Dysmenorrhea (Menstrual Cramps)

Dysmenorrhea is the medical term for pain and cramping associated with menstruation.  The pain and cramping usually appears with the onset of menstruation.  Biochemically speaking, excessive production of prostaglandins by the myometrium and endometrium are the cause of uterine contractions, pointing to nutritional problems. Cramping can spread throughout the entire abdomen and lumbo-sacral region, and even cause pain in the vulva and anus.  In some cases pain can be sufficiently severe to cause fainting.  There is often clotting, and the pain is usually relieved after the blood begins to flow smoothly.

Herbal medicines can be very effective for this condition. However, as with menorrhagia, unless the case is very mild, it is advisable to see your gynecologist to rule out more serious organic diseases.  It is also important to correct nutritional deficiencies while using herbal treatments for a holistic treatment.

TAM doctors believe that chronic tension in the uterus or a small uterus is sometimes the cause, and they explain that this is why, in some women , the cramps cease after childbirth.  TCM doctors see this condition as stagnation of blood and Qi.  The primary treatment goals with Chinese herbs are to break up the blood stagnation (clotting) and relax the uterus.  Herbs that relax the uterus include black cohosh root (Cimicifuga racemosa), cramp bark (Viburnum opulus), kava root and black haw root (Viburnum prunifolium).  Among the many useful herbs to break up blood stagnation are dang gui root, red peony root, red clover blossoms, carthamus flower, and raspberry leaf (as a tea).

From the TCM perspective, due to Qi stagnation it is important to also use bupleurum root.  If pain is severe, you can use Jamaican dogwood (Piscidia erythrina), or yan hu suo tuber (Corydalis yanhusuo).

All of the above herbs can either be used alone or in balanced combinations.

Research Highlights

•  In a controlled crossover study, 33 women followed a low-fat vegetarian diet to determine whether it would reduce dysmenorrhea and premenstrual symptoms.  Pain intensity decreased significantly in comparison to baseline levels on the worst days, and water retention symptoms were also significantly reduced.  Researchers attributed the benefits to dietary influences on estrogen activity (Barnard et al., 2000).

• A randomized, double blind, controlled study involved 556 girls ages 12-21, all of whom suffered from moderate to very severe spasmodic dysmenorrhea.  The subjects received Vitamin B1 (100 mg per day) for 90 days.  Researchers reported that 87% were completely cured, 8% relieved (pain ranged from reduced to almost none) and 5% showed no effect whatsoever.  The results remained the same two months later (Gokhale, 1996).

• A study on 181 healthy Danish women looked at the correlation between dietary habits, especially low intake of fish products and intakes of specific nutrients, and menstrual pain.  Statistical analysis of results were highly significant, supporting the hypothesis that a higher intake of marine omega-3 fatty acids correlated with milder menstrual pain symptoms (Deutch, 1995).