Dysmenorrhea, or abdominal and pelvic pain associated with menses affects more than half of menstruating women, with 15% having such severe pain that they are debilitated for several days per month. This is an astounding number, as these women are often unable to engage in normal daily activities and may require absence from work each month.
Dysmenorrhea is often classified as primary or secondary. Primary dysmenorrhea is poorly understood, and is thought to be related to hormonal imbalance and increased production of prostaglandins and inflammatory mediators by the endometrium, which cause contractions of the uterus leading to cramping and pain. Secondary dysmenorrhea includes an underlying pathology such as endometriosis, fibroid or pelvic inflammatory disease which would require treatments specific to those conditions. NSAIDs such as Ibuprofen are often the pharmacological treatment of choice as they decrease prostaglandin synthesis, however there are also various naturopathic treatment options that work in similar ways and may provide benefit with minimal adverse effects.
Ginger– Several studies have shown the benefit of ginger in relieving pain from primary dysmenorrhea. It has anti-inflammatory and analgesic properties, and is thought to inhibit COX-2 which is the enzyme that is inhibited by NSAIDs that causes inflammation and pain. This supplement can be use preventatively, by consuming it 3-4 days prior to menses. For appropriate dosing, talk to your Naturopathic Doctor.
Topical Heat Therapy– using a hot water bottle or having a warm bath may be beneficial at relieving menstrual cramping as it relaxes the muscle of the pelvic cavity, and has been shown to be as beneficial as NSAIDs in a few studies. This therapy can show immediate benefit, and is very safe.
Exercise– Regular physical activity at least three times per week for 30 minutes per day reduces stress and prostaglandins which are involved in the contractions of the uterus and the perception of pain. Additionally, exercise increases circulation which may benefit cramping due to ischemia of the uterus and also reduces stress which can decrease the response of the sympathetic nervous system, therefore reducing uterine contractions and pain.
Acupuncture and Acupressure: Acupuncture can be helpful to increase circulation to the pelvis, promote relaxation and relieve pain. There are specific points that are indicated for period pain that can be found in different areas of the body such as the feet, hands and abdomen. Acupressure is the application of firm pressure to acupuncture points, so there is no needles involved. This can be helpful as an at home tool to alleviate pain.
Fish Oil – Like NSAIDs, fish oil works by suppressing prostaglandin synthesis and reduces systemic inflammation which may help reduce pain.
Diet– an anti-inflammatory diet can provide beneficial results with painful periods, as often times inflammation is a contributing factor. Reducing refined and processed foods, sugar, coffee, alcohol and red meat and replacing them with whole foods such as vegetables, fruit, healthy fats (avocado, nuts, seeds, cold wate fish, olive oil etc.) whole grains and lean protein (chicken, turkey, fish, legumes) can help reduce inflammation and lead to a less painful period and overall improved health.
B-Vitamins– Vitamin B1 (Thiamine), Vitamin B3 (Niacin) and Vitamin B6 (Pyroxidine) have been shown to help reduce painful periods. Vitamin B1 is often most beneficial in those who are deficient, as a deficiency can lead to muscle cramping and reduced pain tolerance. Vitamin B3 works by causing intense vasodilation that increases blood flow to the pelvic organs, and flushing of the face may occur with this vitamin. Vitamin B6 has been shown to relax the myometrium and is beneficial in the utilization of magnesium which can be helpful in relieving menstrual cramping due to contracted uterine muscles.
Magnesium – Magnesium acts as a muscle relaxant, which is beneficial for reducing menstrual cramping. Studies have shown that women taking magnesium have lower levels of prostglandin F2 in their menstrual blood which is associated with less cramping, increased vasodilation and muscle relaxation.
It is important to talk to your doctor before incorporating any new interventions into your daily routine! For a comprehensive analysis of your case, book an appointment with your Naturopathic Doctor in order to create a treatment protocol that is individualized, will provide the most benefit and is safe for you!
References
Chen, C. X., Barrett, B., & Kwekkeboom, K. L. (2016). Efficacy of Oral Ginger (Zingiber officinale) for Dysmenorrhea: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine, 2016, 1-10. doi:10.1155/2016/6295737
Daily, J. W., Zhang, X., Kim, D. S., & Park, S. (2015). Efficacy of Ginger for Alleviating the Symptoms of Primary Dysmenorrhea: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Pain Medicine, 16(12), 2243-2255. doi:10.1111/pme.12853
Dehnavi, Z., Jafarnejad, F., & Kamali, Z. (2018). The Effect of aerobic exercise on primary dysmenorrhea: A clinical trial study. Journal of Education and Health Promotion, 7(1), 3. doi:10.4103/jehp.jehp_79_17
Proctor, M., & Murphy, P. A. (2001). Herbal and dietary therapies for primary and secondary dysmenorrhoea. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd002124