Are you one of the many women who dread that time of the month? Period pain is a stark reality for many women. Studies indicate that as many as 90 per cent of women experience period pain severe enough to disrupt their regular activity, yet very few will seek health advice about it. Many women believe that period pain is ‘normal’. In a busy world where there is always more to do, a staggering number of women are self-medicating for their period pain in order to just-keep-going. Is there a better way?
Most women are all too familiar with the symptoms of period pain, including the classic cramping pain in the lower abdomen which may radiate to the back and even down the legs. Other symptoms that may be experienced include gastrointestinal symptoms (diarrhoea and/or constipation) and a general feeling of being unwell: this could manifest as moodiness, feeling snappy or teary or just wanting to be left alone. Some women can even experience fever and chills as well as vomiting.
Although it can feel similar, period pain can be categorised into two distinct categories: “primary” and “secondary”. Primary period pain refers to period pain without an apparent underlying cause. Secondary period pain, on the other hand, is categorised as period pain as a result of an underlying condition. Thankfully, natural and herbal remedies can help!
Primary period pain
Period pain without a serious underlying cause is by far the most common type. This form of period pain occurs most frequently in young women and usually starts within a year or two of beginning menstruation. It is usually experienced as cramping pain beginning shortly before or shortly after the beginning of blood flow and lasting for one to three days. While there may not be a “serious underlying condition” causing this pain, something is at its root.
In the case of primary period pain, the culprits are natural inflammatory chemicals released by the body known as prostaglandins or, more specifically, series-2 eicosanoids. It is thought that as the lining of the uterus separates from the uterine wall these series-2 eicosanoids are released, triggering contractions of the uterus, constriction of blood flow to the area and increasing sensitivity of nerve endings and, you guessed it, pain.
This theory is backed up by findings that women with severe period pain tend to have more of these particular prostaglandins in their menstrual blood than women who experience less pain. It has also been found that levels of series-2 eicosanoids in menstrual blood are highest in the first one to two days of the period, which would correspond with the many women who report having period pain for only the first one or two days of their period.
So, who is more likely to experience primary period pain? Studies indicate that young women (<20 years) are more prone to period pain, as are women who have not yet carried a pregnancy. Having a heavy period also seems to be associated with period pain. Smoking is a modifiable risk associated with higher rates of period pain. Experiencing depression, anxiety and/or disruption to social networks is also associated with increases in period pain.
Secondary period pain
Secondary period pain is a categorised as period pain that is caused by an underlying condition. Comfortingly, secondary period pain makes up the much smaller of the two groups. Despite this, it is important to make sure that the possibility of an underlying cause of period pain is ruled out.
Persistent pain
You should further investigate period pain when …
- Period pain occurs in the very first and/or second ever period.
- Period pain begins after 25 years of age with no previous history of pain.
- You are also experiencing infertility.
- You experience heavy bleeding with period pain.
- You experience irregular periods with period pain.
- You receive little or no relief from nonsteroidal anti-inflammatory drugs and/or oral contraceptives.
- A fever or discharge accompanies period pain.
- Pain changes in character.
Period pain may be caused by a variety of different underlying conditions including endometriosis, pelvic inflammatory disease, adenomyosis, fibroids, polyps and congenital outflow obstruction. These conditions may sound complex and, in fact, they are. They need to be diagnosed by your doctor who may use a variety of tests. These areas are too vast to cover in any detail in this article; however, please be aware that natural and herbal remedies have a lot to offer in support of most of these conditions.
Lifestyle modifications
Thankfully, there are many things you can change in your own life to assist in the reduction of primary period pain. Dietary and lifestyle modifications and natural and herbal remedies are the first step on the road to reducing period pain and re-establishing hormonal harmony.
Vegetables ahoy!
