Relieving Menstrual Pain

What is dysmenorrhea?

Dysmenorrhea is a medical term that means “painful periods,” Unfortunately, 50%-90% of menstruating women experience it every month. Ironically, such an essential and life-giving biological function can severely impact us physically and emotionally. There are several ways to decrease menstrual pain and increase the quality of life, allowing for a more pleasant monthly visit from Aunt Flo.

What causes menstrual cramping?

Dr. Vicky Scott is the founder of Asheville Gynecology and Wellness, an integrative GYN practice in Asheville, N.C. She is board-certified in obstetrics, gynecology, lifestyle medicine, and integrative and holistic medicine. She explains that as women get closer to their period, the body starts producing prostaglandins, which are inflammatory compounds that cause the uterus to contract and release its lining. This can cause cramping. Cramps can also occur with an imbalance of estrogen and progesterone, mainly when estrogen levels are too high, or progesterone levels are too low.

The following are the most common symptoms of dysmenorrhea:

  • Cramping and pain in the lower abdomen
  • Low back pain
  • Pain radiating down the legs
  • Nausea
  • Vomiting
  • Diarrhea
  • Fatigue
  • Weakness
  • Fainting
  • Headaches

It is essential to see a gynecologist to address any underlying causes of dysmenorrhea. Other conditions that can cause cramping, pelvic pressure, low back pain, heavy or prolonged periods, and gastrointestinal issues include the following:

Endometriosis is a condition that causes the tissue that usually lines your uterus to grow outside the uterus.

Polycystic ovary syndrome (PCOS) is a common hormone disorder affecting approximately 1 in 10 women of childbearing age. Symptoms include heavy periods, prolonged periods, excessive facial and body hair, weight gain, trouble losing weight, acne, thinning hair, or hair loss. The body tends to produce higher than average amounts of male hormones.

Fibroids are noncancerous growths that develop inside or outside of the uterus. They range in size from as small as a seed to large masses that can cause an enlarged uterus. The symptoms vary depending on the number of fibroids, their size, and location.

Pelvic inflammatory disease (PID) is a bacterial infection of the female reproductive organs. It’s usually caused by sexually transmitted diseases like chlamydia and gonorrhea. Symptoms include:

  • Painful intercourse
  • Bleeding during or after sex
  • Foul-smelling vaginal discharge
  • Burning sensation when urinating
  • Fever
  • Spotting between periods

Adenomyosis is a thickening of the uterus. It occurs when the endometrial tissue that lines your uterus grows into the muscles of your uterus and can cause your uterus to grow two to three times its standard size.

An intrauterine device (IUD) is a small birth control device inserted into your uterus. They’re safe for most people but can occasionally cause side effects, including severe menstrual cramps, irregular periods, and heavy menstrual bleeding. Different types of IUDs are available, some containing hormones while others are hormone-free.

Remedies for Painful Periods

  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce menstrual pain by inhibiting prostaglandin activity and reducing inflammation.
  • Acetaminophen (Tylenol) is another option if NSAIDS fails to work or upset the stomach.
  • Hormone therapy such as the birth control pill, skin patches, or a Depo-Provera shot may prevent ovulation and reduce the severity of menstrual cramps. They can also make periods lighter, shorter, and less painful. This is not an option for women who smoke, have a history of blood clots, have high blood pressure, or have cancer.
  • Regular exercise increases endorphins which can decrease pain.
  • A heating pad across the abdomen can help relax the abdominal muscles.
  • Pelvic floor physical therapy can relieve pelvic floor pain associated with excessive tightening and cramping by helping shortened and contracted muscles to stretch and relax.
  • A hot bath with aromatherapy oils such as lavender, chamomile, and sage can be soothing.
  • Give yourself an abdominal massage by placing your hands over your navel. Begin by making small circles in a clockwise direction. This should be done slowly with moderate pressure for about a minute. Then gradually increase the circling size until you rub the entire abdomen.

Food as Medicine

Dr. Scott recommends proper nutrition and dietary changes to support a healthy and pain-free menstrual cycle. There have been studies that show that women who eat high fiber and low-fat diet have fewer estrogen levels and less painful cycles. Foods eaten can either increase the estrogen effect or reduce it. Here are some dietary and lifestyle recommendations from Dr. Scott:

  • Eat whole grains such as brown rice, whole-grain bread, and oatmeal.
  • Eat broccoli, spinach, carrots, sweet potatoes, Swiss chard, and Brussels sprouts.
  • Eat legumes such as beans, peas, and lentils.
  • Eat fruits such as apples, mangoes, berries, and oranges.
  • Avoid caffeine, alcohol, and tobacco.
  • Avoid refined grains such as white bread, refined cereals, and pastries.
  • Avoid fatty foods such as doughnuts, cheese, French fries, and potato chips.
  • Reduce stress: psychological stress may increase your risk of menstrual cramps.
  • Drink herbal teas such as chamomile, ginger, lemon balm, fenugreek, peppermint, and cramp bark contain anti-inflammatory and antispasmodic compounds.
  • Supplements such as vitamin E, omega-3 fatty acids, vitamin B-1 (thiamine), vitamin B-6, and magnesium may reduce menstrual cramps.

A Traditional Chinese Medicine Approach

In Chinese medicine, the most common reason for menstrual cramping is the stagnation of blood circulation in the lower abdomen. Acupuncture is a safe and effective technique to increase blood flow, relax contractions, and move stagnation. Researchers at The National Institute of Complementary Medicine at Western Sydney University in Australia conducted a study to compare the efficacy of acupuncture for treating dysmenorrhea. The researchers found that, in all cases, acupuncture led to a significant reduction in the intensity and duration of menstrual pain after three months of treatment.

Yoga as Medicine

Vinita Khatavkar is a seasoned yogi who teaches in the Asheville area. She has been practicing yoga since 1989 and says the regular practice of asanas (yogic postures) and pranayama (breathing techniques) are beneficial for relieving menstrual pain. Every asana can be held for 5 to 6 deep breaths or for a longer duration if it helps with the pain. She notes that inversions such as headstands, shoulder stands, deep twists, and backbends should be avoided while menstruating.

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