PMS

Dysmenorrhea: You can be cramp-free

by Marcy Holmes, Women’s Health NP

Your menstrual cycle doesn't have to cramp your style — or anything else, for that matter. You don't have to resort to planning your vacation around your period or buying a separate wardrobe of loose clothing, or whatever else you're trying in order to find relief from menstrual cramps.

What you can do is significantly reduce — and even prevent — painful menstrual cramps (or dysmenorrhea) caused by hormonal imbalance before or during your period. The key is to make positive lifestyle changes that keep hormone levels optimal and produce chemicals that block pain.

In my experience, some of the most effective areas to make changes are exercise, sexual activity, diet and nutrition, and extra herbs and vitamins.

How do menstrual cramps affect your life?

• I miss work/school
• I cancel dates or skip parties
• I avoid planning vacations or special events when I know I'll have my period
• I abandon exercise
• I feel awful, but push through every month

Exercise

I understand that when you're suffering from menstrual cramps, your instinct is to curl up in a ball on your bed with a heating pad. But even staying a little bit active brings benefits:

• Aerobic activity can promote circulation and suppression or evening out of hormone-like fatty acids (called prostaglandins) that send pain signals to the brain. Before your period, these prostaglandins cause small contractions of the uterine wall and the gastrointestinal symptoms that accompany dysmenorrhea. Exercise also releases endorphins, “feel good” neurotransmitters. Maybe a Zumba class or a swim is a new option to try.
• Stretching may produce calming effects that reduce stress and some menstrual symptoms. For me, the challenge of Pilates is invigorating and makes the core area feel toned and less crampy.

To prevent cramps, I find that exercise is most effective when done throughout the month as a regular habit. However, some women are able to minimize cramps when focusing on daily exercise specifically around the time of their periods.

Sexual activity

Many women discover that sexual activity and orgasm relieve their menstrual cramps, possibly from improved circulation in the area and the endorphins released. You might want to see for yourself!

Diet and nutrition

Making adjustments to what you eat can reduce inflammation, which plays an important role in cramping during your menstrual cycle. Specific things to try:

I remind women that reducing menstrual cramps is yet another reason to take steps for better overall nutrition. One woman I know refused to cut back on her morning coffee until she learned she could be cramp free without it. Now, that motivated her. Start with a single step and build on it!

Herbs and vitamin supplementation

Herbs and vitamins offer specific, targeted support to correct frequent patterns of hormone imbalance that can lead to worsening menstrual cramps and other PMS symptoms.

For example, PMS symptoms are common in the latter part of a cycle if a woman's progesterone levels aren't sufficient to balance with estrogen levels, or on the low end of normal. This type of imbalance can lead to heavier menstrual flow and more intense cramps at your period. When you promote balance you often experience less PMS, lighter flow, and less cramping.

Herbs and vitamins are our first choice for naturally balancing hormone behavior in the body. Chasteberry, dong quai, and wild yam can often improve relief of menstrual symptoms overall in many women, including cramps! That's why we've included these herbs in formulating our PMSolution, part of our Personal Program for PMS.

We've also seen many women respond well to the fundamental nutrients in a potent multivitamin, rich in a wide range of nutrients including B vitamins (including folic acid and niacin), vitamin E, and calcium. One example is our exclusive Essential Nutrients in the Personal Program for PMS. Studies have found that many women may find that taking niacin daily through the month, and also taking an additional 100 mg of niacin every few hours during their periods, may remedy their cramping naturally as well.

Talk with your healthcare provider

Severe cramps that start in adolescence may be the result of endometriosis (ectopic endometrial tissue). That's why it is always important to rule out other causes for cramping. Newer or intense menstrual cramping can be a sign of something else (including endometriosis) but also tubal pregnancy, pelvic infection, problems with an intrauterine device (IUD), fibroids, or ovarian abnormalities, among other conditions. So talk to your provider for reassurance.

Women with severe cramps can certainly discuss medical treatment options with their healthcare providers. These might include birth control pills, the Mirena IUS/IUD, or rescue pain-relieving medications, such as higher potency ibuprofen or naproxen.

But whenever possible, it is nice to try a natural approach first if you can. I have heard many women ask if there is there anything other than the Pill they can try to make their cramps manageable and the answer is yes!

You can be cramp free at any age

Whether your period is relatively recent (maybe it's returned after going off the Pill) or you're just a few months from menopause, you can be cramp free. Why not start to make some positive changes so that nothing gets in the way of enjoying life?

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