What is Dysmenorrhea?

Painful menstrual periods (dysmenorrhea) occur in one-third to one-half of women, but in 5% to 10% of women, the pain is severe and disabling. Although many women suffer menstrual pain without any obvious abnormality in the reproductive tract, sometimes it occurs because of pelvic infection, endometriosis, or structural differences in the womb. Because there may be such a problem, if you develop painful cycles, you should consult a gynecologist to be certain everything is normal. If there seems to be no problem, nutritional and vitamin therapy may help relieve the pain.

DysmenorrheaYou usually feel the pain of dysmenorrhea low in the middle of the abdomen as a wavelike cramping ache. You may also feel the ache in your low back or down into your thighs, and you may suffer nausea, dizziness, diarrhea, headache, and flushed feelings along with the abdominal cramping. The pain occurs because of an abundance of "bad" prostaglandins that constrict the blood vessels and cause spasms of the muscular wall of the uterus (womb). What can nutrition offer to stop "the cramps"? Let's see.

What helps Dysmenorrhea?

•  Essential fatty acids may play a more crucial role than any other nutrients in control of dysmenorrhea because of their effect on the production of prostaglandins. If you have not done so, read the discussion in Section we on eicosinoids, pages 24-27, which will explain about the prostaglandins (members of the eicosinoid group) in greater detail. In a nutshell, the body takes the essential fatty acid linoleic acid (GLA) and alters it in a series of steps to produce both the "good" group of eicosinoid messengers and the "bad" group. Proper diet and fish oil (EPA) help to control the production, tipping it in favor of more of the good kind of messenger. Good, in this case, means a prostaglandin (or eicosinoid) messenger that causes the uterus to relax. Bad ones cause spasms and cramping. Recommendation: Begin with a solid macronutrient framework (see macronutrients, Section we, page 23) and to that sound base add gamma-linoleic acid to EPA fish oil in a ratio of 1:4 (GLA:EPA) 1 to 3 times daily. The EicoPro essential fatty acid product manufactured by Eicotec, Inc., of Marblehead, Massachusetts, contains ultrapure sources of linoleic acid and fish oils already combined in the proper ratio. If you cannot get this product, you can purchase linoleic acid in a product called evening primrose oil at most health and nutrition stores, and EPA fish oil as well. Because it is not as pure a form, the milligram dosing will be different. You can make a reasonable substitute by combining evening primrose oil capsules with fish oil capsules plus vitamin E. Take 500 mg of evening primrose oil (a source of linoleic acid in capsule form), plus 1000 mg EPA fish oil, plus 100 IU vitamin E 1 to 3 times a day. (Warning to diabetics: EPA fish oil can cause blood sugar fluctuations in some diabetics. Carefully monitor your blood sugar if you use this supplemental oil and discontinue its use if your blood sugar becomes difficult to control.)

• Niacin along with vitamin C and the bioflavonoid rutin, taken in the premenstrual week, help to prevent or lessen the symptoms of dysmenorrhea. Niacin alone can help to stop cramping once it has begun. Recommendation: Beginning 7 to 10 days before your menstrual bleeding should commence, take 100 mg of niacin, plus 300 mg vitamin C, plus 60 mg rutin each day. During a bout of severe menstrual cramping, you may take 100 mg of niacin every 2 to 3 hours.

•  Vitamin E may act to enhance the release of your body's natural narcotic chemicals, beta-endorphins. Precisely how this occurs is unclear; however, some women can relieve their menstrual pain by using vitamin E. Recommendation: Begin supplementing about 10 days before your menstrual bleeding should begin. Take 100 IU vitamin E (as alpha-tocopherol succinate) 3 times a day and continue for 4 more days.

•  Iron supplementation, if you are low in iron and anemic, may help to relieve your menstrual pain. We could find no indications in the literature that this remedy would help if you were not anemic from iron deficiency. Recommendation: If you are low in iron, take 90 to 100 mg iron as ferrous sulfate 3 times per day (or a prescriptionstrength iron replacement from your physician).

• Magnesium has a relaxing effect on the muscular wall of the uterus. Deficiency of magnesium may worsen painful cramping and low back pain during menstrual bleeding. Recommendation: Take 250 mg magnesium aspartate once or twice a day the day before and the first 2 days of your menstrual period.

Dysmenorrhea Herbal remedies

•  Angelica root, cramp bark, kava kava, and red raspberry have antispasmodic properties and help alleviate cramping.

•  Black haw and rosemary relieve cramps and calm the nervous system.

•  Wild yam contains natural progesterone and can alleviate cramping.

Dosages vary according to the severity of your symptoms. Consult a qualified health practitioner before beginning any herbal regimen.

What makes Dysmenorrhea worse?

• Eat fewer dairy products. They block the absorption of magnesium and increase its urinary excretion. Refined sugars also increase magnesium excretion.

• Caffeine is linked to breast tenderness.

• Sodium causes bloating. Omit salt, red meats, processed foods, and junk/fast foods from your diet for at least 1 week prior to the onset of symptoms.

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