Begin by increasing low fat, high fibre and vegetarian foods in your diet as a basic natural remedy. There is some evidence that a vegetarian diet may decrease the experience of period pain. Classically, a vegetarian based diet is high in fruit and veges and also high in fibre. While you may not want to become fully vegetarian, many meat eaters will easily base all their dinners around meat. A good half-way goal is to incorporate 2-3 vegetarian meals per week. Base these meals on legumes (eg chickpeas, kidney beans, adzuki beans, lima beans etc) or soy-based products such as tofu and tempeh as well as lots of vegetables. The world of vegetarian cooking is a vast and inspiring one. Check out your local library for some great vegetarian cookbooks.
Cut down
Reduce the amount of red meat, eggs and nightshades in your diet. The nightshades are a plant family including eggplant, capsicum, potato, tomato and chilli. These foods are thought to exacerbate inflammation and may worsen period pain. Red meat and eggs are high in arachidonic acid, which may increase inflammatory prostaglandins in susceptible people. When you do eat red meat, make sure it is good quality, lean meat.
Wheat and dairy
Another simple natural remedy is to reducing wheat and dairy in the diet. It is amazing how many conditions improve on a wheat-free and dairy-free diet and this includes period pain. Avoiding wheat means you need to buy wheat-free versions of bread, pasta and biscuits. There are many alternative grains that can be used including rye (bread), spelt (bread and pasta), corn (pasta and corn crackers) and rice (pasta, rice bread and rice crackers). Dairy can be replaced with sheep and goat’s milk products from your local health food store and, to a lesser extent, in your supermarket.
Liver little
Reducing alcohol to 1-2 standard drinks per week is a great natural remedy. Alcohol can place a load on the liver. As it is your liver’s job to metabolise hormones, it is thought that a sluggish liver may exacerbate hormonal imbalance and may, in theory, contribute to increased oestrogen levels, increased fluid and salt retention and heavier menstrual flow.
Good oils
Eat more fish, nuts and seeds. The oils in these foods serve as a natural remedy because they have anti-inflammatory properties and are extremely beneficial for general health. Many people do not eat enough fish. Try to have 2-3 serves per week while remembering to avoid the larger fish such as tuna, swordfish and shark, which can be high in heavy metals. Nuts are also vastly under consumed — around half a cup per day is good. Make sure you vary the types of nuts you eat and buy them unsalted and untoasted. Nuts are not only potentially anti-inflammatory but are good for healthy skin, improving cholesterol readings and bumping up your daily fibre.
Detox
Consume more detoxifying foods including dandelion coffee, lemon juice in water and bitter greens including endive, chicory and rocket. All of these foods have a gentle detoxifying effect on the liver, which will gently assist your daily detoxification processes as natural remedies.
Exercise
Exercise regularly. Exercise is a form of detoxification in itself. When you exercise you increase circulation and oxygenation to the cells, you “burn off” stress hormones, help to stabilise blood sugar levels and, hopefully, work up a good sweat. Quite simply, we were not designed to be as sedentary as many of us now are. Make sure you exercise at least four times per week even if it is only for 30 minutes — more if you have time!
Water
Make sure you are drinking at least 1.5 to 2 litres of purified water per day. Ensuring you do this is a simple daily way to make sure toxins are continually and effectively flushed from the body.
Nutritional supplements and natural remedies
Adopt any of these four simple natural remedies and supplements and relief could be on its way.
- Fish oil: Studies have shown that fish oil supplements assist in the reduction of period pain. A dose of 3000mg per day is recommended.
- Magnesium: Considered the mineral for ‘relaxing’ muscles, magnesium was found to reduce levels of PGF2 alpha in a study of 50 women suffering from period pain.
- Vitamin E has also been shown to improve dysmenorrhoea. A dose of 500IU of the form of d-alpha tocopherol taken throughout the cycle is recommended.
- B vitamins: Several B vitamins including B6 and niacin have been shown to decrease period pain. The B vitamins are thought to be absorbed best when taken as a group and there are many good multi-B supplements on the market. B vitamins are also good for stress and energy levels, which never goes astray!
