Dysmenorrhea (Painful Periods)

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. 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. Dysmenorrhea may be a sign that our hormones and our bodies are not working at optimum levels.

Who Experiences Dysmenorrhea and What Are the Symptoms?

Often painful periods occur early in life occur without an underlying problem. As time goes on, it can be due to 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, those whose periods started before 12 years of age, or those who have low body weight.

Dysmenorrhea is the most common menstrual disorder, which typically starts within one 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 of Dysmenorrhea

Simple treatment may include the use of a heating pad. Medications that may help dysmenorrhea 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 also help with the muscle cramps since the uterus is essentially a muscle.

Five-Tiered Approach to Helping Dysmenorrhea and Cycle Problems:

1. Control stress: Use deep, diaphragmatic breathing throughout the day.
2. Avoid triggers: Consider food sensitivities. Remember that your bowels are neighbours of your uterus. When your bowels are irritated, often your uterus becomes irritated as well. Try to treat constipation and 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. Healthy eating: Eat more plant-based, whole foods and minimize inflammatory foods.
5. Support yourself with good food and nutrients: Take 2 TBSP of flaxseed for the first two weeks of your cycle to support estrogen.

Safe, Over the Counter Suggestions:

• 2 Tablespoons of ground flaxseed 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 your cycle, which helps to supports progesterone.
• Primrose oil in the progesterone phase (last two weeks of your cycle).
• Chastetree Berry throughout your cycle (or progesterone phase, at least).
• Blackcurrant Bud to support your adrenals every day.
• High dose of 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 to help you with overall stress management.