst in the teens and twenties and usually eases with age or after childbirth. Up to 90% of menstruating women report some cramping, and trial entrants typically rated theirs 6 or more out of 10; pain that stops you working or sleeping despite painkillers is common but not something to put up with, and the NHS says to see a GP when pain is severe or changes.^{8, 12, 16} Cramps in the lower back, thighs or buttocks are referred pain from the same contractions; one-sided cramps, or cramps after bleeding has finished, belong in the "not normal" list below.

Which supplements have trials for period pain?

The 2016 Cochrane review of 27 trials in 3,101 women rated every supplement trial low or very low quality, mostly because they were small and single.¹² Within that, the numbers:

So "what vitamin stops menstrual cramps" has an answer, vitamin B1, resting on one old trial, and "what deficiency causes period cramps" has none, though the vitamin D trials recruited women with low levels. The magnesium questions, the most asked, come down to three small trials and no comparison of forms.¹¹ Ginger and chamomile are the drinks with evidence; no fruit, tea or food has been shown to stop period pain, and cloves have no trial. No trial has compared sleeping or resting positions, and acupressure has only small, mixed trials.⁴

Do PMS supplements work: B6, magnesium, calcium, agnus castus, evening primrose?

Different question, different evidence. Vitamin B6 at up to 100 mg a day roughly doubled the odds of improvement across nine trials of 940 women, all low quality; the NHS says 200 mg or more a day can cause nerve damage and that adults should not take more than 10 mg of vitamin B6 a day in supplements unless advised to by a doctor.^{15, 19} Magnesium has the three small trials above. Calcium, agnus castus and evening primrose oil have small trials of mixed quality that no large review has settled, so we leave them ungraded. PMDD, severe premenstrual mood symptoms, is a GP diagnosis with medicine options. Heavy periods are the commonest route to iron deficiency: iron supplements for heavy periods.

When is period pain not normal?

See a GP if pain starts several days before bleeding, lasts beyond it, is getting worse year on year, wakes you or is one-sided: signs that clinicians look for. The NHS lists the symptoms of endometriosis, where lining-like tissue grows outside the womb, as period pain severe enough to stop your normal activities, heavy periods, pain in the lower tummy or back at any time, pain when you poo or pee, pain during or after sex, extreme tiredness and difficulty getting pregnant; a GP can examine and refer you, and a laparoscopy (keyhole camera) confirms it.¹⁷ Adenomyosis, where lining tissue grows into the womb's muscle wall, causes heavy, painful periods and pelvic pressure, is commoner in the thirties and forties and shows on ultrasound or MRI.¹⁸ Fibroids, pelvic infection and a copper coil also cause secondary period pain; a hospital can give stronger pain relief, scan you and rule out the emergencies.

Call 999 or go to A&E for sudden severe pain, especially one-sided, with faintness, collapse or shoulder-tip pain, above all if you could be pregnant (an ectopic pregnancy or a twisted ovary presents as the worst period pain ever); for pain with a high temperature and feeling very unwell; or for bleeding soaking through a pad or tampon every hour. Call 111 if you are unsure, or if painkillers and heat have not touched the pain by the second day.¹⁶

How do you read a period supplement label?

Period-comfort sachets and capsules usually combine several of the nutrients above, often at or near reference-intake levels, with botanical extracts such as saffron, chamomile, raspberry leaf and green tea. Set each nutrient's dose against the trial doses in the table: the trial figures are evidence for the ingredients, not results for any product, and the authorised wording belongs to the nutrient, so vitamin D contributes to the maintenance of normal bones and teeth and to normal muscle function whatever the pack. Green tea extract carries caffeine; anyone pregnant, breastfeeding or on medication asks a GP first.

The Wellgard women's health guide begins with what causes BV and why it comes back.

Frequently asked questions

Why isn't ibuprofen helping my period cramps?

They do not work for everyone: in the Cochrane review, 45 to 53% of women taking one got moderate or excellent relief, against 18% on placebo.¹ Take the first dose as the first ache begins, add heat, and if that fails on two cycles, see a GP: a different anti-inflammatory, hormonal contraception or a check for endometriosis are the next steps.¹⁶

Does period pain get worse with age?

Primary period pain usually eases with age. Pain that worsens through your twenties, thirties or forties points to a secondary cause such as endometriosis, adenomyosis or fibroids, and is a reason to see a GP.^{17, 18}

What is the best drink for period cramps?

Ginger tea or ginger powder has the most trials; chamomile tea has one.^{6, 12} No trial has tested alcohol or caffeine, which some women find worsen cramps.

Can magnesium stop or delay your period?

No. Magnesium has no effect on whether or when a period comes; its three small trials looked only at cramp pain.¹¹

Sources

1. Marjoribanks J, et al. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database of Systematic Reviews, 2015. PubMed 26224322.
2. Jo J, Lee SH. Heat therapy for primary dysmenorrhea: a systematic review and meta-analysis. Scientific Reports, 2018. PubMed 30389956.
3. Armour M, et al. Exercise for dysmenorrhoea. Cochrane Database of Systematic Reviews, 2019. PubMed 31538328.
4. Proctor ML, et al. Transcutaneous electrical nerve stimulation and acupuncture for primary dysmenorrhoea. Cochrane Database of Systematic Reviews, 2002. PubMed 11869624.
5. Daily JW, et al. Ginger for primary dysmenorrhea: systematic review and meta-analysis. Pain Medicine, 2015. PubMed 26177393.
6. Moshfeghinia R, et al. Ginger for pain in primary dysmenorrhea: systematic review and meta-analysis. Journal of Integrative and Complementary Medicine, 2024. PubMed 38770631.
7. Gokhale LB. Curative treatment of primary (spasmodic) dysmenorrhoea. Indian Journal of Medical Research, 1996. PubMed 8935744.
8. Hsu TJ, et al. Zinc supplementation in primary dysmenorrhea: systematic review and meta-analysis. Nutrients, 2024. PubMed 39683510.
9. Lin KC, et al. Vitamin D supplementation for patients with dysmenorrhoea: a meta-analysis. Nutrients, 2024. PubMed 38613122.
10. Snipe RMJ, et al. Omega-3 long chain polyunsaturated fatty acids for reducing dysmenorrhoea pain: systematic review and meta-analysis. Nutrition and Dietetics, 2024. PubMed 37545015.
11. Proctor ML, Murphy PA. Herbal and dietary therapies for primary and secondary dysmenorrhoea. Cochrane Database of Systematic Reviews, 2001. PubMed 11687013.
12. Pattanittum P, et al. Dietary supplements for dysmenorrhoea. Cochrane Database of Systematic Reviews, 2016. PubMed 27000311.
13. Mohammadi MM, Karimi Z. Effect of saffron on premenstrual syndrome and dysmenorrhea: a systematic review and meta-analysis. Korean Journal of Family Medicine, 2026. PubMed 41151539.
14. Bowman R, et al. Raspberry leaf use in pregnancy: a systematic integrative review. BMC Complementary Medicine and Therapies, 2021. PubMed 33563275.
15. Wyatt KM, et al. Vitamin B-6 in premenstrual syndrome: systematic review. BMJ, 1999. PubMed 10334745.
16. NHS. Period pain. nhs.uk/conditions/period-pain.
17. NHS. Endometriosis. nhs.uk/conditions/endometriosis.
18. NHS. Adenomyosis. nhs.uk/conditions/adenomyosis.
19. NHS. B vitamins and folic acid. nhs.uk/conditions/vitamins-and-minerals/vitamin-b.