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Menstrual cramps, also known as dysmenorrhea, affect over 50 percent of all menstruating women worldwide. Such a painful experience leaves many relying on pharmaceuticals for relief. Mother Nature also provides tools that can relieve this monthly discomfort.

Dysmenorrhea is a Greek term meaning “painful menstruation.” It is most often experienced just prior to, or at the beginning of a woman’s period and will only abate as the flow continues. The pain may vary from being mild to debilitating, forcing some women to take time off from work or school. It is believed that the pain is caused by uterine contractions and ischemia (lack of blood flow). Causes of menstrual cramping vary from woman to woman but are often classified as either primary or secondary dysmenorrhea.

Primary Dysmenorrhea

This cyclic pain is associated with menses that have not been connected to any physical abnormalities or any pelvic-disease states. These types of cramps usually manifest within six to 12 months after a woman’s first menses and typically begin to decrease in intensity after childbirth. The pain may start a few hours before or at the onset of menses and tends to be most intense in the first one to two days of menses. Dysmenorrheic pain may be crampy, spasmodic, or even a dull constant ache. It may radiate down the thighs or be accompanied by fatigue, nausea, or diarrhea.

Secondary Dysmenorrhea

This cyclic pain is associated with a disease state or physical abnormality such as uterine fibroids, endometriosis, or pelvic inflammatory disease. Occurrence of secondary dysmenorrhea varies depending on development and intensity of the existing pathology.

The Naturopathic Alternative

Diet has always been the mainstay of healing within the naturopathic world. Addressing the consumption of foods most likely to aggravate existing conditions is the basis of optimal healing. In the case of menstrual cramps, eliminating foods high in arachidonic acid is the key to dealing with cramping. This fat produces a type of prostaglandin (specifically PGE2) that increases inflammation within the body. Dairy products, beef, pork, chicken, and turkey are all high in arachidonic acid. While decreasing PGE2 production, increasing healing prostaglandins will help. PGE1 and PGE3 are anti-inflammatory and anti-spasmodic. These are found in fish such as salmon, tuna, and sardines. Many nuts and seeds such as flaxseeds and pumpkin seeds can help in the production of the “good” prostaglandins.

Specific nutrients have also been shown to help in relieving menstrual cramps. Vitamin B₃ (niacin) has been proven to help ease pain in 87.5 percent of women involved in one study. Women were given 100 mg of niacin twice a day for one month and then every few hours during menstruation. The mechanism of action is believed to increase blood flow to the uterus thereby relieving the pain. (Please note that the study used niacin and not niacinamide; therefore, one may experience the “niacin flush” when using high doses of vitamin B3.) Adding vitamin C and rutin (a bioflavanoid) each day seemed to increase the effectiveness of the niacin in relieving cramping.

Herbal Remedies

Traditionally, many herbs have been used to treat dysmenorrhea. Black cohosh (Cimicifuga racemosa) is known to alleviate menopausal symptoms and has also been used to treat dysmenorrhea throughout the world. Tincture doses or capsules every two to four hours have been effective by helping to relax the uterus.

Another popular group of herbs is the Viburnum sp, such as crampbark or black haw. Both herbs have proven in animal and human studies to be a uterine anti-spasmodic. Crampbark specifically should be used if the cramping is of a congestive nature (bloating or nausea) and includes pains radiating down either the back or thighs. While black haw is more indicated for heavier menstrual flow, both can be used in either tincture or capsule form.

Menstrual cramping for many women can be managed through non-invasive techniques. Simple changes in diet and supplementation of nutrients and/or herbs can bring relief. If you would like to choose these avenues of healing, consult a qualified health-care practitioner such as a licensed naturopath or herbalist to rule out other pathologies thereby addressing the totality of your health.

Rupi Mitha, ND, is a licensed naturopathic doctor and doula practising at the Brampton Naturopathic Clinic in Ontario. Dr. Mitha is also a part-time faculty member at the Canadian College of Naturopathic Medicine.

Source: alive #265, November 2004