Period pains commonly affect mainly younger women, but not exclusively, as older women may sometimes experience them as well. When periods first begin in early teens, they are usually not painful, but may become so in mid to late teens or later depending upon the reason for the onset of the pain. The development of pain with menstruation is usually taken to indicate the presence of ovulation, the time when the egg is released, within each menstrual cycle.
Period pain or to use the medical term, dysmenorrhoea, most often occurs because of excessive muscle contractions of the uterus with each period.
Four common gynaecological problems may, however, cause the periods to become painful and they include:
• infection of the tubes or ovaries
• fibroids
• endometriosis, where the lining of the womb is found in other tissues such as the wall of the uterus or around the ovaries
• a deficiency of the mineral magnesium, the most commonly deficient nutrient in women of child-bearing age, which is needed for optimum muscle function. Any woman with excessively painful or heavy periods, in particular if there is pain throughout the month or an irregular menstrual cycle, should see her general practitioner for a gynaecological check-up. A simple examination would normally determine if one of these problems is present.
Often no cause is found and simple dysmenorrhoea is diagnosed. In this situation periods are often painful for the first 24 or 48 hours and perhaps even for the day before the onset of menstruation. Period pains are often felt as mild to severe cramp-like pain or discomfort in the lower abdomen. It can also be felt as low back pain or aching down the legs and, when severe, can be accompanied by giddiness, faintness, nausea and even occasional vomiting. These other symptoms are probably due to the hormonal and chemical changes that occur with menstruation. Symptoms of premenstrual syndrome such as irritability, mood swings, depression or breast tenderness may also be present, but are not particularly related to the presence of period pains.
Ilana was a 30-year-old barrister, who had endured severe period pain and vomiting every month for seventeen years.
‘It was like someone jerking a knife into my stomach. I’d be doubled over with pain and I’d always have to spend the first day of my period in bed. I experienced nausea and bloating and found it very difficult to function properly at work. I’m a barrister, so I have to be able to think clearly. Taking time off every month was affecting my reputation and career prospects adversely. I had so many symptoms before my period which meant that I was really only normal for seven days each month. I read about the WNAS and went along to their London clinic. I was asked to follow a very restricted diet initially, which was pretty tough, and to take supplements and to exercise. Within the first month, to my utter amazement I had no pain. The nausea went as well as the bloating, I just couldn’t believe it. That was nine years ago, and I haven’t had any period problems since. I am able to relax my diet, but I know if I go back to my old ways my symptom will start to return. This programme was a complete cure for me, it totally revolutionised my life. I feel healthy and stable and am extremely grateful to the WNAS.’
A variety of treatments already exist that may be helpful, and could be suggested by your doctor when you seek advice.
• Magnesium check Measure your red cell magnesium, to see whether you have a deficiency. This is a simple blood test, and should be readily available.
• Painkillers Your doctor may recommend the use of certain types of painkillers or hormonal products. Some mild painkillers may not be very effective for severe pain but a more powerful sort, which are either prescribable (mefenamic acid-Ponstan) or are available on the advice of your pharmacist, can be particularly useful. It may be necessary to try a number before finding the most effective one for you.
• The contraceptive pill A number of hormonal preparations are available but often the most useful, particularly in young women who require contraception, is to use the oral contraceptive pill. The more modern low dose pills have much fewer side effects than older preparations.
• Iron Your doctor can prescribe iron supplements if you are anaemic as well.
There are a number of avenues you can explore to help reduce painful periods:
• Physical exercise may sometimes be helpful with a variety of gynaecological problems, and may help your tolerance of pain. Try to exercise three or four times per week. During a painful period try to do some gentle yoga exercises instead of strenuous exercise.
• Heat seems to have a soothing effect. Applying a hot water bottle or a thermal heat pad can be very soothing.
• Changing and improving your diet can help also with minor hormonal abnormalities some of which are thought to underlie such gynaecological problems. Ensuring a well balanced diet without excessive consumption of fatty foods, and with a good intake of fibre from fruit and vegetables may help control hormone metabolism and can reduce some of the excessive hormonal swings that occur during the menstrual cycle.
• Eat a diet rich in EFAs, especially fish oils (see page 489). Women with period pains are known to have a lower intake of these oils, which may have anti-inflammatory, and painkilling properties.
• Some minerals may also be helpful. Magnesium is particularly important in muscle and hormonal functions. Its balance with calcium influences the contraction of uterine muscle and one study suggests that taking supplements may help reduce period pains. Good dietary sources of magnesium include all vegetables, especially green ones, nuts, seeds, beans, peas and lentils. Sugar, sweets, cakes and biscuits are low in most important minerals.
• If your periods are heavy, ensuring a good dietary intake of iron is also important, and this is found in red meat, fish, chicken, eggs, nuts, seeds and vegetarian protein.
Magnesium supplements can be obtained from health-food shops. At the WNAS we tend to use magnesium amino acid chelate. A magnesium rich multi-vitamin, multi-mineral supplement might also be helpful, but too much magnesium may cause loose stools. Remember if your period pains do not respond to these self help measures or painkillers you must consult with your general practitioner or family planning clinic.
When period pain is due to muscular spasm, acupuncture and cranial osteopathy will be obvious choices as they both help to free up pockets of blocked energy in the body. Herbal and homeopathic remedies are also worth a try. If the pain is caused by an infection, this will need to be dealt with by conventional medicine. However, complementary therapy will help to boost the immune system which increases your resistance to infection in the long-term. Often when nutritional deficiencies have been addressed, particularly low magnesium levels, and the muscles are functioning normally, the period pains subside. It may therefore be worthwhile following the advice given in this chapter for a few months before seeking further advice.
“ I am delighted to say that a recent test showed that my bone mass has improved and I no longer have signs of osteoporosis. If I had my time again I would undoubtedly have eaten more sensibly, and I would not encourage a young female athlete to diet as we did. I still run 40 miles per week, and work as a PE teacher in Nottingham. I have improved my diet, and I now take Efecal with the hope that I can maintain my new bone mass.”
Llana