Painful cramping during our period is one of the most common gynaecological conditions in reproductive individuals. Also termed dysmenorrhea, it is not a normal occurrence and it shouldn’t be something you that have to live with month in and month out – and that's if your cycle is regular. Because the prevalence of dysmenorrhea is so high, it has been accepted as an expected and normal experience for individuals. But it is more than just pain – it can be debilitation for days at a time, being withdrawn from work, school, anxiety and depression as a result.
Why are you cramping?
Underlying the sensory and emotional turmoil of period pain, there is physical tissue damage occurring in the pelvis; we see activation and contraction of uterine tissue and surrounding muscles being the divers of pain and discomfort. Those who experience period pain have been shown to have an increase in prostaglandins, the inflammatory messengers, which act on our pelvic tissue causing contraction and cramps, and they are highest during your first two days of your bleed.
What’s to blame? the dynamic, ever-changing, and influenceable balance of oestrogen and progesterone. Progesterone is protective again prostaglandins and inflammation. So, days before a bleed there is a drop of progesterone causing an increase in circulating prostaglandins therefore, causing those too well-known symptoms of period pain. Other symptoms like nausea and vomiting, lower back pain, bowel changes, fatigue and headaches are an outcome of those prostaglandins circulating throughout the body.
What is it telling us?
The timing and nature of cramping and discomfort before the period is the body's way of communicating imbalances in your hormones and excess inflammation. As noted before, the balance of oestrogen and progesterone is always fluctuating and is easily affected by external factors.
As progesterone drops, naturally, the oestrogen levels will rise. The issue with this is that oestrogen can stimulate inflammation in the body and when there is an excess, we begin to experience real pain! Oestrogen excess can occur from poor oestrogen clearance by the liver, poor elimination in the bowels, increased fat tissue, or alterations in oestrogen receptors. Beyond the body, in day to day life, we are exposed to oestrogen mimicking molecules from our personal care products, in our food packaging and more.
How we can manage these hormone imbalances and inflammation?
By managing inflammation and balancing hormones, we can manage cramping and pain. Supplements and nutrients that block prostaglandin production and promote anti-inflammatory pathways in the body result in reduced prostaglandin activity and subsequent cramping that is causing us this unnecessary pain.
When it comes to balancing hormones, it's important to first understand what the drivers of the imbalances are. Enhancing natural detoxification through the liver, promoting clearance in the bowels to avoid hormone reabsorption, managing weight, seeking out oestrogen mimicking chemicals or investigating any underlying causes is essential to achieve the right results.
Diet and Naturopathic Management
Dysmenorrhoea is not a genetic condition but is common in families due to learned behaviour and diet choices.
Many studies have shown a link between the occurrence of dysmenorrhea and diet. A 2018 study saw food groups that were found to be most aggravating to pain include coffee, fat and high sugar alongside a low intake of fruit, vegetables, and quality protein. The benefit of whole foods and protein is due to natural detoxification processes. Whilst nutrients and amino acids from fruit, vegetables, and protein will provide building blocks for the pathways of liver detoxification, fibre from fruit and vegetables will enhance the elimination of those hormones through bowel motions and out of the body.
If you are experiencing dysmenorrhea or feel there is an aspect of your period that seems out of whack, don’t freak out! By seeking Naturopathic care, we can identify underlying mechanisms that play into and affect your period and we can address and change these. We will consider nutrition and herbal medicine, helping to alleviate pain, target inflammation, and reduce muscle spasm whilst also looking at long term management of your hormones. We can tailor-make a prescription for you’ because no-one’s periods are the same, so why they should they be treated the same?
Bernardi, M., Lazzeri, L., Perelli, F., Reis, F. M., & Petraglia, F. (2017). Dysmenorrhea and related disorders. F1000Research, 6. https://doi.org/10.12688/f1000research.11682.1
Harada, T. (2013). Dysmenorrhea and Endometriosis in Young Women. Yonago Acta Medica, 56(4), 81–84.
Kartal, Y. A., & Akyuz, E. Y. (2018). The effect of diet on primary dysmenorrhea in university students: A randomized controlled clinical trial. Pakistan Journal of Medical Sciences, 34(6), 1478–1482. https://doi.org/10.12669/pjms.346.16477
Patel, S., Homaei, A., Raju, A. B., & Meher, B. R. (2018a). Estrogen: The necessary evil for human health, and ways to tame it. Biomedicine & Pharmacotherapy, 102, 403–411. https://doi.org/10.1016/j.biopha.2018.03.078
Pattanittum, P., Kunyanone, N., Brown, J., Sangkomkamhang, U. S., Barnes, J., Seyfoddin, V., & Marjoribanks, J. (2016). Dietary supplements for dysmenorrhoea. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD002124.pub2