Period Pain

by Emily Starr


Nearly every woman has experienced menstrual cramps and period pain at some stage of her reproductive life. A recent meta-analysis of 21,573 young women in high school or university found that 71.1% experience dysmenorrhoea (scientific name for period pain/cramps). Over 20% of the students reported needing to have time off school or university due to the severity of the pain, and over 40% of the students reported that their classroom performance and concentration was negatively affected due to the pain (PMID: 31170024).


The prevalence of painful periods is on the rise with the modern world of high stress, increased artificial light exposure from phones and laptops, plastics, pesticides, toxic cosmetics, lack of rest, and poor dietary choices all playing a role.


Women will have around 360-400 periods in their life. This equates to three years of a woman’s life spent menstruating. The good thing is, you don’t need to spend those three years of your life in pain, there are strategies to help reduce the pain and ease the discomfort of menstruation.

Physical stress associated with psychological, behavioral and social distress.

What causes period pain?

For most women period pain is caused by hormone-like substances called ‘prostaglandins’. Prostaglandins are made by almost every cell in your body. They are derived from arachidonic acid, which is an inflammatory Omega 6 fatty acid derivative. Prostaglandins aren’t all bad, we need them for a wide range of bodily functions like contraction and relaxation of smooth muscles, dilation and constriction of blood vessels, control of blood pressure, and regulation of inflammation.

In the uterus it is prostaglandins which cause the muscles to contract each month so you can release your uterine lining/endometrium and have a period. This is a normal process for women of menstruation years. However, if prostaglandin levels are too high due to increased inflammation in the body, this is when we generally have more pain and cramping.


Excess prostaglandins = more period pain and cramping.


Primary vs Secondary Dysmenorrhoea

Primary dysmenorrhoea is classified by lower abdominal pain in the absence of coexisting pathological conditions.


Secondary dysmenorrhoea is where there is an underlying pathological condition (i.e. not just caused by high prostaglandins).


Other causes of period pain/ dysmenorrhoea:

- Endometriosis (most common cause of secondary dysmenorrhoea)

- Adenomyosis

- Pelvic inflammatory disease

- Fibroids

- Endometrial polyps

- Ovarian cysts

- IUDs

- Pelvic congestion

- Inflammatory bowel disease

- Trauma and Psychological conditions

- Urinary diseases


How can period pain be relieved?

Luckily for period pain sufferers, you aren’t alone, and there is a whole bunch of natural therapies that are scientifically proven to help. Number one thing would be working with a holistic health practitioner to help determine the underlying cause of your period pain. Especially if it is severe, it is a good idea to rule out any pathological underpinnings.



Omega 3:6 Ratio

- Modern western diets consist of a 30:1 ratio (30- Omega 6 and 1-Omega 3). Which is not great at all. Omega 6 fatty acids are inflammatory (when consumed in excess), and Omega 3 fatty acids are where we get our anti-inflammatory benefits.

- Omega 6 is found in vegetables oils (e.g. sunflower, safflower, canola, rapeseed oils), sunflower seeds, nuts, beans, seeds, and grains.

- Omega 3 is found in fish like salmon, herring, mackerel, sardines, fish oils, flaxseed oil, flaxseeds, walnuts, and chia seeds.

- We need both fatty acids as they are essential to the body, but in a health ratio (which is uncommon in the modern Western diet). Aiming to eat more omega 3 food sources, and less omega 6 food sources is a great place to start.

- A trial comparing fish oil and ibuprofen for primary dysmenorrhoea found that supplementation of fish oil was more effective than ibuprofen at reducing the pain (PMID: 24049587)


Ginger

- Ginger inhibits the production of prostaglandins

- A Systematic Review and Meta-Analysis of clinical trials for the use of ginger for primary dysmenorrhea found it was an effective treatment (PMID: 26177393)


Magnesium

- Magnesium reduces inflammatory markers in the body and relaxes smooth muscles, making it amazing for pain and cramping

- A Cochrane review found that magnesium is effective at reducing pain associated with menstrual cramping (PMID: 11687013)


Vitamin D

- Vitamin D supplementation has been shown to reduce pain in primary dysmenorrhoea due to its ability to reduce prostaglandins (PMID: 27147120)

- This shows how important daily sun exposure it for reducing pain and inflammation


Wild Yam (Dioscorea villosa)

- Traditionally used for painful periods and cramping, and still so effective today. Wild Yam is a key herb for reducing spasm of the cervix and uterus.

- Wild Yam contains steroidal saponins, phytosterols, alkaloids and tannins which help to reduce spasm and inflammation


Cramp Bark (Viburnum opulus)

- As the name suggests the bark of this plant is great for relieving cramping associated with the menstrual cycle

- A study from the 1970’s found that viopudial, a constituent from this plant showed anti-spasm activity. However, not a lot of research has been done since.


These are just a few of my favourites for reducing pain and cramping associated with the menstrual cycle. I would always recommend checking in with a Naturopath or Herbalist before taking any of these supplements as they may not be right for you. If your pain is severe and ongoing I would most definitely have a chat to your health provider about discussing potential underlying causes.


I hope you have happy, pain-free periods!



Emily