Conditions
Period cramps: what helps and when to see a doctor
Period cramps are the pain in the lower belly that comes before or during your period. They usually ease with heat, exercise and over-the-counter anti-inflammatory medicine. If the pain gets in the way of your life or has changed, the doctor evaluates you by video, gives you a lab order if needed and, if appropriate, prescribes a treatment.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Sudden severe belly or pelvic pain if you could be pregnant, especially if your period is more than 1 week late
- Fainting or feeling faint
- Shoulder pain together with pelvic pain
- Very heavy vaginal bleeding with dizziness or weakness
- Severe lower belly pain with fever
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At a glance
Period cramps
Common symptoms
- Pain or cramping in the lower belly before or during your period
- Back or leg pain
- Sharp or aching pain that comes and goes
- Pain that keeps you from work or school
- Other names
- Dysmenorrhea · Menstrual cramps · Painful periods
- Usual test
- Complete blood count (CBC) if bleeding is heavy
- Treatment
- Heat, anti-inflammatories and, if appropriate, hormonal birth control
On this page(8)
What are period cramps?
Painful periods are called dysmenorrhea. According to MedlinePlus, primary dysmenorrhea is the most common kind: it is not caused by another condition, but by chemicals called prostaglandins that make the uterus contract.
Secondary dysmenorrhea often starts later in life and is caused by a problem in the uterus or other reproductive organs, such as endometriosis or fibroids. This pain tends to get worse over time.
How we care for you by video
You see Dr. Diana Nieves Castro, MD, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish. She asks what the pain is like, when it started, how heavily you bleed, whether you have a fever, whether you could be pregnant and what you have tried.
If you bleed heavily, we give you a lab order for a complete blood count (CBC) at a lab near you, to check for anemia. If the pain points to a cause such as endometriosis or fibroids, we refer you to gynecology. If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
If you are under 21, a parent or legal guardian must sign the consent, stay on camera for the whole visit and show photo ID.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text.
Request your visit.
Book a visit and choose "Doctor visit". You pay by card when you request it.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer.
Get your plan.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. If needed, you get a lab order or a referral.
What the visit costs
Period cramps are handled in a US$79 doctor visit, with no membership. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. A doctor’s note for work or school is included. See all prices.
Symptoms
Period cramps usually feel like this:
- Pain or cramping in the lower belly before or during your period
- Back or leg pain
- Sharp or aching pain that comes and goes
- Pain that keeps you from work or school
Period cramps relief and treatment
MedlinePlus suggests trying these first:
- A heating pad or hot water bottle on your lower belly, or a warm bath.
- Exercise and relaxation techniques, such as yoga.
- An over-the-counter anti-inflammatory (NSAID), such as ibuprofen or naproxen, which lowers prostaglandins. Follow the package directions.
If that is not enough, the doctor may consider hormonal birth control, which also helps with the pain of primary dysmenorrhea. See birth control online. For secondary dysmenorrhea, treatment depends on the cause.
According to MedlinePlus, see a doctor if anti-inflammatories and home care don’t help, if cramps suddenly get worse, if severe cramps start after age 25, if you have a fever with the pain, or if the pain happens outside your period.
When to go to the ER
Sudden severe pain can be an ectopic pregnancy or an infection. For your safety, go to the emergency room or call 911 if you have:
- Sudden severe belly or pelvic pain if you could be pregnant, especially if your period is more than 1 week late
- Fainting or feeling faint
- Shoulder pain together with pelvic pain
- Very heavy vaginal bleeding with dizziness or weakness
- Severe lower belly pain with fever
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
What can I take for period cramps?
When are period cramps not normal?
Does birth control help with period pain?
Can I get a doctor’s note for period cramps?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-02 · Updated: 2026-10-02
Sources (4)
- Period Pain (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Painful menstrual periods (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Ectopic pregnancy (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Iron-Deficiency Anemia (NHLBI, NIH) (opens in a new tab) (accessed 2026-10-02)