Why we should start normalizing it
What's going on when it happens
What to do about it
BY JESSICA GUERRA, MSN CANDIDATE + INNATE RHYTHM INTERN
This blog is for educational purposes only. We encourage you not begin any supplement protocol without consulting with your personal healthcare professional.
AHH, PERIOD PAIN. The terrible experience and symptom we have heard countless times is “normal” to have. Bending over in agonizing pain even after taking over-the-counter (OTC) pain medication, using a heating pad, drinking every kind of tea, etc. is normal? No, absolutely not!! Severe pain is NEVER normal and something that should never be shrugged off.
It’s unfortunate because the “solution” we hear from Western medical doctors is often prescribing hormonal contraceptives (HC’s) or a stronger pain medication that can’t be found OTC. Although these can be good solutions and can truly help manage the pain, they’re Band-Aids at best. If you stop taking the pain medications or HC’s, then your pain will very likely return. That’s why you must find a healthcare practitioner who will help you find the underlying reason that this pain is happening, aka the root cause.
The medical term for period pain is dysmenorrhea. In Greek it means “painful monthly bleeding.” The way dysmenorrhea occurs and functions is not fully understood because it’s complex and can depend on many different factors (1). One thing that has been confirmed is that in women who experience this, there is a hyper-secretion of prostaglandins, which are a group of lipids (fats) that play a role in the body’s response to inflammation, before menstruation (2,3). The prostaglandins narrow the blood vessels that supply the uterus, resulting in less blood supply being sent to the uterus, causing the uterus to contract more which leads to cramping (3).
PROSTAGLANDINS ARE PRODUCED BY PROGESTERONE, a hormone secreted by the female reproductive system that is dominant after ovulation, in the second half of your cycle during the luteal phase (4). When progesterone drops right before menstruation, prostaglandin levels increase. This means that dysmenorrhea only occurs in women who have ovulatory cycles. This explains why inhibiting ovulation with hormonal birth control, for example, is often a recommended option for dysmenorrhea (5). The issue with this is that once a woman decides to stop taking their hormonal birth control and they begin ovulating again, the dysmenorrhea will come back, like it never left and sometimes with even greater force.
Dysmenorrhea can be divided into two categories: primary and secondary. Primary dysmenorrhea is caused by the excess in prostaglandins before menstruation, as described in previous paragraphs, due to the drop in hormones. Secondary dysmenorrhea is when the pain is caused by an underlying medical disease, disorder, or structural abnormality within or outside the uterus. The most common underlying medical diseases include endometriosis, fibroids, adenomyosis, endometrial polyps, pelvic inflammatory disease, and at times even the use of an intrauterine device (IUD) for birth control (1).
Out of all the diseases listed above, ENDOMETRIOSIS IS THE MOST COMMON CAUSE OF SECONDARY DYSMENORRHEA. Endometriosis is an inflammatory disease when there is abnormal growth of endometrial tissues that’s not in the uterus (where it should be growing instead). With people who have this condition, the endometrial tissue will grow on either the ovaries, fallopian tubes, or other organs in the pelvic cavity (2). If you’re experiencing severe pain with your periods, we urge you to get properly screened for endometriosis.
HERE ARE SOMOE TROUBLING STATISTICS FOUND BY RESEARCHERS (1):
↠ Among all women, dysmenorrhea is one of the most common gynecological problems.
↠ The prevalence of dysmenorrhea varies between 16-91% for women of reproductive age
↠ Severe pain is seen in 2-29% of women
↠ The prevalence of dysmenorrhea in adolescents is 80%, and 40% of these adolescents had severe dysmenorrhea
↠ Women who have very severe pain are left incapacitated for 1 to 3 days each time they get their period, leading them to miss school and/or work.
This is honestly so heartbreaking to know that so many women struggle with dysmenorrhea at one point in their lives or another. Some even deal with it since the first time they got their period! In this society we have normalized it far too much and it’s time that we stop minimizing the pain women go through, and especially begin to help teenagers who are experiencing the worst pain rather than jumping to suppressing the pain with hormonal birth control.
It's important to know that pain-free periods are possible. This will take time and effort to achieve, unlike the immediate solutions of OTC medications or hormonal birth control, but in the end, it can be an avenue to feeling more empowered in your body.
