It is estimated that as many as 90% of women experience pain with their menstrual cycle at some point during their reproductive years. Usually the pain is mild and only lasts for 1-2 days. However, for some women the pain lasts several days and can be so severe that it interferes with their ability to work, go to school, socialize or participate in sport. Like many other symptoms, menstrual pain is often a message from the body that something is out of balance and needs attention. This article will review the two main causes of menstrual pain, and potential treatments to help women feel better all month long.
The medical term for painful periods is dysmenorrhea. There are two main subcategories of dysmenorrhea, primary and secondary. Primary dysmenorrhea is caused by natural chemicals called prostaglandins, which are found in the lining of the uterus. These chemicals cause the blood vessels and muscles of the uterus to contract and are released as the uterus gets ready to shed its lining. Prostaglandins can also contribute to the nausea and diarrhea that some women experience during their menstrual cycle. Prostaglandin levels go down as the lining is shed, which is why symptoms improve within the first few days of a period.
About 10% of young women and adolescents with dysmenorrhea have secondary dysmenorrhea. Secondary dysmenorrhea is caused by a structural disorder in the reproductive organs. The most common cause of secondary dysmenorrhea is endometriosis. Endometriosis is a condition where the tissue that lines the uterus grows in other areas of the body, such as the ovaries, bladder and rectum. Similar to the lining of the uterus, this tissue grows and recedes each month with a woman’s menstrual cycle, causing significant inflammation and pain. The pain with endometriosis tends to get worse over time and it often lasts longer than primary dysmenorrhea. For example, women with endometriosis may experience pelvic pain throughout the month and not just during their menstrual cycle. Women with mild endometriosis may be able to manage their menstrual cramps with anti-inflammatory medications, however, overtime they often need to increase the amount of medication as their condition progresses.
Many women with endometriosis go undiagnosed for years, partly because the gold standard to correctly identify endometrial lesions requires an invasive procedure called a laproscopy. However, newer technology over the past few of years has made it easier to diagnose endometriosis with less invasive procedures. Due to the progressive nature of the disease, the high reliance on pain-relieving medications, and the significant impact endometriosis can have on a woman’s ability to work and go about her daily activities, women with any pain during their menstrual cycle, especially young women, should be thoroughly worked up and treated.
Menstrual pain (either due to primary or secondary dysmenorrhea) often improves when we reduce the amount of saturated fats and inflammatory foods in a woman’s diet, screen for and correct underlying nutritional deficiencies, and with natural anti-inflammatory herbs such as boswellia and ginger. If needed and under the supervision of a naturopathic doctor, natural treatments can often safely be combined with conventional treatments. Most women will notice a reduction in pain within 3 months of treatment.
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References:
https://pubmed.ncbi.nlm.nih.gov/24284871/
https://www.aafp.org/afp/2014/0301/p341.html#afp20140301p341-b4
https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods