Period pain: does warmth really help? Over-the-counter painkillers and when to see a gynaecologist
This answer is a draft. It stays unpublished until legal review and source verification are complete.
Period pain (dysmenorrhoea) is generally described as affecting about 70% of women in Japan, with 20–30% affected badly enough to disrupt daily life. The idea that it is "something to put up with" is still strong here, so simple steps such as warmth and painkillers are often delayed. Here are the measures with evidence behind them, and the signs that mean a visit to a gynaecologist (婦人科, fujinka).
Measures and their evidence
| Measure | Details | Strength of evidence |
|---|---|---|
| Warmth | Heat pads (kairo, 使い捨てカイロ), a hot-water bottle or a belly warmer (haramaki) on the lower abdomen and lower back; a bath at 38–40°C (100–104°F). Overseas research has reported heat patches as effective as painkillers | Medium to high |
| Painkillers (NSAIDs) | Ibuprofen, loxoprofen, naproxen, etc. Take as soon as the pain starts, or if it comes at the same time every month, anticipate it and take one just before. They suppress prostaglandin production, so they work less well once it has been produced | High |
| Acetaminophen (paracetamol) | Gentle on the stomach, but for period pain NSAIDs usually work better | Medium |
| Exercise and stretching | Light aerobic exercise and yoga have been reported to ease the pain | Medium |
| Diet | Cut back on caffeine, alcohol and cold drinks; iron, magnesium and omega-3 are supplementary | Low to medium |
| Sleep and stress | Lack of sleep and stress make the pain feel worse | Medium |
| Kampo (traditional herbal medicine) | Tōki-shakuyaku-san, Kami-shōyō-san and others are sometimes prescribed under health insurance | Medium |
| Low-dose pill (LEP) and progestin preparations | Covered by health insurance. Suppress ovulation and thin the lining, greatly reducing pain and bleeding. Slow the progression of endometriosis | High |
| Mirena (intrauterine progestin-releasing system) | Covered by health insurance, effective for 5 years | High |
Signs that mean a gynaecologist
| Sign | What it may indicate |
|---|---|
| Bedridden despite painkillers; missing school or work | Dysmenorrhoea that qualifies for medical care |
| Pain getting worse year by year | Endometriosis (increasing in the 20s–30s; left alone it can lead to infertility and swollen ovaries) |
| Lower abdominal pain outside your period; pain on passing stools or during sex | Endometriosis |
| Heavy bleeding (an overnight pad fills within 1–2 hours, many liver-like clots), anaemia | Uterine fibroids, adenomyosis |
| Irregular cycle; no period for 3 months or more | Hormonal problems |
| A sudden change in pain or bleeding after age 40 | Fibroids, adenomyosis, others |
- Taking over-the-counter painkillers: one dose early, at the start of the pain. Not on an empty stomach (hard on the stomach). Keep to the daily maximum. If you need them on 10 or more days a month, see a doctor.
- "They stop working if you take them" is a misunderstanding: painkillers hardly cause tolerance at all. Putting up with the pain lowers your quality of life instead.
- Warming tools: stick-on heat pads (kairo) over your underwear on the lower abdomen and lower back (never directly on skin — risk of low-temperature burns), a belly warmer (haramaki), a hot-water bottle. Cold pushes the pain the wrong way, so keep the lower abdomen warm even under summer air-conditioning.
- Teenagers: pain is often strong in the first few years after periods start, and it is normal for junior-high and high-school students to see a gynaecologist. The low-dose pill can be prescribed to teenagers too. If it means missing school, go with a parent.
- Work and periods: the Labour Standards Act provides for menstrual leave (Article 68), which you can request (at most companies it is unpaid).
- PMS (premenstrual syndrome): irritability, bloating and headaches before a period are a separate issue, and you can ask a gynaecologist about these too.
[Verify] Check the share of women who experience period pain and the share with disrupted daily life, and the research on heat patches, against the Japan Society of Obstetrics and Gynecology and related studies. Check the current scope of health-insurance coverage for the low-dose pill and similar.
Misunderstanding 1｜Period pain is something to put up with
Pain that keeps you in bed qualifies as dysmenorrhoea and can be managed under health insurance. Putting up with it is not a virtue, and can delay the discovery of endometriosis.
Misunderstanding 2｜Take the painkiller once the pain is strong
It works better taken before the pain-producing substance is made. As soon as the pain starts, or anticipate it and take one just before.
Misunderstanding 3｜Taking painkillers every month means they stop working, or harms you
At the right dose, tolerance hardly develops. But if you need them on 10 or more days a month, see a gynaecologist about the underlying cause.
Misunderstanding 4｜Warmth is just a comfort thing
Research has shown that heat eases the pain. Heat pads, belly warmers and baths are measures with evidence.
Misunderstanding 5｜The pill is for contraception, not for period pain
The low-dose pill (LEP preparations) is covered by health insurance for dysmenorrhoea and endometriosis. It can be prescribed to teenagers too.
---
Sources
- Japan Society of Obstetrics and Gynecology, "Guidelines for Obstetric and Gynecological Practice: Gynecology Outpatient Edition" [産婦人科診療ガイドライン：婦人科外来編] (dysmenorrhoea)
https://www.jsog.or.jp/modules/diagnosis/
- Japan Society of Obstetrics and Gynecology, "Know the conditions: dysmenorrhoea and endometriosis" [病気を知ろう：月経困難症・子宮内膜症]
https://www.jsog.or.jp/citizen/
- Ministry of Health, Labour and Welfare (MHLW), "Support site for working women's mind and body" [働く女性の心とからだの応援サイト] (menstrual leave and information on menstruation)
https://www.bosei-navi.mhlw.go.jp/
⚠️ Editorial note: the source URLs above were identified by search. Our working environment cannot reach go.jp domains, so the contents have not been checked against the text. Verify every source before publication and record who checked it and when.
About this article
What we share here are ideas and everyday practices passed down among people living in Japan, together with general information drawn from public sources. They are not official recommendations, and they are not professional instruction. Practices vary between households and regions.
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