Period cramps
Menstrual cramps are a result of contractions of the uterus, caused by Prostaglandins. For your period to begin, Prostaglandins cause the uterus to contract, and cut off the blood supply to the uterine lining, so that it can shed. The ratio of Oestrogen to Progesterone can also be key to this. If Oestrogen is elevated compared to progesterone, which is common in Early Perimenopause and during Puberty, Prostaglandins also increase, leading to more pain.
The pain may start a day or 2 before the period begins, and lasts a few hours to a few days. With severe pain, it’s not uncommon to see nausea, vomiting, bowel changes, fatigue, dizziness and fainting. Following up with your GP is really important if you experience bowel or bladder symptoms, pain during or after sex or if the pain stops regular functioning like going to school or work.
There are 2 categories for period cramps:
Primary Dysmenorrhoea - when there is no other disorder complicating or causing the period pain.
Secondary Dysmenorrhoea - when disorders affecting the reproductive organs contribute to the cramping. Examples include Uterine Fibroids, infection, PCOS/PMOS or Endometriosis. It can take some time working with your GP and Gynaecologist to come to these diagnoses, so don’t be afraid to remind your GP of your pain at your checkups.
During a “perfect period” from a Chinese Medicine perspective, there is no pain… but don’t be too worried if you period is not perfect. Pain signifies an imbalance in the circulation of blood and Qi, which happens when the circulation becomes stuck, congested, cold, depleted, or inflammed. The following are TCM diagnoses for period pain:
QI STAGNATION - “Stress and tension blocking circulation”
Overwork, stress, frustration or an out of balance nervous system might contribute to this
There is bloating, breast tenderness, mood swings or irritability before the period
Bowels might be affected, either sluggish, or alternating between sluggish and loose.
Pain feels crampy, distending and comes in waves. Tight pants and weight on the belly might feel as though it makes the pain worse
Pain might decrease after the flow starts properly
Physical obstruction of flow with tampons or cups might increase crampiness
BLOOD STASIS - “Blood flow is blocked”
The pain here is fixed and stabbing, and worse with pressure. A lot of Women with Endo will fall into this category
There is often dark blood, heavy bleeding and clots larger than a 10c piece. Pain will often lessen after clots are passed
There will be some overlap with the Qi stagnation symptoms
COLD UTERUS - “Cold slows and obstructs circulation”
Cramps relieved dramatically by heat. You will have a heat pack or hot water bottle with you. Hands, feet and belly may feel cold.
Your cycle might be long, and the pain often starts before bleeding does
Flow is lighter than blood stasis. There may be clots and dark or purplish flow.
Pain is often contracting and tight, made worse by cold exposure from the environment or cold food and drinks
DAMP-HEAT - “Inflammation and congestion”
The pain is burning and period is bright red and heavy. There may be a strong odour
Acne
Pelvic swelling, possible bacterial infections, STIs or fungal infections (thrush)
Qi AND BLOOD DEFICIENCY - “Under nourishment”
If your pain is dull, empty, dragging and aching, or if the pain is worse after the period
If the pain improves with rest and pressure
Flow might be with pink or light coloured bleeding, but may also be heavy if there is also a deficiency of Qi.
Dizziness, fatigue, anxiety, poor sleep, loose bowels
YANG DEFICIENCY
Similar to above, but feeling very cold, tired and depressed.
Abdominal pain, relieved by warmth and pressure. Dull headaches.
YIN DEFICIENCY
Pain at then end or after the bleeding, especially in the lower back
Scanty flow
Dry eyes, ringing in the ears, exhaustion
Lifestyle for Period Pain:
Rest - especially during the period. If flow is heavy, this is especially important. Vigorous exercise should be avoided, as it can make the pain worse and flow heavier. Some women find that lying down and resting makes the pain worse. If this is you, there is significant ‘stagnation’ so gentle movement might be better than complete rest.
Stress management techniques like reducing commitments, gentle exercise, meditation and socialising, especially in the lead up to the period
Try a couple of cycles with no cups or tampons. This can dramatically reduce the amount of cramping for some women. The uterus may sense that the cup/tampon as an obstruction (like a clot) that it needs to contract to release.
Avoid exposure to cold during the period - avoid swimming, ice baths and rug up. Avoid food straight from the fridge or freezer, opting for cooked, warm foods. Pay attention to keeping your belly, lower back and feet warm
Use a heat pack or hot water bottle to manage the symptoms. This will have the most benefit if your pain is Cold or Yang deficient. All types of pain, it should help a bit, with the exception of Damp-heat.
Food as therapy:
Magnesium rich foods - Green leafy vegetables, legumes & beans, tuna, artichoke, figs, barley, oats, brown rice, almonds, Brazil nuts, cashews, pumpkin seeds, broccoli, parsnips, peas, pumpkin and sweet potatoes
Omega-3 fats from oily fish (wild-caught salmon, herring, mackerel, anchovies, sardines etc), and nuts and seeds (flax seeds, flaxseed oil, hemp seeds, chia seeds)
Warming spices help if your pain is relieved by warmth (cinnamon, ginger, spring onions, chives) Other spices, like citrus zest, saffron or Chamomile might be helpful. It’s beneficial for all types to eat food warm and cooked.
If you have Qi or blood Stagnation type pain, dispersing foods like onions, garlic, pepper, cardamom, cumin, fennel, dill, ginger, turmeric, watercress can be useful. As can small amounts of sour foods - citrus, pickles, plums, umeboshi plums may be useful. Eggplant and seaweed can be very beneficial.
The amount of period pain can be related to hormone balance, so continue with high fibre, vegetable rich meals, with adequate protein to help your hormones work at their best.