Posted: Monday, February 23, 2015 8:45 am
DEAR DOCTOR K: Can you recommend drug-free ways to relieve menstrual pain and cramping?
DEAR READER: For most women, menstruation is accompanied, at one time or another, by pain and cramping known as dysmenorrhea. For some women, the pain is so severe that it causes them to miss work and social events. Some doctors don’t regard menstrual pain as a “serious” problem. But any symptom that interferes with your personal or work life needs to be attended to and not dismissed.
The cause of menstrual pain appears to be overproduction of the chemicals known as prostaglandins. Prostaglandins are shed with the lining of the uterus during a woman’s period. High levels can cause painful contractions in the uterus.
A combination of one or more of the following non-drug therapies should help relieve your menstrual pain:
— HEAT. Applying heat to the stomach or back may provide temporary relief of pelvic pain. You can use a heating pad, a thermal pack or a hot water bottle. Or try a hot shower or bath.
— HERBAL PREPARATIONS. Fennel and ginger preparations may be effective when taken as needed for menstrual symptoms.
Chinese herbalists sometimes recommend preparations containing angelica root, fennel and cinnamon bark, among other herbs. These are taken on the days you feel pain. A review of 39 trials involving close to 3,500 women found significant reduction of pain and overall symptoms with Chinese herbs compared with drug treatments. However, the studies analyzed in this trial were generally of small size and poor quality.
— SUPPLEMENTS. Vitamin E, taken before your period starts, and then during the first three days of menstruation, has been shown to reduce the pain and severity of dysmenorrhea. It likely works by reducing the production of prostaglandins. Vitamin B1 may also help.
— ACUPUNCTURE. There is limited but promising evidence for the effectiveness of acupuncture for menstrual pain. The acupuncture sites that usually are stimulated for dysmenorrhea include above the ankle, the upper part of the foot, and the fleshy skin between the thumb and forefinger. Why should stimulating these parts of the body that are distant from the uterus relieve menstrual pain? I don’t understand the theory behind acupuncture well enough to answer.
— RELAXATION TECHNIQUES. Progressive muscle relaxation, mindfulness meditation and biofeedback are examples of relaxation techniques. They can have a calming effect when you have menstrual pain.
Progressive muscle relaxation focuses on relaxing your muscles in sequence from the tips of your toes up to the top of your head or vice versa. Begin by curling your toes, holding them tight, holding them tighter still, and then releasing them. Then move on to contracting and releasing the muscles around your ankles, calves, knees, buttocks, hands, etc. Tighten muscles as you inhale and relax them as you exhale.
So, there are approaches other than medicines to relieve menstrual pain. However, if they don’t give you adequate relief, don’t reject medicines altogether. They really can help, and the side effects are infrequent.