Hot water bottle, popping Advil like it’s candy, cancelling work (and any other plans) so you can curl up in a ball and die a little bit...sound familiar?
We all know that time of the month can be downright awful- PMS, cramps and pain that for some women are completely debilitating. But if no one has told you this before, let me be the first- it doesn’t have to be this way!
Before we dive into what we can do about, let’s look at WHY this is happening in the first place.
What is Dysmenorrhea?
Dysmenorrhea is the fancy medical term for painful periods. According to Dr. Aviva Romm, the pain may be of varying intensity, can come in waves or be constant and may radiate to other parts of the body like the lower back, legs and vulva (1). We automatically think of cramps when it comes to painful periods, but the cramps are often accompanied by other uncomfortable symptoms like dizziness, backache, headache, nausea, vomiting and diarrhea (yes, period poops are a thing!).
Menstrual cramps can occur on their own, which is referred to as primary dysmenorrhea. Secondary dysmenorrhea, on the other hand, is when menstrual cramps are due to an underlying pathology, such as endometriosis or uterine cysts.
What Causes Menstrual Cramps?
In order for the uterus to shed the endometrial lining every month, your uterus needs to contract. Prostaglandins, hormone-like molecules that are involved in pain and inflammation, trigger the uterine muscles to contract (2). According to the Mayo Clinic, “higher levels of prostaglandins are associated with more severe menstrual cramps.” (2) In fact, women with menstrual cramps “appear to produce as much as seven times more” prostaglandins than women who don’t experience cramps (1). Seven times is a lot more times! So there’s an actual scientific reason for your cramps. Your uterus isn’t just evil and trying to make you suffer, I promise.
As for secondary dysmenorrhea, the underlying pelvic imbalance needs to be addressed for the cramps to be resolved.
Are Menstrual Cramps Normal?
While painful periods can be a sign that there is something else going on, one thing is for sure- you’re in good company. It’s estimated that internationally, 45-95% of adolescent girls and women experience dysmenorrhea, with debilitating and incapacitating dysmenorrhea occurring in approximately 7-15% of women. (1)
So yes, menstrual cramps are normal! But I'll say it again, just because cramps are really common and "normal" doesn't mean it's "just the way it is." There are many ways you can support your body to decrease monthly period cramps, and I truly believe your cramps are your body telling you it needs a little extra love and support ;)
If You Have Menstrual Cramps: Start Here
Diet & Exercise Are Foundational
Oftentimes, increasing exercise and changing your diet is enough to make a significant difference for even severe menstrual cramps. (3)
Focusing on foods that decrease inflammation is super important. That means eliminating refined foods as much as possible, and including a whole foods approach. A key place to start is to increase fruits and vegetables, which contain antioxidants and important vitamins and minerals that reduce inflammation. Omega 3’s and Essential Fatty Acids (EFAs) are another important dietary factor to increase and here’s why- Omega 3’s help to combat prostaglandins, which are part of the inflammatory pathways that can contribute to menstrual pain. (1) You can get Omega 3’s by increasing your cold-water fish consumption to 2-3 times per week or by taking a good-quality supplement. Remember, the body can’t produce Omega 3’s, they need to be taken in through the diet.
Increasing exercise and movement is helpful to get blood flowing to the pelvis, which can help reduce period pain when done regularly. Incorporating a regular movement practice like yoga, stretching, resistance training, running, swimming, dancing- anything that gets your blood moving- will be helpful here!
Magnesium for the Win!
Magnesium is fantastic for reducing cramps and can make a difference when it comes to minimizing menstrual cramp pain. It's also nourishing to the nervous system, calms anxiety and can help with sleep! Take 300-600mg daily (throughout the month) of a high quality magnesium citrate or bisglycinate. Keep in mind, you've reached your maximum dose when your bowels become loose. If this happens, just back off the dose a bit!
If you try switching up your diet and include regular exercise, and are still needing some support, then herbs can be wonderful allies here.
Helpful Herbs for Menstrual Cramps
For the sake of simplicity, we’re going to be focusing on menstrual cramps that don’t have any underlying condition associated with them. If you have a condition such as fibroids, endometriosis, pelvic inflammatory disease (PID), or anything else that causes painful periods, make sure you’re seeking out support for treating the root causes over the long-term. Seeing a herbalist may be a great strategy do this!
