Menstrual Pain - Why It's Not Normal And What You Can Do About It!
Are you glued to your hot water bottle every month around your period? I’m here to tell you that although experiencing pain during your period is common it is NOT normal.
Let’s start with a brief rundown of what is happening in your body throughout the month. The menstrual cycle is split into 4 phases and is made up of changes happening in the ovaries and uterus which can impact on your symptoms systemically:
Menstruation- This is where the lining of the endometrium is shed also known as your period or monthly bleed. This phase can be associated with pain, low energy and feeling slower and our hormones oestrogen and progesterone are typically at their lowest during this time.
Follicular phase - The follicular phase goes from the time your period starts until ovulation.This is where your body is developing and maturing follicles in your ovaries to prepare for ovulation to occur. The length of your follicular phase can vary depending on if ovulation is delayed but it is usually around 7-10 days. During this time the uterus is also building up a thick inner lining with estrogens support to prepare for a potential fertilised egg to implant and grow.
Ovulation - Ovulation occurs around mid cycle (again this can vary depending on many factors). Ovulation is when the dominant and mature follicle bursts and an egg leaves the ovaries to enter the fallopian tube. We have an oestrogen peak before ovulation and post-ovulation we have a progesterone rise. After ovulation the progesterone released causes the uterus lining to stop thickening and prepare for a fertilised egg.
Luteal phase - The luteal phase lasts from ovulation till the start of your next period and usually lasts between 9-16 days. This is where your endometrium or uterine lining gets ready to either support a pregnancy or break down and shed for menstruation. If the egg released at ovulation is not fertilised then you bleed. Progesterone and oestrogen drop and menstruation begins, starting the cycle over again.
So where does period pain come into this?
After ovulation Prostaglandins, PGF2a and PGE2 are released which causes the uterine muscles to cramp. Prostaglandins are therefore necessary for the uterus to contract and relax and to allow the uterine lining to shed aka have a period. However an excess of prostaglandins released can cause excessive pain and cramping. From a naturopathic perspective, menstrual pain often points to underlying imbalances in the body such as a higher oestrogen-to-progesterone ratio, thyroid issues, inflammation or conditions like endometriosis or adenomyosis. Having lower progesterone in relation to oestrogen can be associated with increased heaviness and pain of periods because progesterone controls the growth of the lining of the uterus and keeps it from overgrowing or thickening whereas oestrogen helps to thicken the lining. This essentially means that progesterone has a period lightening effect so having lower progesterone tends to correlate with heavier and more painful periods.
The good news is that there are many dietary, lifestyle, nutritional and herbal supplement options available that can support you. All methods that we utilise as naturopaths focus on reducing inflammation, limiting excess prostaglandin production, reducing pain, regulating hormones, increasing uterine blood flow or treating underlying conditions like endometriosis.
Dietary adjustments for painful periods:
The foods we consume can significantly influence our menstrual health. Here are some key things that can help:
Fibre - In order to clear excess oestrogen you need to be passing a bowel motion every day. This means that dietary fibre is your new best friend. Flaxseed meal is a great source of fibre for painful periods because it contains phytoestrogens that help to regulate oestrogen levels and contains essential fatty acids for anti-inflammatory effects. Aim for 2 tablespoons of flax per day by adding it into morning oats or smoothies.
Raw carrots - Raw carrots also help improve oestrogen detoxification. You can make a simple raw carrot salad with strips of carrot, apple cider vinegar and salt.
Cruciferous vegetables - These include broccoli, cauliflower and brussel sprouts which contain indole-3-carbinol which aids in oestrogen clearance. Aim for a daily cup of these veggies or half a teaspoon of powdered broccoli sprouts.
Limiting certain foods - Limit cow's dairy (goat's dairy is often tolerated well), alcohol, refined sugar, vegetable oils, and caffeine from your diet. These foods are known to exacerbate inflammation and can therefore worsen period pain.
Spices and herbs - Cooking with lots of fresh spices and herbs is a great way to add anti-inflammatory and antioxidant compounds into your diet - think ginger, turmeric, rosemary, parsley and garlic. You can also drink strong ginger tea during the initial days of your period to help with cramping and chamomile tea for bloating.
Lifestyle shifts for a pain-free cycle:
Your day to day habits can also greatly improve or worsen your period pain. Here are some things to add in for an easier monthly bleed:
Reduce Xenoestrogen Exposure - Minimise exposure to harmful xenoestrogens found in plastics and pesticides. Opt for organic produce when possible and use glass or stainless steel containers and consider non-hormonal methods of contraception.
Managing stress - Chronic stress can lead to hormonal imbalances that impact menstrual pain. Stress is just a part of life, but the way we handle it is what drives the way it impacts our body and mind. Integrating a few simple stress reduction strategies in your day can really help, these include - regular exercise, mindfulness, deep belly breathing, yoga, staying connected with loved ones and spending time in nature off screens.
Heat therapy - Using a hot water bottle is a tried and true method of relieving pain from menstrual cramps. In fact heat therapy has been shown to be as effective as NSAIDs and aspirin for menstrual cramp pain. You can use a heat patch, pad or water bottle for continuous low level topical heat therapy.
Castor oil packs - These can be applied before your period to help you improve circulation and lymphatic flow which may help reduce period pain.
Nutritional & Herbal supplements
If you are already doing all the right things and find you are still struggling you may benefit from personalised nutritional or herbal supplements.
Essential Nutrients - Ensure you're getting enough of essential nutrients such as zinc, Vitamin D, Omega 3, Magnesium, Iron, B6, B12, and Iodine. These play vital roles in hormonal balance, pain management and overall health.
Gut Health - Addressing underlying gut issues, whether it's SIBO, leaky gut, or antibiotic damage, can significantly improve menstrual health. A healthy gut microbiome can effectively regulate oestrogen levels and reduce systemic inflammation.
Herbal support - Naturopaths use a whole range of herbs to help combat painful cramping periods. Some of these include Crampbark, Lemon balm, Peony, Turmeric, Ginger, Corydalis, and Californian poppy and these all have different properties from anti-cramping to hormone regulating and pain-relieving.
Your period is your monthly report card and painful periods are a sign that your body needs attention. Listening to it and making holistic changes can not only alleviate pain but also help address other areas of your health. If you would like to start addressing your period pain and get to the bottom of your hormonal concerns, book in with one of our naturopaths today and we’d love to help you out.
