It’s that time of the month, and you can’t do anything because you are in too much pain. If you are someone who struggles with a painful periods, keep reading because this is for you.
What is Dysmenorrhea
Dysmenorrhea is the medical term for painful periods. There are two different classifications of dysmenorrhea:
1. Primary Dysmenorrhea: Is common menstrual cramps/pain without any physical abnormalities or disease. It usually occurs 6-12 months after the first menstruation. The pain can start 1-2 days before or on the first day of the menses. Pain is felt in the lower abdomen, back or thighs. The pain usually lasts 2-3 days and range from mild to severe, with the first day or two being the worst. Primary dysmenorrhea can be accompanied by nausea, vomiting, fatigue, and diarrhoea. This pain can become less with age and possibly even stop after having a baby.
2. Secondary Dysmenorrhea: Painful menstrual cramps occur due to a reproductive system disorder such as endometriosis, pelvic inflammatory disease, ovarian cysts, celiac disease, thyroid conditions, adhesions, congenital malformations, infections, polyps or uterine fibroids. This pain usually begins earlier in the cycle and lasts longer than primary dysmenorrhea. It is not typically accompanied by nausea, vomiting, fatigue, and diarrhoea. The underlying cause is the main focus point of treatment.
Causes of dysmenorrhea
There are several factors which may cause dysmenorrhea including both behavioural and psychological factors such as:
- Lack of blood flow and oxygen to the uterus (ischemia)
- Increased production and release of uterine prostaglandins (especially PgF2-alpha and PgE2). These prostaglandins cause uterine contractions and pressure which blocks the blood supply to vessels causing ischemia and pain. Studies have shown that women with dysmenorrhea produce 8-13 times more PgF than women without dysmenorrhea. During the first and early in the second half of the menstrual cycle, both PgF2 and PgE2 are low. They rise sharply and reach their highest levels just before and after the start of the menses. This increase in prostaglandins may be related to a decrease in progesterone levels towards the end of the cycle before menses start. (learn how the menstrual cycle works)
- Dysmenorrhea is also a sign that ovulation has occurred. If ovulation does not occur, no progesterone is produced in the second half of the cycle and there is subsequently no increase in the prostaglandin concentration in the uterine lining.
- Stressful environments may increase dysmenorrhea.
- Nutrient deficiencies and an unhealthy diet may increase the severity of dysmenorrhea.
- Negative attitudes towards menstruation, a history of sexual abuse and a sense of personal disempowerment or low self-esteem may worsen your symptoms.
- Cultural/social expectations and the idea that menstruation is seen as dirty or disgusting may lead to a negative or embarrassed attitude towards menstruation which again may lead to an increase in symptoms.
Symptoms of Dysmenorrhea
- Aching pain in the abdomen
- Feeling of pressure in the abdomen
- Pain in the lower back, hips and inner thighs
- Accompanied by bloat, nausea, vomit, fatigue and diarrhoea.
Diagnosis
Most women don’t have to see a doctor to diagnose their menstrual pain unless the pain is too severe. A doctor or gynaecologist will look at your symptoms and perform an ultrasound and pelvic exam. During this exam, they will insert a speculum (an instrument to see inside the vagina) and examine your vagina, cervix, and uterus. The doctor will also feel for any lumps. A small sample of vaginal fluid may be taken for testing.
Diagnosis for secondary dysmenorrhea may include a laparoscopy (cut in the abdomen to insert a camera) and MRI.
Risk factors
Women may have an increased risk for dysmenorrhea if they:
- Smoke (smoking may prolong the pain)
- Drink alcohol during the menses (alcohol may prolong the pain)
- Are overweight
- Started their period before age 11
- Have never been pregnant
Treatment
A holistic approach includes looking for factors that may aggravate the condition such as your diet, lifestyle, environment and emotionally. Primary dysmenorrhea is more of a functional problem causing the pain and not a disease, therefore treatment should be focused on pain relief while correcting the underlying dysfunction.
Nutrition
A healthy diet is fundamental to an effective treatment program. Something as simple as regularly eating breakfast has been found to be inversely related to the incidence and severity of dysmenorrhea. One aspect of changing the diet is to avoid foods that may contribute to the condition. The other is to increase foods that provide important nutrients for a functioning menstrual cycle.
Many women has experienced pain relief by switching to good nutritional habits such as:
- Eat smaller portions frequently
- Eat plenty fresh fruit and vegetables
- Drink one glass of water for every 10 kg body weight
- Limit dairy products
- Reduce or eliminate sugar
- Limit or avoid alcohol and caffeine intake
- Eat good quality and mainly plant based or whole foods and grains
- Avoid processed (junk) food
- Avoid artificial sweeteners and preservatives
- Reduce your sodium especially when experiencing fluid retention, oedema or breast tenderness
Important nutrients to prevent and treat dysmenorrhea:
- Vitamin B1 (thiamine): A large study found that 100 mg of thiamine helped to alleviate dysmenorrhea completely in up to 87% of the study subjects.
