How to manage painful periods: Practical tips for both immediate relief and long term wellbeing.

Do you suffer from painful periods that stop you in your tracks? Unfortunately, so too do a lot of Australian women. What’s especially upsetting is the widespread belief that this is a normal part of our cycle and something we must endure.

But painful periods are in fact not normal at all! Which is why we’ve put together this guide to explain some of the mechanisms behind period pain, how to find immediate relief as well as protocols that may assist you to make your monthly cycle less painful and disruptive in the long run.

Painful periods are also sometimes referred to as Dysmenorrhea and is classified into two types, primary and secondary Dysmenorrhea.

Primary Dysmenorrhea refers to menstrual cramps that are not associated with any other disease, usually beginning 1-2 days before menstruation and last from 2 to 4 days [1].

Secondary Dysmenorrhea is pain that is caused by a disorder in the reproductive organs. Conditions such as endometriosis, fibroids, pelvic inflammatory disease, or cervical stenosis can trigger secondary dysmenorrhea [2]. This type of pain tends to begin earlier in the menstrual cycle and last longer than typical cramps.

The intensity of symptoms can vary, but they often include:

Cramping in the lower abdomen

Back pain and pain radiating down the leg

Nausea and vomiting

Headaches and dizziness

General fatigue

These symptoms are not just minor inconveniences. They are incredibly taxing to manage, and for many women debilitating enough to interfere with their daily activities and quality of life. It's important to address these symptoms seriously and seek effective treatment options, both medical and holistic, to manage the condition effectively.

But what causes periods to be so painful?

What on earth is our uterus doing to cause such mayhem? Well, the uterus is always contracting, but the contractions are so small we don’t really feel them. Except during menstruation, the uterus contracts significantly more to shed the uterus lining. Pain occurs when the blood vessels are squeezed during the process. As the contraction temporarily cuts off blood supply to the cells of the uterus, these cells release chemicals that trigger pain. Prostaglandins are also released, which trigger even stronger contractions increasing pain levels and inflammation.

We know that high levels of prostaglandins are the main cause of primary dysmenorrhea - and so lowering prostaglandin levels can be a key to reducing period pain [3].

Why do some women have higher levels of prostaglandins than others?

1. Hormonal Fluctuations

Women who experience hormonal imbalances, particularly with higher levels of oestrogen relative to progesterone, tend to produce more prostaglandins. Oestrogen promotes the production of prostaglandins, which can exacerbate the intensity of menstrual cramps. High estrogen can have many causes, but one common one can be a high exposure to endocrine-disrupting chemicals (EDCs). Another is when your liver is not functioning at an optimal level, as our livers are essential to metabolising and clearing excess estrogen.

2. Nutritional Deficiencies:

Certain nutrients, like omega-3 fatty acids, magnesium, and vitamin B1, can naturally help reduce the production of prostaglandins. A deficiency in these nutrients might increase the severity of menstrual cramps.

3. Underlying Health Conditions:

Conditions like endometriosis and uterine fibroids are associated with increased production of prostaglandins. Women suffering from these conditions often report more severe menstrual pain.

4. Lifestyle Factors:

Stress and lack of exercise can also elevate prostaglandin levels. High-stress levels, in particular, can disrupt hormonal balances, leading to enhanced prostaglandin production during menstruation.

As dysmenorrhea can be a sign of an underlying condition such as endometriosis, it’s important to speak to your GP or healthcare provider to determine what may be causing your painful period.

To manage and potentially reduce the pain associated with your periods, consider the following immediate and long-term strategies:

Immediate Relief for Period Pain:

Heat Therapy:

Applying a heat pack to your lower abdomen can help relax the uterine muscles and reduce the contraction intensity, thereby easing the pain.

OTC Pain Relievers:

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can reduce the production of prostaglandins and alleviate pain. However, they should be used judiciously and under the advice of a healthcare provider.

Integrative Medicine and Nutritional Supplement Support for Managing Painful Periods

When it comes to managing dysmenorrhea, several nutritional supplements and natural therapies can play a pivotal role in alleviating symptoms and promoting long-term wellness.

Magnesium:

This mineral is crucial for muscle relaxation and nerve function, which can help ease uterine contractions. Research has shown that magnesium deficiency may play a significant role in PMS and Dysmenorrhea with a number of studies highlighting the efficacy of magnesium supplementation in prevention and treatment of symptoms [4]. Clinical trials have demonstrated magnesium to be more effective than a placebo for menstrual pain relief [5]. Magnesium glycinate or bisglycinate are particularly effective forms due to their high bioavailability and gentle effect on the stomach.

Omega-3 Fatty Acids:

Known for their anti-inflammatory properties, omega-3s can reduce the production of prostaglandins. High-quality fish oil supplements or plant-based sources like flaxseed oil are recommended.

Vitamin E:

Vitamin E relieves primary dysmenorrhea by inhibiting prostaglandin production by suppressing phospholipase A2 and COX activity. It also promotes prostacyclin action, with consequent vasodilation and muscle relaxation. [6]

Vitamin B1 (Thiamine):

Studies have suggested that vitamin B1 can significantly reduce the pain of dysmenorrhea and improve menstrual health by helping to calm and relax the muscular walls of the uterus [7].

Vitamin D:

Adequate levels of vitamin D are essential for calcium absorption, a mineral that helps with muscle function and may reduce menstrual cramps. Furthermore, vitamin D has been linked to reducing levels of inflammation in the body.

Turmeric (Curcumin):

The active compound in turmeric, curcumin, has potent anti-inflammatory properties that can help lower prostaglandin levels. Turmeric supplements should contain piperine, which significantly enhances curcumin absorption.

Chaste Tree Berry (Vitex Agnus-Castus):

This herb has been traditionally used to balance hormones, particularly in reducing prolactin and increasing progesterone levels [8], which reduces the amount of prostaglandins released andsubsequent pain.

Cramp Bark:

As its name suggests, cramp bark is used for relieving cramps, including those caused by menstruation. It works as a muscle relaxant and can be taken as a tea or supplement.

Exercise:

It might feel like the last thing you want to do while experiencing a painful period, but exercise can reduce pain sensitivity and lower prostaglandin levels. Prostaglandin production increases in periods of high stress, which can be alleviated by moderate exercise. Studies have shown moderate levels of physical activity throughout the month can reduce pain severity [9].

Understanding the underlying causes of dysmenorrhea and utilising a combination of conventional and integrative treatments can lead to significant improvements in your monthly cycle and overall wellbeing. Every woman’s experience with menstrual pain is unique, and what works for one may not work for another - but you don’t have to accept painful periods as a way of life.

At Flynns Beach and Lord Street Pharmacy, our integrated pharmacist is dedicated to helping you find the best-personalised treatment plan.

We encourage you to come in and discuss your symptoms and treatment options.

Whether you need advice on the right supplements, lifestyle adjustments, or just need someone to guide you through your symptoms, we're here to support your journey to better health.