The right to painless periods
If you are one of the estimated 50% or more of women who dread “that time of the month” due to cramping, shooting, dragging pain which accompanies your period you may have been told “it’s all part of being a woman”, “it’s just something you’ll have to put up with” 1. Yeah, easy for you to say, mate. You’re not the one who feels like Freddy Kruger has taken up residence in your uterus. Period pain is variable from woman to woman. Some only experience mild discomfort and others will experience severe pain and other symptoms causing disruption to their lives.
Just because something is common doesn’t make it normal nor acceptable 2. Women have a right to painless periods, and with a little knowledge, it is possible for most women to reduce or even eliminate period pain.
How to tell if your period pain is primary or secondary
Period pain or dysmenorrhea as it’s known medically comes in two flavours:
- Pain just before menses and continuing for 1-3 days of menstruation (cramping, shooting, dull, or dragging; may also experience referred pain in buttocks and legs)
- No other gynaecological conditions present such as endometriosis or fibroids
- Mood changes
- Altered bowel habits
- Starts not long after the first period and often improves after pregnancy
- Responds to anti-inflammatory medications
- Other gynaecological conditions are present such as endometriosis, adenomyosis, fibroids or pelvic inflammatory disease
- Pain symptoms as above
- May also experience pain with urination, defecation and sexual intercourse
- Mood changes
- Change to bowel motions
- May begin during ovulation and continue through to menstruation
- Usually appears well after menarche and the pain increases throughout each cycle and may last for longer periods of time.
- May not respond as well to anti-inflammatory medications
Get a diagnosis
When it comes to your body accurate information is your best ally. I encourage you not to self-diagnose but get it investigated by a suitably qualified professional so you can get the correct treatment.
The remainder of this article will concentrate on primary dysmenorrhea.
What causes period pain?
After you ovulate and start to make the hormone progesterone, there is a build up of omega 6 fatty acids (generally considered to be more pro-inflammatory) in the cell membranes of your uterus. Just before menstruation starts the hormone progesterone declines and these are released and trigger inflammatory molecules (prostaglandins, leukotrienes). Prostaglandins are required to stimulate contractions that help the endometrial lining to shed (and initiate a menstrual bleed), and they also cause blood vessels to constrict. Some women produce these in excess. Leukotrienes also increase sensitivity to pain. Around menstruation, antidiuretic hormone increases further enhancing uterine contractions and blood vessel constriction. Some women are more sensitive to this process than others.
From the above we can see an effective treatment for period pain would involve reducing inflammation, relaxing smooth muscles and stopping the blood vessels from constricting. So, what are the options?
“It’s easy with naprogesic.”
Standard medical treatments for period pain include:
Non-steroidal anti-inflammatories (NSAIDs)
NSAIDS are a symptomatic treatment, which reduces inflammation by downregulating the by-products of excess prostaglandins. Side effects of these include stomach pain and heartburn. NSAIDs have been shown to damage the digestive tract lining and increase the risk of ulcers 3.
Oral Contraceptive Pill
The OCP works by shutting down ovulation. No ovulation = no progesterone and less build up of omega 6 inflammatory acids.
Your natural prescription for pain-free periods
As inflammation drives period pain it makes sense to reduce the potential for this, right? Eliminating inflammatory foods from your diet can have a significant impact on period pain and hormonal health in general 4. Limit or eliminate refined carbohydrates (sugar), fried foods, processed meats and excess dairy mainly A1 cows milk. Include plenty of fresh fruits, vegetables and quality lean protein as well as healthy Omega 3 fats found in oily fish (mackerel, salmon or sardines, chia and flax seeds) 5.
The idea that regularly moving your body can help reduce period pain is not new. In 1943 Billing presented a series of stretching exercises to lessen the symptoms of dysmenorrhea. More recent trials have shown stretching and yoga exercises performed 15-20 minutes twice a day for 3 -4 cycles reduces pain duration and intensity, decreases the rate and volume of bleeding and lowers the amount of pain-relieving medications used6. Regular exercise releases endorphins which increase pain tolerance, relieve stress and improve blood circulation to the pelvic region 7. Even simply walking 20-30 minutes a day at a brisk pace will help.
Stress makes pain worse and increases inflammation so if you are suffering a from tension, overwork and overwhelm take steps to get this under control7.
Nutrients for period pain
Magnesium relaxes smooth muscle and reduces the spasms and contractions of the uterus responsible for pain8. Leafy green vegetables are good sources of magnesium so make sure you are getting two serves a day. You can also supplement with up to 300mg/day. Chose an amino acid, citrate or bi-glycinate form of magnesium to reduce the risk of loose bowel motions.
Zinc is a mineral often deficient especially in those women who consume a predominantly plant-based diet. Zinc is an antioxidant and reduces inflammation by inhibiting prostaglandins and improving blood flow to the uterus 9. A 2015 trial showed supplementing 50mg of zinc sulphate twice a day four days before menstruation reduced the need for pain medication 10. You could also supplement 20mg/day month round for similar benefits.
Herbs for period pain
There are quite a few options, and product quality varies between formulations, so it’s worthwhile consulting an experienced herbalist to get a formulation right for you.
Turmeric and Ginger
These two herbs can be a regular part of your diet. Both have anti-inflammatory effects, and ginger is beneficial as a circulatory stimulant. Add to smoothies, curries, soups and use as a tea.
As the name suggests, cramp bark (Viburnum opulus) is a herb which reduces spasmodic cramping. It releases tension from smooth muscles in the uterus. I use it for my clients as a tincture to provide symptomatic treatment and often combine it with Corydalis for added pain relief.
As natural hormone expert Lara Briden says, “Vitex is a strong medicine and is not for everyone”. Vitex can be useful in reducing period pain in those women who have high prolactin or those who get painful periods with PMS11. The best way to determine if you have elevated prolactin is to get tested. Vitex shouldn’t need to be used long term. If it is the right herb for you, improvements should be seen within 3-6 months.
Often thought of as a sleep herb, Valerian is also an effective muscle relaxant. On a cellular level, it opens potassium channels and blocks calcium channels inhibiting muscle spasms. Its ability to induce relaxation is also of benefit if stress is a factor. Valerian doesn’t need dosing all month long. A 2011 trial of 100 women, took 255g of a valerian extract three times a day from day 1 through 3 of menstruation. After the second cycle, self-reported pain levels decreased from 7.5/10 to 2/10. 12.
Period pain may not be a life-threatening condition, but it can be a life “interrupting condition” for many women. The good news is this “common” condition can be improved by lifestyle, nutrition and herbal medicine.
Norelle Hentschel is a degree qualified Naturopath and operates a clinic in Crows Nest, North Sydney. She enjoys helping people feel better and can assist with a broad range of health conditions or general health maintenance.
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- Trickey R. Women, Hormones & the Menstrual Cycle. 3rd ed. Fairfield: Allen & Unwin; 2011.
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