Struggling with period pain (dysmenorrhea)? Here’s how Physiotherapy can help.
If painful periods are regularly throwing your routine off track, you’re not alone. Up to four in five women aged 18 to 44 experience troublesome period pain. Three-quarters of those reported that bothersome periods had a substantial impact on work, study, exercise, mental health and relationships.
Cramping, pelvic heaviness and pain radiating to the lower back, abdomen or legs are common symptoms –sometimes accompanied by nausea, diarrhoea or fatigue. When these symptoms start to affect your physical, mental or emotional wellbeing, it’s worth seeking support.
Women’s Health Physiotherapists are specially trained to assess and treat period pain, offering evidence-based therapies that can help to reduce discomfort help you feel more in control each month.
Understanding period pain
There are two main types of period pain, primary and secondary dysmenorrhea.
Primary Dysmenorrhea
The most common type, this pain isn’t caused by an underlying condition. It is linked to high levels of prostaglandins, which are hormone-like chemicals that trigger uterine contractions to shed the lining.
Secondary Dysmenorrhea
This pain is associated with a medical condition such as:
Endometriosis
Adenomyosis
Fibroids
The role of the pelvic floor in period pain
Your pelvic floor is a group of muscles, ligaments, and fascia that sit at the base of your pelvis. These muscles support key organs like the uterus, bladder, and bowel, and they’re closely linked to your nervous system.
When you experience period pain, bloating, or pelvic discomfort, your body instinctively protects itself by tensing muscles, including the pelvic floor. This is called muscle guarding.
Over time, this can lead to:
Unconscious gripping
Reduced muscle flexibility
Impaired coordination between the diaphragm and pelvic floor
More sensitivity to pain
Tight pelvic floor muscles don’t stay isolated. They often:
Refer pain to the back, hips, inner thighs or abdomen
Disrupt bladder, bowel and sexual function
Increase pressure in the pelvic cavity, making cramping worse by limiting blood flow
So instead of helping, pelvic floor tension can amplify your period pain, creating a frustrating feedback loop:
Pain → Muscle Guarding → Reduced Movement & Blood Flow → More Pain → More Tension
The good news is you can break the cycle.
Strategies to ease period pain
Movement and exercise
Gentle movement is incredibly effective for managing menstrual discomfort.
Benefits include:
Releasing endorphins (your natural pain relief hormones)
Improving blood flow to the uterus and pelvic floor
Lowering inflammation
Regulating hormones
Boosting your mood and energy
Heat Therapy
Use a hot water bottle, wheat bag or warm bath
Heat helps by:
Relaxing uterine and pelvic floor muscles
Improving blood circulation
Reducing cramps and spasms
Stretching
Tight muscles around the hips, pelvis, and lower back often become reactive during your cycle. Target gentle stretches that open the hips, lengthen the spine and encourage relaxation of the pelvic floor.
Stretching:
Eases muscle tension
Improves flexibility
Calms the nervous system
Reduces the intensity and spread of period pain
Diaphragmatic Breathing
Your diaphragm and pelvic floor are closely connected. As you breathe in and out, both should move in rhythm. But when you're stressed or in pain, that rhythm breaks down.
Practicing slow, deep breathing can:
Encourage pelvic floor relaxation
Stimulate your parasympathetic nervous system (your "rest and digest" mode)
Lower pain perception
Help your whole body settle into a calmer state
TENS (Transcutaneous Electrical Nerve Stimulation)
TENS units deliver low-level electrical stimulation that can interrupt pain signals before they reach your brain. This is based on the pain gate theory (i.e. your nervous system can only focus on so many signals at once).
TENS is:
Drug-free
Portable
Easy to use
Manual Therapy
Hands-on techniques to reduce muscle tension from a Pelvic Health Physiotherapist can:
Release overactive pelvic floor muscles
Improve circulation
Reduce central and local pain sensitivity
Self-Care & Emotional Health
Pain is never just physical. Your emotional state, stress levels, and coping strategies all influence how pain is felt and processed.
Self-care strategies could include:
Journaling or creative expression
Spending time with loved ones
Mindfulness or meditation
Saying no to obligations during your cycle
Doing something that brings you joy
How a Pelvic Health Physiotherapist can help
Pelvic Health Physiotherapists are trained in assessing and treating the complex relationship between your muscles, nerves, hormones and pain systems.
We offer:
Assessment: To understand your muscle patterns, breathing, posture and pain triggers
Pelvic floor rehabilitation: Including relaxation techniques and gentle strengthening if needed
Manual therapy: Internal (with your consent) or external release work to reduce muscle tension
Education: About your body, your cycle, and what’s normal versus what’s not
Pain management tools: Breathing, stretching, TENS and pacing
Referrals and collaboration: We work closely with GPs, specialists and psychologists if needed
When to seek support
Consider reaching out to a Pelvic Health Physio if you:
Have pain that stops you from going to work, school, or social events
Need medication every cycle just to get through the day
Experience referred pain, bowel/bladder issues or sexual pain
Period pain is common but that doesn’t mean it’s normal.
Understanding the roles of your pelvic floor, your nervous system and your emotional wellbeing are key to managing your menstrual health. With support from a Pelvic Health Physiotherapist, you can move toward cycles that feel more manageable, less painful and more in tune with your body.
Book An Appointment
Book an appointment with one of our Women’s Health / Pelvic Health Physiotherapists today.
To make a booking, phone 07 5337 9853.
