That Time of the Month Doesn’t Have to be a Pain
Menstrual cramps (dysmenorrhea) may occur immediately before or during a woman’s menstrual period. There are two types of dysmenorrhea: primary dysmenorrhea and secondary dysmenorrhea.
Primary dysmenorrhea (common menstrual cramps) usually begins one to two years after a woman starts getting her period. The pain typically starts shortly before or at the onset of menstruation and continues for one to three days. It is generally felt in the lower abdomen and/or lower back and can be mild to severe.
Secondary dysmenorrhea is pain caused by a disorder in the woman’s reproductive organs (e.g. fibroids, endometriosis or pelvic inflammatory disease). These cramps usually begin earlier in the menstrual cycle and last longer than common menstrual cramps.
Menstrual cramps are caused by contractions in the uterus, which is a muscular reproductive organ. These contractions can cause pressure on nearby blood vessels, cutting off the supply of oxygen to the muscle tissue of the uterus and resulting in pain.
Conventional approaches to managing menstrual cramps generally include anti-inflammatory medications. Unfortunately, these can result in stomach irritation and stress to the liver and kidneys.
Fortunately, there are a number of evidence-based alternatives.
While some studies are unclear, there does appear to be a correlation between dysmenorrhea and low intake of vegetables and fruits, as well as high intake of polyunsaturated fat, ham, beef and other red meat.
A low-fat vegetarian diet was associated with increased serum sex-hormone binding globulin concentration and reductions in body weight, dysmenorrhea duration and intensity, and premenstrual symptom duration. The symptom effects might be mediated by dietary influences on estrogen activity.
There was a positive correlation found between skipping breakfast and constipation on the intensity of dysmenorrhea.
Dietary supplements with fish oil can substantially reduce menstrual discomfort.
Treatment of primary dysmenorrhea with ginger for 5 days had a statistically significant effect on relieving intensity and duration of pain.
(Since we have added ginger to our morning smoothie, my wife has had a significant reduction in her menstrual cramps)
Cramp bark, Ginkgo biloba, and chaste tree extract are supplements that may benefit women suffering from PMS.
Exercise can decrease the duration and severity of dysmenorrhea. Studies show that exercise helps relieve stress and elevates mood. Stress is a significant perpetuating factor that can heighten menstrual discomfort.
A study by Helms showed a 41% reduction of analgesic medication used by the women who received acupuncture and no change or increased use of medication seen in the control group.
Both primary and secondary dysmenorrhea respond favorably to acupuncture.
Acupuncture appears to have an effect on stress, inflammation and hormones, with respect to the management of dysmenorrhea.
Spinal manipulation may be an effective and safe non-pharmacological alternative for relieving the pain and distress of primary dysmenorrhea.
Sample Treatment Plan for Dysmenorrhea (under the direction of a healthcare provider):
- Diet – Increase cold water fish, fruits and vegetables. Decrease dairy, salt, sugar and saturated animal fats (especially premenstrual)
- Fish oil – 1-3 g
- Cramp Bark
- Ginger – Up to 4 g
- Stress management techniques
- Exercise – 3-5x/weeks, moderate intensity
- Heat to abdomen and low back
- Acupuncture – 2-3 courses of 4-6 treatments (2-3 cycles) and then as needed
- Chiropractic – 2-3 courses of 4-6 treatments (2-3 cycles) and then as needed