A 2005 article in "American Family Physician" reports that dysmenorrhea, or menstrual cramping, is the leading cause of recurrent, short-term absenteeism among adolescent women. An estimated 10 to 15 percent of women must curtail their daily activities or take medications due to menstrual pain. Many women who wish to avoid standard medical treatments for this common condition turn to supplements for relief.
Physiology
Dysmenorrhea results in large part from the release of prostaglandins in the menstrual fluid. Prostaglandins are chemicals that promote uterine contractions and provoke inflammation and pain. Vasopressin, a pituitary hormone that constricts blood vessels and increases uterine contractility, may also play a role.
Medical Approaches
Non-steroidal anti-inflammatories, such as aspirin, ibuprofen and naproxen, are first-line medical treatment for menstrual cramps. These drugs interfere with the production of prostaglandins. When dysmenorrhea is severe and a woman is not planning on becoming pregnant, doctors often prescribe oral contraceptives to interrupt menstrual cycling. Other potential therapies include male hormones, muscle relaxants or even nerve transaction surgery or hysterectomy.
Vitamins and Minerals
A 2001 review of seven clinical trials published in "Cochrane Database of Systematic Reviews," evaluated the effectiveness of herbal and dietary therapies for dysmenorrhea. Vitamin B1, or thiamine, at a dose of 100 mg daily, was found to be better than placebo for menstrual cramping. Magnesium was also found to be useful, but the optimal dose and form have not been determined. Vitamin B6 showed some benefit in small trials, but, again, the optimal dose has not been ascertained. Vitamin E, 2,500 IU started two days prior to menstruation and continued for five days, also proved helpful in at least one of the studies.
Herbs
An untold number of herbs have been used to treat menstrual cramps, and empirical evidence suggests that several may be useful. However, clinical studies have not yet provided sufficient data to evaluate the effectiveness of most of these preparations. The Japanese remedy toki-shakuyaku-san, a combination of peony root, Cnidium rhizome, Atractylodes rhizome, Hoelen, Alisma rhizome and dong quai, proved more effective than placebo in one study. In her book, "Prescription for Herbal Healing," Phylllis Balch recommends amaranth tea, Angelica sinensis extract, or a traditional Chinese formula that includes cinnamon twig and Poria. Traditional herbalists use various combinations of shepherd's purse, cramp bark, valerian, oat straw, pennyroyal, cinnamon, ginger, chasteberry and others.
Miscellaneous Supplements
Based on observations that Danish women, whose diets are high in omega-3 oils, have fewer menstrual symptoms than other women, one small 1996 study published in the "American Journal of Obstetrics and Gynecology" showed that 2 g of fish oil daily significantly reduced menstrual pain in adolescents. Natural progesterone cream has been suggested by some authors, as has daily supplementation with 200 to 500 mg of niacin during the menstrual cycle.
Mechanical Approaches and Lifestyle Changes
Acupuncture and acupressure have proven beneficial for some women suffering from dysmenorrhea. Transcutaneous nerve stimulation and topical heat have also demonstrated some effectiveness. Regular exercise, both during menses and at other times, is recommended by most experts, as is smoking cessation. Stress reduction is important, because depression and anxiety have also been linked to dysmenorrhea.
Considerations
Although dysmenorrhea is a common problem among women, sudden, intense cramping or any change in your personal pattern should prompt a visit to your doctor. Pelvic cramping can be the result of uterine fibroids or cysts, infection, early miscarriage or endometriosis. If you are taking medications or supplements for other problems, consult your physician before adding new supplements to your daily routine.
References
- "American Family Physician"; Dysmenorrhea; French L; 2005
- "A Maverick of Medicine Speaks to Women"; Duane Townsend, M.D., Rita Elkins, M.H.; 2003
- "Cochrane Database of Systematic Reviews"; Herbal and dietary therapies for primary and secondary dysmenorrhea; Proctor M, Murphy P; 2001
- "Prescription for Herbal Healing: Menstrual Problems"; Phyllis A. Balch, CNC; 2002
- "American Journal of Obstetrics and Gynecology"; Supplementation with omega-3 polyunsaturated fatty acids in the management of dysmenorrhea in adolescents; Harel Z, et al.; 1996