- B3 (niacin): May help to relieve pains.
- Vitamin C and rutin: Increases the effectiveness of Niacin for the treatment of menstrual cramps.
- Vitamin E: Helps to relieve cramps and decrease overall blood loss.
- Calcium: Helps to maintain muscle tone which lessens cramping.
- Omega 3 Fatty Acids: Helps with the production of antispasmodic and anti-inflammatory prostaglandins.
Important foods include:
- Black currant, flax or hemp seed oil
- Nuts and seeds
- Whole grains
Herbs
Herbs are incorporated for their antispasmodic, uterine tonic, analgesic (pain relief), sluggish pelvic circulation, and anti-inflammatories properties. Balance hormones (See our Femina Herbal Extract) and improve physiologic and emotional stress responses with herbal medicine.
The main focus point is to treat the underlying cause of the condition. For severe cases, over-the-counter or prescription conventional medicines can be combined with natural therapies for acute pain relief. Hopefully, over time the need for pain medications will decrease.
Black Cohosh
Black cohosh is known for its relaxant effects on the uterus in dysmenorrhea and may be helpful in both congestive and spasmodic menstrual cramps to a severe nature.
If your menses is associated with PMS, irritability, and anxiety, then black cohosh would be an even more indicated herbal choice for menstrual cramps.
Black cohosh is spasmolytic and anti-inflammatory to the smooth and skeletal muscles, making it particularly useful in the treatment of dysmenorrhea with associated aching discomfort in the lower back and legs and nervous tension.
The salicylates and gallic acid in black cohosh are analgesic (pain relieving) and anti-inflammatory; this may help to reduce prostaglandin excess if given before the period.
Black cohosh is approved by the German Commission E for the treatment of premenstrual complaints, including dysmenorrhea and neurovegetative symptoms of menopause.
Motherwort
Motherwort has uterine spasmolytic and sedative effects. Herbalists consider motherwort as a wonderful uterine tonic, as it improves uterine muscles, relieves pelvic congestion, improves circulation and relieves vascular congestion.
Motherwort may reduce pain via a reduction in inflammatory mediators, as well as enhance the synthesis of prostaglandins.
This hypotensive nervine is useful for headaches, insomnia, and vertigo as well as gynecological and obstetrical conditions. It’s used for the treatment of nervous exhaustion, irritability, hysteria, and nervous excitability as well as used clinically for the treatment of dysmenorrhea.
Valerian
This is a well-known sedative and nerve tonic. Valepotriates are mainly responsible for its calming effects. Valerian is relaxing to smooth muscles and stress-related disorders such as period pain and PMS. Relieve period pains with its antispasmodic and anti-inflammatory properties.
Additionally, it is excellent for anxiety, nervous tension, agitation, panic attacks, irritability, insomnia, nervous headaches, and exhaustion.
Schisandra
Schisandra has a normalising effect on the entire body. It will take you from any extreme back to a balanced state. It may open you up to physical and mental exercise and protect you from environmental stress.
This herb can increase your energy at a cellular level by stimulating the central nervous system without making you nervous. It is used for the depletion from stress, chronic fatigue, anxiety, depression, irritability, dizziness, and insomnia.
Schisandra raises body enzymes which help to detoxify the body in a way that improves mental clarity. It’s also protective of the liver and helps to maintain liver function and regeneration.
It is a popular herb among women for its ability to make the skin soft, smooth and beautiful by balancing fluids in the skin.
Stress management
It’s important not to overlook stress as a cause of pain. Stress may also affect your hormone production as well as your ability to handle the pain. By reducing your stress levels you can relieve lower back and pelvic area tension and pain. A study has demonstrated that women with higher stress levels are twice as likely to experience dysmenorrhea in their following cycle.
Learn how to manage your stress in our blog How to take control of your stress and anxiety.
Improve your posture
Yoga and Pilates are wonderful ways to improve posture. By improving the position of your spine you promote proper circulation and nerve stimulation to the pelvic organs.
Change your attitude
Change the way you think and feel about your menstrual cycle. Being a woman, and having the menses is a beautiful thing. Your body works in such an intricate way. You can conceive, grow and carry a baby to bring it into this world. You wouldn’t have been able to do this if you didn’t have a menstrual cycle. The survival of our species is dependent on it.
Women who feel self-empowered and in control of their own lives experience less severe and less frequent symptoms. Learn how to practice self-worth and improve your self-esteem.
