Heavy or Painful Periods? Here's What's Driving It
"It's just a heavy period, isn't it, it’s always been this way for me." I hear a version of this most weeks, usually said with a shrug that doesn't match how disruptive the actual bleeding is. Heavy or painful periods are common, but common isn't the same as normal, and there's almost always something specific underneath it.
A small amount of cramping in the first day or two, the kind that responds to ibuprofen, is just your uterus contracting and is entirely normal. Pain beyond that, or bleeding heavy enough to disrupt your day, usually points to one of a few underlying patterns.
The first is an imbalance between oestrogen and progesterone. Progesterone's job in the second half of your cycle is partly to act as a brake on oestrogen. When ovulation doesn't happen properly, that brake is missing, and oestrogen ends up relatively unopposed. This matters because oestrogen has a direct effect on mast cells, the immune cells responsible for releasing histamine. Unopposed oestrogen primes these cells, increases the enzyme that makes histamine, and reduces the enzyme that clears it. The uterine lining is packed with mast cells, so this combination can show up directly as heavier bleeding and more pain. It's a useful thing to understand if you've also noticed histamine type symptoms, flushing, itching, worse hay fever, clustering around your period.
The second, and one people are often surprised by, is anaemia. Low iron doesn't just follow heavy periods, it can also cause them, creating a cycle that's hard to break without addressing the iron side directly.
There's also a dietary link worth knowing about. A1 casein, found in most standard dairy, breaks down into a compound that can trigger inflammatory activity and stimulate mast cells. Some women notice a real difference in period pain, flow and skin when they switch to A2 dairy or reduce dairy generally, worth a personal experiment rather than a blanket rule.
And finally, an underactive thyroid can quietly sit behind all of this too, since it affects ovulation and pushes you toward that same unopposed oestrogen picture.
Once we know what's actually driving things, there's a lot that can help, and it's worth introducing support gradually rather than all at once so you can see what's actually making a difference.
Where I'd usually start:
Getting a proper iron panel done if bleeding is heavy, rather than assuming levels are fine
Magnesium in the evenings, which relaxes the uterine muscle and can meaningfully ease cramping
Zinc, taken with food, which supports circulation and calms the same pathway that drives period pain
Ginger, which has a genuinely good evidence base for period pain when taken consistently across the month, not just during your period
Turmeric can help with pain and inflammation too, but hold off if you're anaemic, as it can interfere with iron absorption, and take it away from any iron supplement if you are using both.
If your periods have been heavy or painful for a while and you've been told to just get on with it, that's not the end of the conversation. There's usually a clear reason, and usually something we can do about it.