Dysmenorrhea is the medical term used to describe pain before or during menstrual periods. Symptoms of dysmenorrhea can begin immediately following ovulation (mid-cycle) and can last until the end of menstruation (end of your bleed). Your cycle starts on the first day of your bleed and ends on the first day of your next bleed. An average cycle can last anywhere from 28-35 days on average. Estrogen levels increase for the first half of your cycle, preparing for the production of an egg. An egg is released at mid-cycle (ovulation) and then your hormones change to become more progesterone dominant to help promote the implantation of a fertilized egg. If an egg is not fertilized, then your period starts and both estrogen and progesterone are at their lowest levels again, ready to repeat the cycle.


Dysmenorrhea is often associated with changes in these hormonal levels in the body. You can have high or low levels of estrogen and progesterone, which will affect the length of your cycle, and the pain in your cycle. Women with healthy hormone levels should not have an appreciable change in their symptoms throughout their cycle, including pre-menstrual symptoms or painful periods. Dysmenorrhea is one of the first signs that we have that our hormones and our bodies are not working at optimum levels. Pay attention to this, and make some adjustments.


In young women painful periods can often occur without an underlying problem. In older women it is more often due to an underlying issues such as uterine fibroids, adenomyosis (thickening of the lining of the uterus), or endometriosis (endometrial tissue from the lining of the uterus is found outside of the uterus in the pelvic cavity and beyond). Dysmenorrhea is more common among those with heavy periods, irregular periods, whose periods started before twelve years of age, or who have a low body weight.


Dysmenorrhea is the most common menstrual disorder and is estimated to occur in 20% to 90% of women of reproductive age. Typically it starts within a year of the first menstrual period. When there is no underlying cause often the pain improves with age or after having a child.


Symptoms typically last less than three days. The pain is usually in the pelvis or lower abdomen. Other symptoms may include lower back pain, pain that radiates to the thighs, diarrhea, or nausea.


Dysmenorrhea occurs less often in those who exercise regularly and those who have children early in life. Treatment may include the use of a heating pad. Medications that may help include NSAIDs such as ibuprofen, hormonal birth control, and the Mirena IUD, which increases the levels of progesterone in the body. Taking vitamin B6 or magnesium may help with the muscle cramps, since the uterus is essentially a muscle.


You can take a five-tiered approach to helping with Dysmenorrhea and cycle problems. They are:

  1. Control Stress – use deep, diaphragmatic breathing throughout the day
  2. Avoid triggers – consider food sensitivities; remember, that your bowels are neighbors of your uterus. When your bowels are irritated, often your uterus becomes irritated as well. Treat constipation/diarrhea
  3. Regular detoxification – exercising, deep breathing, and brushing your skin (the largest organ of your body) can help with detoxification. Our periods are a great way to help with detoxification, and if your periods are short, too light, or absent, this important piece of detoxification may be part of the problem.
  4. Eat more plant-based, whole food; minimize inflammatory foods
  5. Support yourself with good food and nutrients. 2 TBSP flax seed first two weeks of cycle – supports estrogen


Here are some safe, over the counter suggestions:

  • 2 Tablespoons of ground flax seed for the first two weeks of your cycle to support estrogen
  • 2 Tablespoons of sesame seeds (or Tahini spread) for the last two weeks of cycle, which helps to supports progesterone
  • Primrose oil in the progesterone phase (last two weeks)
  • Chastetree Berry throughout your cycle (or progesterone phase, at least)
  • Blackcurrant Bud to support your adrenals every day
  • High dose fish oils during the pre-menstrual phase (every couple of hours)
  • Magnesium during menstruation to relax the uterus
  • B6 during pre-menstrual and menstrual phase as well; this can be taken every couple of hours

Seeing a physiotherapist can help with the symptoms of dysmenorrhea. Expect your physiotherapist to assess the muscles and connective tissues of your abdomen, pelvic girdle and pelvic floor. Your physiotherapist can teach you how to relax these muscles, use deep breathing and other relaxation strategies, and help you with stress management.


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