A pain in the month. Is period pain just something to ‘put up with’ ?

Most women are unaware that there are really useful natural ways to help them deal with their period pain.   Instead, we simply believe that the pain is something to be put up with.  However, instead of reaching for the over-the-counter pain relief medications I would like to suggest trying some remedies that may actually treat the cause of period pain rather than just the uncomfortable symptom of pain.

Pain during or just prior to menstruation is thought to result from the overproduction of substances called prostaglandins.  These are hormone-like chemicals that the body produces in order to make the wall of the uterus contract before and during a period.  There are many types of prostaglandins in the body, some of which are pro-inflammatory (encourage inflammation) and others which are anti-inflammatory.  It may well be that in women who experience period pain there is an imbalance in the production of these prostaglandins with over-production of the inflammatory type which could be the cause of pain.

Evidence is beginning to accumulate to suggest a role for fish oil supplementation (omega 3 fatty acids) for the relief of period pain (1,2,3).  One study found that supplementation with fish oil (containing high concentrations of the long chain omega 3 fatty acids EPA and DHA) for two months caused a significant reduction in pain symptoms(3).  These essential omega 3 fatty acids may have their affect via their influence on prostaglandin synthesis.  The prostaglandins derived from omega-3 fatty acids are of the anti-inflammatory type, hence it would seem sensible for women who suffer from dysmenorrhoea to increase their consumption of omega 3 fatty acids, found in oily fish e.g. mackerel, salmon, trout, and sardines or consider taking a fish oil supplement (providing around 250-300mg of EPA and 250-300mg DHA daily).  For vegetarians walnuts and flaxseeds contain a short chain omega 3 fatty acids that may also be helpful.  A supplement of flaxseed oil providing 500-700mg alpha-linoleic acid a day could be considered. 

In contrast, some of the prostaglandins derived from excess consumption of omega 6 fatty acids (found in many foods, vegetable oils, margarines etc) are pro-inflammatory.  In fact, a study found that women who experienced period pain had a lower dietary omega 3:omega 6 ratio (i.e. low amounts of omega 3 fatty acids in the diet and high amounts of dietary omega 6 fatty acids, an imbalance common in the UK today) than women who did not experience pain(1), the authors of the study concluded that “A higher intake of marine omega 3 fatty acids correlates with milder menstrual symptoms”. 

A recent preliminary study(4) seems to suggest that women who suffer from recurrent period pain may have a slightly disrupted metabolism of certain fatty acids causing an imbalance in the production of pro- and anti-inflammatory prostaglandins.  As mentioned in (numerous) previous posts omega 3 fatty acids are very important for optimal health and wellbeing and I would certainly recommend regular inclusion of these essential fats in the daily diet.

Other nutrients have also been shown to be useful in managing period pain.  Vitamin E, various B Vitamins, calcium and magnesium all seem to be important:

Vitamin E supplementation seems to be effective in relieving menstrual pain (5,6,7).  In one study daily administration of 150 mg of vitamin E improved the condition of 68% of dysmenorrhea patients (5).  In another study 500IU vitamin E (350mg) per day, given two days before the beginning of menstruation and through the first three days of bleeding, was effective in relieving pain (6).  The latest study (7) was carried out in 278 girls aged 15-17, the participants were given 200IU (around 135mg) vitamin E or a placebo (inactive tablet) twice a day beginning two days before the expected start of their period and continued through the first three days.  Treatment was continued over four consecutive cycles.  Girls receiving the vitamin E treatment had lower pain severity and duration after two and four months, they also had lower blood loss.  Vitamin E may well have its affect via mediation of the inflammatory reaction described above.It may be useful to take 135mg Vitamin E twice daily just prior and for the first few days of your period for a couple of cycles to see if this helps reduce pain. 

Vitamins of the B family (particularly B1, B3, B6, B12) also seem to be important in the relief of menstrual cramps.  A broad spectrum B vitamin supplement may be useful if taken for a few days prior to and throughout your period. 

For many women calcium and magnesium can be helpful in relieving pain.  Both of these minerals are important for the proper functioning of our nerves and muscles and seem to act as natural painkillers.  Many women find that taking 1000mg of calcium and 500mg of magnesium daily throughout their cycle reduces their period pain.  A review paper (8) found that magnesium was helpful in reducing period pain and reduced the need for additional pain medication in order to ease symptoms.  The National Diet and Nutrition Surveys have found that many women in the UK do not achieve recommended daily intakes for magnesium.  Including plenty of nuts, seeds and wholegrains in the diet will boost your levels of this vital nutrient.

Finally I would like to mention ‘stress’.  We all experience it at times!  However, a recent study(9) has found that work-related stress (such as low co-worker social support, low job security, and poor job control) was associated with a higher risk of painful periods.  15.5% of the women in the study, which included 2772 women in total, reported experiencing menstrual pain that limited their daily activity.  Limiting stressful situations, taking time to be calm and relax (perhaps treating yourself to a massage at the start or your period) may well be helpful in controlling pain symptoms.  Stress has been linked to the over-production of inflammatory chemicals in the body which, as described earlier, may be connected to period pain.