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The pain that comes with menstrual cramps is so commonly experienced that it’s considered to be a normal part of menstruation, and not the disorder that it actually is. Why this pain occurs is still a question being asked by researchers, because certain processes require a deeper level of understanding– but we have enough clinical information in order to do something about it.

In this article, we’re going to simplify this data while highlighting the significant role that nutrition plays when it comes to reducing menstrual pain.

 

Understanding Menstrual Cramps

‘Dysmenorrhea’ is defined as painful spasms in the lower abdomen, occurring just before and/or during menstruation. The pain typically lasts for 8–72 hours and may radiate to the back and thighs.

Dymenorrhea comes in two forms: regular menstrual pain (called primary dysmenorrhea) and menstrual pain that’s indicative of a larger issue (secondary dysmenhorrhea) – it’s important to see a gynaecologist and determine which one you have.1

This article focuses on the first type: something that has stumped researchers for ages, because of the sheer number of processes that could possibly account for the pain. They have, however, formed a broad outline of the steps that take place, which the scientific community at large has accepted as the most likely explanation. Here’s what they believe happens –

Right Before Menstruation Begins:

At this stage, the cells in the uterus’s inner lining (the ‘endometrium’) begin to produce large amounts of compounds that we can call PGs (short for ‘prostaglandins’).

PGs have hormone-like effects. In other words, they can influence the way our cells behave and can thus regulate the amount of pain that we feel as well as our body’s temperature, inflammation levels, and our sleep.

Studies have found that women who experience menstrual pain have a comparatively higher number of PGs.

During Menstruation:

The endometrium now breaks down and peels off, which is what causes the bleeding.

As this lining disintegrates, the cells release PGs into the uterus, which causes the uterine muscles to contract more. The increased contraction lowers the levels of oxygen in the muscles, eventually leading to pain. The PGs also seem to increase the sensitivity of nerves in the area, lowering a one’s threshold for pain. Some of the PGs also enter the bloodstream, causing headache, nausea, vomiting, and diarrhoea.

 

Managing Menstrual Pain

Given that more PGs can mean greater pain, it makes sense to reduce their numbers. While this can be done through anti-inflammatory drugs and oral contraceptives, even simple changes in our nutrition can go an incredibly long way.

Here are certain dietary changes that can help reduce menstrual cramps (and how):

1] Lowering the fat and increasing the fibre in one’s daily diet:

Oestrogens are female sex hormones that thicken the uterus’s lining each month, in anticipation of pregnancy. This thicker lining increases menstrual flow, which is another factor that’s associated with period pain and the quantity of PGs.

A low-fat and high-fibre diet (where the fat content is limited to 20-25% of the day’s total calories, and at least 40 g of fibre is consumed) can reduce oestrogen levels.2,3 Reducing the fat intake of a typical Western by half is estimated to lower oestrogen levels by about 20%.4

It’s also, in general, important to replace unhealthy fats from one’s diet with healthy fats, because of the vital functions that healthy fats serve in the body.

 

2] Eating fish/supplementing with fish oil

The menstrual pain-lowering effect of fish oil is actually quite fascinating! Here are three ways in which it does this:

#1: The omega 3 fatty acids in fish oil suppress the production of PGs.9

#2: Studies show that women who suffer period cramps have a lower volume of gray matter in regions of the brain linked to pain transmission and mood regulation. This variance of gray matter could account for the menstrual cramps or be a result of it; either way, its association means that it needs to be addressed. Luckily, studies show that supplementing with omega 3 fatty acids can boost the brain’s gray matter.5-8

#3: Mental stress is associated with increased period pain. An omega 3 fatty acid called DHA reduces the stress-response of certain nerve cells, which can also diminish the harmful effects of prolonged stress on the body.10

In fact, a study found that the menstrual pain relief brought on by fish oil supplementation was greater than that of the anti-inflammatory drug, ibuprofen.11

 

3] Lowering body fat 

There are two types of fat: obese and lean. The obese type of fat produces a comparatively higher number of compounds that lead to inflammation – PGs are an example of these compounds.12

Since inflammation and obesity go hand-in-hand, it’s unsurprising that a higher BMI (Body Mass Index) has been associated with severer menstrual cramps.

 

4] Getting Plenty of Micronutrients

‘Micronutrients’ refers to the vitamins and minerals found in the food we eat, which play extremely important roles when it comes to our overall health. Lower levels of B-group vitamins as well as vitamins D and E have been associated with menstrual cramps.13

Let’s take a look at how vitamin B12, for example, can have an effect on menstrual pain –

One of the many functions that this vitamin is needed for includes the proper functioning of our nervous system. In a condition known as Central Sensitisation Syndrome, the pain one experiences can get abnormally enhanced in the nervous system, occurring to due to several dietary as well as emotional reasons. In this case, a study has shown that combining fish oil and vitamin B12 supplementation reduces the pain over 50% better than fish oil alone.14

 

Additional Tips

Sleep Well.

Because of the intricate relationship that general pain seems to have with sleep, menstrual pain can lead to disturbed sleep, which in turn can worsen the pain.1

The best way to break out of this cycle? Try improving the quality and duration of your sleep. Find tips here.

Cut Down On Alcohol and Avoid Cigarettes.

Both of these have shown to increase the severity of period pain, possibly because they tend to promote inflammation.15,16

Exercise.

Studies have found that exercise reduces menstrual cramps, although the exact reason is not well understood. A likely reason is that by reducing one’s weight and stress levels, it improves blood circulation and strengthens muscles – and both of these can increase one’s resistance to pain.17

Considering that the modern lifestyle has become busier, more stressful and less nutrition-friendly, it’s no wonder that so many women go through menstrual cramps.

And, as these studies clearly show, a healthier diet and lifestyle can make all the difference.

 

References:

1. Iacovides S, et al. Human reproduction update 2015: dmv039.

2. Goldin BR, et al. Cancer 1994, 74(3 Suppl): 1125-1131.

3. Bagga D, et al. Cancer 1995, 76(12): 2491-2496.

4. Prentice R, et al. Journal of the National Cancer Institute 1990, 82(2): 129-134.

5. Sato O, et al. No To Shinkei 1967, 19(8): 773-777.

6. Haast RA, Kiliaan AJ. Prostaglandins Leukot Essent Fatty Acids 2015, 92: 3-14.

7. Bradbury J. Nutrients 2011, 3(5): 529-554.

8. Conklin SM, et al. Neuroscience Letters 2007, 421(3): 209-212.

9. Tokuyama S, Nakamoto K. Biol Pharm Bull 2011, 34(8): 1174-1178.

10. Champeil-Potokar G, et al. J Neurochem 2015.

11. Zafari M, et al. Caspian Journal of Internal Medicine 2011, 2(3): 279-282.

12. Makki K, et al. ISRN inflammation 2013, 2013.

13. Proctor ML, Murphy PA. Cochrane Database Syst Rev 2001(3): Cd002124.

14. Deutch B, et al. Nutrition Research 2000, 20(5): 621-631.

15. Parazzini F, et al. Epidemiology 1994: 469-472.

16. Harlow SD, Park M. Bjog: An International Journal Of Obstetrics & Gynaecology 1996, 103(11): 1134-1142.

17. Proctor M, Farquhar C. British Medical Journal 2006, 7550: 1134.

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