Here are some dietary changes + supplements to consider shown to improve period pain:
1. DIETARY CHANGES TO CONSIDER (6):
↠ High-fiber diet will help reduce the production of prostaglandins
↠ Consuming more fish, eggs, vegetables, and fruits
↠ Reducing the amount of meat and dairy consumed due to the role of arachidonic acid, a type of fat present in animal fats, in creating more prostaglandins.
↠ Eating breakfast in the morning no later than 2 hours after you wake up
↠ Avoid caffeine while on your period due to coffee’s vasoconstriction effect (narrowing blood vessels and essentially slowing down the flow of blood around the body). This is what prostaglandins do, so adding caffeine to the mix could make the pain even worse (7).
2. SUPPLEMENTS TO CONSIDER (2,6,8):
↠ Magnesium. It can reduce the production of prostaglandins and reduce muscle spasms. Magnesium glycinate and magnesium malate have a better absorption rate and less of a laxative effect than other magnesium supplements like magnesium hydroxide or magnesium citrate. Other ways to get magnesium in your body is by taking Epsom salt baths.
↠ Zinc. It has strong antioxidant and anti-inflammatory properties that help to reduce the production of prostaglandins and pain intensity.
↠ Fish oil. It has an anti-inflammatory effect that helps reduce period pain due to the omega-3 fatty acids in fish oil reducing prostaglandin production.
We also can’t forget the importance of MOVEMENT! If you exercise regularly and make sure to exercise before you start your period, exercise has a strong effect on the prevention of dysmenorrhea. It does this by reducing mental pressure, improving mood, reducing the percentage of body fat, reducing stress levels, and improving the circulation of blood in your body. Although it may be difficult to do at times, taking a brisk walk for 30 minutes a day during the first three days of your period will help reduce the severity of your period pain (6).
We hope this blog post helps give you hope that you don’t have to continue suffering through painful periods, and that it empowers you to begin making the necessary changes in your life! Remember, every journey is a marathon not a sprint. Begin to make a few changes at a time to ensure that you can actually stick to them, and we encourage you to seek out a healthcare professional who can guide you along this process.
Updated April 2022
Written by: Jessica Guerra, Intern for Innate Rhythm.
Reviewed by: Haley Smith, MSN, FAMM Owner of Innate Rhythm
1. Nagy H, Khan MAB. Dysmenorrhea. In: StatPearls [Internet]. StatPearls Publishing; 2021.
2. Hendrickson-Jack L. The Fifth Vital Sign: Master Your Cycles & Optimize Your Fertility. Fertility Friday Publishing; 2019.
3. Barcikowska Z, Rajkowska-Labon E, Grzybowska ME, Hansdorfer-Korzon R, Zorena K. Inflammatory Markers in Dysmenorrhea and Therapeutic Options. Int J Environ Res Public Health. 2020;17(4):1191. Published 2020 Feb 13. doi:10.3390/ijerph17041191
4. Nagy B, Szekeres-Barthó J, Kovács GL, et al. Key to Life: Physiological Role and Clinical Implications of Progesterone. Int J Mol Sci. 2021;22(20):11039. Published 2021 Oct 13. doi:10.3390/ijms222011039
5. Bernardi M, Lazzeri L, Perelli F, Reis FM, Petraglia F. Dysmenorrhea and related disorders. F1000Res. 2017;6:1645. Published 2017 Sep 5. doi:10.12688/f1000research.11682.1
6. Bavil DA, Dolatian M, Mahmoodi Z, Baghban AA. Comparison of lifestyles of young women with and without primary dysmenorrhea. Electron Physician. 2016;8(3):2107-2114. Published 2016 Mar 25. doi:10.19082/2107
7. Najafi N, Khalkhali H, Moghaddam Tabrizi F, Zarrin R. Major dietary patterns in relation to menstrual pain: a nested case control study. BMC Womens Health. 2018;18(1):69. Published 2018 May 21. doi:10.1186/s12905-018-0558-4
8. Uysal N, Kizildag S, Yuce Z, et al. Timeline (Bioavailability) of Magnesium Compounds in Hours: Which Magnesium Compound Works Best?. Biol Trace Elem Res. 2019;187(1):128-136. doi:10.1007/s12011-018-1351-9