Period cramps. They are almost as common as the uterus itself, but are they a signal that something isn’t right? Medically termed “dysmenorrhea”, but commonly referred to as the bane of being a woman, period cramps can actually be caused by many things.
The good news is, they can generally be greatly reduced or eliminated in most cases. Pain is often the first indicator of disease, and yet many women live with intense period pain every month and do not think to remedy what is underlying this symptom that their body is using to alert them that something is amiss.
What is dysmenorrhea and what causes it?
Dysmenorrhea can be classed as either primary or secondary dysmenorrhea. Primary dysmenorrhea is caused by common uterine contractions, but they are too strong and/or too close together in time. Between these contractions, the uterine muscles do not completely relax, and the blood flow to the uterus is reduced, which causes the pain that we all know as cramps. This pain is often caused by an imbalance in prostaglandins, which are a hormone-like substance.
Secondary dysmenorrhea is when the pain is caused in large part by an organ disease that is underlying such as endometriosis or pelvic inflammatory disease (PID). If you have nearly debilitating cramps that don’t respond to ibuprofen there is a good chance you have secondary dysmenorrhea and you will want to get a check up to figure out the underlying cause. The focus of this article is on primary dysmenorrhea.
As mentioned, the cause of cramps is an imbalance of prostaglandins, specifically more of the “bad” prostaglandins PGF2α and PGE2, which are released from the endometrium during your period. There are certain “risk factors” for painful periods, including early menarche, long or heavy periods, obesity, stress, smoking, and alcohol use.
What you can do to reduce cramps
The best thing you can do for menstrual pain is to make sure you have an optimized lifestyle, including nutrition, exercise, rest, and stress reduction (whatever form that may take for you). You can see a simple list I made to help guide you with these here.
A specific thing that you can do to help regulate your prostaglandin levels is increasing your consumption of the omega-3 fatty acid EPA, which is used by the body to form the beneficial prostaglandins. You can get this from fish oil like cod liver oil, or flax or evening primrose oil if your body can efficiently convert those fats into EPA. Be sure to eat less of the yellow oils and grains and more pastured animal products and produce to naturally tip the scales in your favor for a good balance of fats.
Certain vitamins and minerals you will want to make sure you are not deficient in are magnesium (which is a natural muscle relaxer and also helps regulate prostaglandin levels), calcium (also a muscle relaxer, make sure you have adequate vitamin D for absorption), zinc, vitamin C, vitamin B3, and vitamin B6 (all implicated in proper prostaglandin levels). Many nutrients are known to play roles in having low pain or pain-free periods, and there are probably many that we have yet to discover, so I recommend getting your nutrition from high quality whole foods and only supplementing when or if necessary. If there are other hormonal imbalances, that may be the cause of off kilter prostaglandin levels and should be dealt with appropriately.
One thing that can actually work wonders for some women is drinking more water. There is a hormone, vasopressin/antidiuretic hormone (ADH), that will stimulate contraction of smooth muscle, that’s the stuff your uterus is made of. Your body uses ADH to reserve water inside of you rather than letting it be released in urine. When you drink more water, there is no need for your body to employ ADH to reserve water, since you have plenty. It is best to make sure you are well hydrated a few days before your period is due to start. I don’t recommend forcing yourself full of water, but make sure to drink when you are thirsty. If you find that you are peeing a lot and still thirsty when you are drinking a lot, make sure you are getting enough good quality salt in your diet. I love the celtic grey sea salt.
There are always times that it is good to see the doctor, particularly if you are already keeping your lifestyle healthy in the above ways. Check with your doctor to make sure nothing else is going on if you have any of these problems:
- Pain that changes in the way it presents or begins when you have not had it before;
- Pain that is either one sided or radiating;
- You are having pain during pregnancy;
- Normal pain dampening efforts are not effective;
- There are new symptoms associated with the pain like vomiting, diarrhea, or faintness;
- The pain is worse towards the end of the period;
- The pain is worse with pressure, bowel movements, or sex;
- Or a fever or discharge accompanies the pain.
With dysmenorrhea, symptom relief can be important. I recommend focusing on symptom relief that is going to nourish you in one way or another rather than the typical medical approach, which includes prostaglandin inhibiting drugs, the pill, pain killers, or even as severe as a hysterectomy.
There are many ways to naturally deal with menstrual cramps while nourishing your body. These include herbs, massage, acupuncture, treating the liver, treating any bowel related problems, chiropractic and osteopathy, relaxation, aromatherapy, warmth, yoga, or sex/orgasm.
Herbs that may help
If you are interested in herbs, there are a few types that can benefit period pain. There are the uterine tonics, which are believed to regulate the muscular activity of the uterus. While they do help with contractions, which sounds bad, they make them more regular and rhythmic. These include false unicorn, unicorn, blue cohosh, dong qaui, and raspberry leaf.
If you have period pain that is crampy, colicky, and comes in different waves you may want to try antispasmodics. This is generally for intense period pain that may even be accompanied by vomiting or diarrhea. These herbs are cramp bark, black haw, blue cohosh, wild yam, szechuan lovage, and chinese peony (which is often combined with licorice root).
Emmenagogues can increase the strength of uterine contractions and can be used to start menstruation. If you have dull congestive pain with a period that is slow to start you can try using mugwort.
The warming herbs help the antispasmodic herbs work better and are good for those who have period pain that is aggrevated by cold (like foods, ambient temperature, etc.) and relieved by heat. Ginger and cinnamon are good examples.
When there is tension or anxiety associated with the period paid, good herbal remedies would include relaxing herbs. These include valerian, Chinese Peony, Jamaican dogwood, cordalis, vervain, and chamomile.
Anodynes, or pain relieving herbs, are more of a last resort, since they are focused on symptoms rather than the underlying cause. These include cordalis, Jamaican dogwood, wild lettuce, and pasque flower.
Even though prostaglandins are recently discovered and there aren’t specific herbs that are meant to be prostaglandin inhibiting, many herbs that are commonly used for period pain turn out to be prostaglandin inhibiting herbs such are ginger, feverfew, and turmeric.
In addition, if there are underlying hormonal issues you may want to try hormone regulating herbs specific to what you are working with.
If you have worked out your diet and lifestyle and are still experiencing period pain I would suggest finding a holistic practitioner that can help you in whatever you may be experiencing. If you choose to use herbs it is best to use them under the care of an herbalist or to only use those that are very safe, nourishing herbs. Period pain is actually something that is relatively easy to at least reduce through optimizing lifestyle and often your whole health will be better for it.
Women, Hormones, and the Menstrual Cycle – Ruth Trickey
Fertility, Cycles, and Nutrition – Marilyn Shannon
Herbal Healing for Women – Rosemary Gladstar