Is period pain normal, and when is it not?

Mild-to-moderate cramping is common. Pain that prevents work or school, doesn't respond to NSAIDs, worsens over years, or comes with pain during sex or bowel movements suggests endometriosis or adenomyosis and warrants specialist assessment.

Pain that stops you functioning is not something to endure. Average diagnostic delay for endometriosis is 7-10 years, largely because severe pain is normalised.

NSAIDs started a day before the period and taken regularly work better than waiting for pain to build. If they fail, that itself is diagnostically useful.