Herbal support
There are many herbal remedies that are wonderful for period pain. Herbal remedies that address pain directly will often be used alongside herbs that help to address hormonal balance, support stress, assist the liver, build blood etc. It is highly recommended that you see a qualified herbalist or naturopath in order to receive the appropriate herbal remedies for your individual symptoms at an effective dose. Some herbal remedies that your herbalist may use in your herbal mix include:
Cramp bark (Viburnum opulus): The name alone suggests its valuable role in assisting with period pain. Experiments have indicated that this herb helps to block smooth muscle spasm, which supports its long traditional use in this area.
Ginger (Zingiber officinalis): Being a very warming herb, ginger is great for the type of period pain that is alleviated by warmth. Ginger is thought to have a prostaglandin-inhibiting effect which contributes to its pain relieving qualities. Ginger is also particularly good if symptoms of nausea are experienced along with period pain.
Cinnamon (Cinnamomum zeylandicum) is another warning herb and also good for the type of period pain that improves with warmth. Cinnamon is thought to be good for period pain due to ‘stagnancy’, which is often characterised by dark clots in the menstrual fluid.
Bupleurum (Bupleurum falcatum): This is a herb originating from Chinese medicine where it is used widely for hormonal conditions. Bupleurum has been found to have anti-inflammatory properties and also has a beneficial effect on the liver. Traditionally, bupleurum has been used widely for menstrual troubles arising from stress and worry.
Dong quai (Angelica sinensis): Another Chinese herb used widely for hormonal conditions including period pain. Dong quai is traditionally used to reduce uterine spasm and reduce pelvic congestion and pain.
Homoeopathy
Homoeopathy can be wonderful for relief from period pain and the correctly chosen homoeopathic natural remedies can bring almost instantaneous pain relief. There are literally thousands of homoeopathic remedies to choose from and again, seeking advice from a trained homoeopath is highly recommended. Some useful homoeopathic natural remedies for period pain include:
Sepia: Use when there is period pain with a dragging down sensation or heaviness in the pelvic area. The pain may travel down the thighs and there is often great irritability emotionally.
Mag phos: Use when there is cramping pain coming in spasms similar to labour pains. There may also be sharp or cutting pains which ease with the application of heat.
Cimicifuga: Use when there are strong labour-like pains of the uterus with headaches for several days before menstrual flow begins.
Aconite: When there is sudden and severe pain with anxiety.
Ferrum phos: Painful menstruation with a flushed face and fast pulse; abdomen feels congested for several days before the flow begins, which is bright red in colour.
Spiritual menstruation
As a naturopath, I find it important to continually reassert the mind/body connection. A healthy diet and lifestyle will not be enough for a person who is spiritually or emotionally disengaged. Equally, the most spiritual of people cannot ignore the laws of nature; their body still need to be adequately nourished.
Alexandra Pope is a psychotherapist who has done a lot of work in the area of “women’s business” and she encourages women to embrace the rhythms of their menstrual cycle. In her book, The Wild Genie, she likens the female menstrual cycle to the seasons, with the time after bleeding and through to ovulation (mid-cycle) akin to spring and summer. Over this time, women tend to have energy to burn; this is an expansive time, a time to be doing, a time when women feel active, powerful and creative. After ovulation and into menstruation, she likens to autumn and winter. This is a time to pull in energetically. During menstruation, women intuitively want to draw inward, they need to slow down; this is a time to nourish the self and to reflect.
Often, varying emotions are brought to the surface during menstruation. These emotions are not “irrational” but rather deep emotions that are demanding to be heard. By creating the time and the space energetically during menstruation, we can become in touch with the profound intuitive wisdom that is so easily missed in the constant doing of daily life. By not being in tune with the natural energy currents of the body, we can create an inner tension. Equally, by cooperating with the inner seasons, a lot of the inner tension can fall away.
The experience of period pain may be common but that does not mean it should be considered ‘normal’. Period pain is a flag indicating that balance has been tipped somewhere along the line. To restore balance, the cornerstones of good diet, good lifestyle and a rich and satisfying emotional/spiritual connection all need to be engaged.
Kate Mirow is a naturopath who uses nutrition, herbal medicine and homoeopathy to help her patients achieve their full health potential. She can be contacted at her clinic in Manly, NSW on 02 99777888 or at kmirow@yourhealth.com.au.
