What causes period pain?

Period pain is caused by prostaglandins, natural chemicals that make the muscle of the womb contract to shed its lining each month. Every cycle the lining of the womb thickens in case of a pregnancy. When no pregnancy happens, hormone levels fall and the lining is shed, and the womb contracts to push it out. Those contractions are the cramps you feel.

Women with period pain have higher prostaglandin levels than women without it, and the levels are highest during the first two days of a period.^A Prostaglandins also act on blood vessels and nerves around the pelvis, which is why the cramps often come with nausea, headache, tiredness or diarrhoea.^A The medical name for all of this is dysmenorrhoea.

It is extremely common. A 2026 review of 336 studies across 70 countries put the worldwide share of women of reproductive age with period pain at about 71 percent, and a review of studies from sub Saharan Africa found much the same, 73 percent.^BC If your period hurts, you are in the majority, not the exception.

Primary and secondary period pain

Doctors separate period pain into two kinds: primary, which has no underlying disease behind it, and secondary, which is caused by a condition such as endometriosis.^A

Primary period pain

Primary period pain is the ordinary kind, driven by prostaglandins alone. It usually starts within a year or two of the first period, is worst on the first day or two and settles as the bleeding tails off. It is uncomfortable, sometimes very, but it is not a sign that something is wrong.

Secondary period pain and endometriosis

Secondary period pain has an underlying cause, and the most common one is endometriosis, in which tissue similar to the womb lining grows outside the womb, for example on the ovaries or the lining of the pelvis. It affects about one in ten women of reproductive age, around 190 million worldwide, and the World Health Organization notes that the average time to diagnosis is between four and twelve years.^D Adenomyosis, fibroids and pelvic infections can cause secondary pain too. The pattern is different: the pain often starts earlier in life than it used to, lasts beyond the period and gets worse over time.

When to see a doctor

See a doctor when period pain stops you living normally or does not ease with ordinary painkillers, when you have pelvic pain outside your period, or when you have pain during sex, when passing urine or when opening your bowels.^AE The European endometriosis guideline lists exactly these symptoms as reasons to consider endometriosis, together with heavy bleeding, tiredness and difficulty falling pregnant.^E A GP or gynaecologist can examine you and arrange a scan. Given how long diagnosis can take, it is better to ask early than to put up with it.

What helps against period pain?

Heat, regular exercise and TENS all have trial evidence behind them, and all three are drug free, so they suit women who want to take fewer painkillers or cannot take them. Here is what the research says about each.

Heat

A hot water bottle on the belly is the oldest remedy there is, and the evidence backs it. A 2018 review of trials pooled six studies of heat patches worn on the lower abdomen at about 40 degrees C and found less pain than with no treatment, and less than with paracetamol, although the authors cautioned that the trials were small.^F Heat relaxes the muscle of the womb and improves blood flow to the area.

Exercise

Moving helps, even when it is the last thing you feel like. A Cochrane review of nine trials concluded that exercise for about 45 to 60 minutes, three or more times a week, regardless of intensity, may give a clinically meaningful reduction in period pain, while rating the evidence as low quality.^G A walk, a swim or a yoga session during the month counts; it does not have to be a hard workout.

Relaxation

Breathing exercises and relaxation are low risk and many women find them calming, but good evidence that they reduce period pain is lacking: the Cochrane review of behavioural treatments found mixed results across three small trials.^H Treat them as a comfort, not a cure.

TENS

TENS, short for transcutaneous electrical nerve stimulation, sends gentle electrical pulses through pads on the skin. The pulses stimulate the nerves under the pad and can dampen the pain signals travelling to the brain. The current Cochrane review, updated in 2024 with 20 trials and 585 women, concluded: "High frequency TENS and low frequency TENS may reduce pain compared with placebo or no treatment", and rated the evidence low certainty because of the risk of bias in the trials.^I In practice TENS is used on its own or together with heat, and it can be worn under clothes while you carry on with your day.

The Beurer Menstrual Relax: heat and TENS in one pad

The Beurer EM 50 Menstrual Relax and EM 55 Menstrual Relax+ combine TENS and heat in one soft, reusable pad that sticks to the lower belly and is worn under clothing. The heat programme warms the pad to 43 degrees C, the TENS has 15 intensity levels, and the two can be used together or separately. The pad is rechargeable over USB and gives up to six sessions of 20 minutes per charge, so it goes in a handbag for work or the taxi. Beurer TENS devices are classified as medical devices in both South Africa and Europe, and Beurer's clinical studies on the Menstrual Relax found that over 80 percent of users felt pain relief during the first three days of their cycle.

The EM 55 Menstrual Relax+ is the larger version: a bigger pad gives wider heat and TENS coverage over the lower belly. Both are for abdominal use only, for period pain and endometriosis pain, and the instructions say to stop if the treatment feels unpleasant or irritates the skin. If you have a pacemaker, are pregnant or have a medical condition, check with your doctor before using any TENS device.

From the Beurer South Africa shop

Original price R 1,499.00

Current price R 1,269.00

Beurer Menstrual Pain Relief EM 50: Period & Endometriosis Pain Relief with TENS & Heat Pad

Beurer

in stock

View product

Original price R 1,999.00

Current price R 1,699.00

Beurer Germany EM 55 XL Menstrual Period Pain Relief & Endometriosis Pain Relief | TENS & Heat

Beurer

in stock

View product

Common questions about period pain and the Beurer Menstrual Relax

Does TENS really help with period pain?

A 2024 Cochrane review of 20 trials found that TENS may reduce period pain compared with a dummy device or no treatment, though it rated the evidence as low certainty. Beurer's own studies on the Menstrual Relax pads found that over 80 percent of users felt relief during the first three days of their cycle.

Can I use heat and TENS at the same time?

Yes. On the EM 50 Menstrual Relax and EM 55 Menstrual Relax+ the heat and the TENS can be used together or separately, with 15 TENS intensity levels and one heat programme at 43 degrees C.

What is the difference between the Beurer EM 50 and the EM 55?

Both pads combine TENS and heat and run for up to six sessions of 20 minutes per charge. The EM 55 Menstrual Relax+ has a larger pad, so the heat and the TENS cover a wider area of the lower belly.

When should I see a doctor about period pain?

When the pain stops you living normally or does not ease with over the counter painkillers, when you have pelvic pain outside your period, or when you have pain during sex, when passing urine or when opening your bowels. These can be signs of endometriosis, which affects about one in ten women of reproductive age.

Where can I buy the Beurer Menstrual Relax in South Africa?

From the Beurer South Africa online shop at beurer.co.za. The EM 50 Menstrual Relax and EM 55 Menstrual Relax+ are listed with the current price in this article.