Take a strong enough dose. If your pains are not eased, ask your doctor or pharmacist if the dose that you are taking is the maximum allowed. An increase in dose may be all that you need.

Most women with painful periods have mild pain that they can treat themselves at home. However, if your pain becomes more severe and is interfering with your usual activities, you should see your doctor.Turn on the TENS machine when the pads are attached in the correct places. You'll feel a slight tingling sensation pass through your skin.

Switch the TENS machine off after you've finished using it and remove the electrodes from your skin. Are there any risks of side effects? Again, the main symptom is lower tummy pain during your periods (menstrual cramps). With secondary dysmenorrhoea, your periods tend to become more painful after several years of 'normal' periods (that is, periods with normal, mild, period pains). Take the first dose as soon as your pain begins, or as soon as the bleeding starts, whichever comes first. Some doctors advise to start taking the tablets the day before your period is due. This may prevent the pain from building up.TENS is not a cure for pain and often only provides short-term relief while the TENS machine is being used. The cause is often not clear (this is called primary dysmenorrhoea). In primary dysmenorrhoea, the womb (uterus) is normal. It is thought that normal body chemicals called prostaglandins build up in the lining of the womb. Prostaglandins help the muscular wall of the womb to contract and remove the lining of the womb during a period. TENS may be able to help reduce pain and muscle spasms caused by a wide range of conditions including:

If your GP feels that you have secondary dysmenorrhoea, they may arrange further tests (such as an ultrasound scan) or refer you to a specialist (usually a gynaecologist) for their opinion and other investigations. The investigations that are carried out depend on the likely underlying problem. They may include: However, the treatment is generally very safe and you may feel it's worth trying instead of, or in addition to, the usual medical treatments. Trying TENS

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There was a significant reduction in period pain when high-frequency TENS (more than 50 pulses per second) was compared to sham TENS (where the machine looks the same but doesn’t deliver a pulse). In women with period pain there seems to be a build-up of too much prostaglandin, or the womb may be extra sensitive to the prostaglandins. This may cause the womb to contract too hard. This reduces the blood supply to the womb and leads to pain. Secondary dysmenorrhoea TENS machines stimulate the release of these chemicals, with different types of endogenous opioids released depending on the frequency of stimulation. Tests and an internal (pelvic) examination are not normally needed unless symptoms are unusual. In that case an underlying cause of painful periods (secondary dysmenorrhoea) may be suspected. Secondary dysmenorrhoea Both types improved pelvic pain, pain after sex, and quality of life, but not period pain. This was a very small study (11 women in each group) and there was no control or placebo group. So we need larger studies with a proper control group before we can be sure if TENS works for endometriosis pain.

It’s easy to see why devices like these might be popular. Half of people with period pain say over-the-counter medication such as ibuprofen doesn’t get rid of their period pain. Most people with endometriosis report major issues with getting adequate pain relief.Some people cannot take non-steroidal anti-inflammatory painkillers. For example, people with a stomach ulcer, and some people with asthma. If you are going to use the device occasionally (less than 4-5 days per month) you may just need a device that allows you to change the intensity. There's not enough good-quality scientific evidence to say for sure whether TENS is a reliable method of pain relief. More research is needed and clinical trials are ongoing. A physiotherapist or pain specialist may be able to loan you a TENS machine for a short period if they think it could help. Take the tablets regularly, for 2-3 days each period, rather than 'now and then' when pain builds up.