I like to approach menstrual cramps from two angles:
Tonify & support the uterus all month long (long-term approach)
Alleviate & minimize pain in the moment (symptom management approach)
Uterine Tonics: A Long-Term Approach
You know how your uterus needs to contract to get rid of the endometrial lining? Well, when your uterus contracts too hard, it hurts and can cause cramps (makes sense!). I think of uterine tonics as the dumbbells of your uterine muscle. When taken all month long, uterine tonics will gently contract your uterus (tonifying it), which is sort of like your uterus lifting weights. So on the big day of your bleed, the contraction of your uterus to shed its lining, isn’t going to be such a shock because it’s been “working out” and it’s muscles have been toned- it’s ready! This means the contractions aren’t going to be as painful. Uterine tonics are thought to work by “regulating the muscle activity of the uterus and help initiate contractions that are regular, rhythmic and more orderly.” (3)
My Favorite Uterine Tonic Herbs:
- Raspberry leaf (Rubus idaeus)
- Black Cohosh (Actaea racemosa)
- Dong Quai (Angelica sinensis)
- Motherwort (Leonurus cardiaca)
- Crampbark (Viburnum opulus)
- Lady’s Mantle (Alchemilla vulgaris)
These can be taken alongside liver herbs (to facilitate proper hormone cycling and reduce inflammatory toxins in the system) such as:
Dandelion Root (Taraxacum officinalis), Milk Thistle (Silybum marianum), Barberry (Berberis vulgaris), Oregon Grape Root (Mahonia spp.), Rosemary (Rosmarinus officinalis) or Schisandra (Schisandra chinensis).
Nervines and adaptogens can be really nice when supporting the menstrual cycle, as oftentimes stress plays a HUGE part in the imbalance of the delicate and complex reproductive system. Check out this article about my favorite adaptogens here>>> Adaptogenic Herbs: The Stress-Busting Gems of the Herbal World
Pain Relief Herbs: An “In-the-Moment” Approach
Uterine tonics (and everything mentioned above) can be an amazing way to support your uterus and overall hormonal health over the long-term. But just like working out your biceps, your uterus isn’t going to get strong and buff overnight! It needs a few months to build up it’s strength before you might notice a significant difference when that time of the month comes knockin’ on your door (or insides). So in the meantime, it’s important that you get some pain relief! And bonus points if it isn’t motrin, Advil or tylenol because all of those have their own side effects that can become harmful for your digestive tract, liver and kidneys over time.
The good news is there are some great herbs that I’ve seen work wonders to take the edge off of the pain so you don’t feel like curling into a tiny ball and disappearing for 2+ days out of the month.
These herbs are anti-spasmodic (meaning they stop painful spasms) and anodyne (relieves pain). They work best if you take them a few days before you usually start to feel your cramps.
My Favorite Cramp-Relieving Herbs:
- Crampbark (Viburnum opulus)
- Wild Yam (Dioscorea villosa) - endangered, so be mindful to source out cultivated, NOT wild-crafted sources
- Corydalis (Corydalis yanhuso)
- White Peony (Paeonia lactiflora) - For best effects, traditionally given with Licorice Root (Glycyrrhiza glabra)
- Jamaican Dogwood (Piscidia erythrina)
- Wild Lettuce (Lactuca virosa)
- Pasque Flower/Pulsatilla (Anemone pulsatilla)
- Ginger (Zingiber officinalis)
Some of these are quite strong, and they can be useful in combination, so I recommend consulting with a herbalist to get the best results!
My Favorite Cramp-Ease Tincture (for “I need relief right now” pain)
Crampbark (Viburnum opulus) 1:3 60ml
Corydalis (Corydalis yanhuso) 1:3 40ml
Ginger (Zingiber officinalis) 1:3 5ml
The herbs: Crampbark is a classic and reliable anti-spasmodic herb that’s been used for centuries to bring down the intensity or completely eliminate painful menstrual cramps. Corydalis is a Traditional Chinese Medicine (TCM) herb that's in the Opium plant family and is thought to have 1-10% the strength of the opium poppy (1). It works fantastically well to decrease period pain. Ginger helps to stimulate circulation to the pelvis to break up congestion and has been shown to be as effective as NSAIDs in relieving pain (4).
Dose: Take 2-3ml twice daily in the 3-4 days leading up to your period (works best if you take it leading up to the cramps!) Can be taken in the moment as well. Take 5 ml, as needed. Keep in mind it may lower blood pressure in larger quantities.
With all of this, the main takeaway I want you to leave with is yes, period pain is super common and can be a very normal part of the menstrual experience, BUT I do believe that cramps can be an indication that your body needs a little extra love and support. So don’t just accept it as “the way it is,” take a look at your diet, incorporate more movement and exercise on a regular basis, actively work to decrease your stress and incorporate herbs to kick your cramps to the curb.
As always: Consult a herbalist and/or knowledgeable health practitioner before taking any herbs, especially if you’re on medication to make sure there are no interactions or contraindications.
- Romm, A. (2014) Botanical Medicine for Women’s Health. Churchill Livingstone
- Mayo Clinic: Menstrual Cramps
- Tricky, R. (2003) Women, Hormones & the Menstrual Cycle. Griffin Press, South Australia
- Aviva Romm’s Article: Natural Alternatives to Pain that Don’t Wreck Your Health