Menstrual Cramps

The menstrual cycle is a normal and predictable cycle that involves the shedding of the uterine lining once a month. The cycle repeats itself throughout a woman's reproductive years. Medically, menstrual cramps are known as dysmenorrhea, which literally means painful menstruation.

A complete menstrual cycle can be anywhere from twenty-one to thirty-five days long, with a twenty-eight-day cycle being average. The menstrual period, which marks the beginning of the cycle, lasts from three to seven days. During the rest of the cycle, intricate physical and hormonal changes occur that prepare the body for the possibility of pregnancy. During the first half of the cycle, the ovary prepares to release an egg. During this time, the body increases production of the hormone estrogen. This causes the lining of the uterus, the endometrium, to grow and await a fertilized egg. Meanwhile, the pituitary gland has released a follicle-stimulating hormone, causing an egg-bearing follicle in the ovary to develop. About halfway into the menstrual cycle, ovulation occurs and an egg is released from the follicle. This is followed by a rise in the hormone progesterone, which prepares the uterus for implantation of a fertilized egg. Progesterone influences the lining of the uterus to become rich in blood vessels and glandular tissue-a nourishing soft, spongy "nest." If the egg is not fertilized, however, the nest the body has prepared is not needed and, approximately two weeks after ovulation, the levels of both estrogen and progesterone drop. This triggers menstruation, and the enriched spongy lining of the uterus leaves the body as menstrual blood. About one-quarter cup of blood is lost with each menstrual period.

When menstrual cramps occur, it is usually just before the cycle starts or with the onset of menstruation. They can last anywhere from a few hours to a few days. Menstrual cramps feel like muscle contractions or sharp spasms in the lower abdomen. They may radiate to the back or down the thighs, and range from mildly achy to wrenchingly painful. In the severely afflicted, cramping may be accompanied by nausea, vomiting, headache, nervousness, fatigue, diarrhea, fainting, bloating, breast tenderness, mood swings, backache, and/or dizziness.

Women who suffer from cramps seem to produce greater amounts of prostaglandins, which are hormones secreted by the uterine lining, than other women do. These hormones affect the smooth muscle of the uterus, causing an increase in uterine contractions. The contractions interfere with blood flow, reducing the amount of oxygen reaching the uterus and resulting in pain. A large increase in prostaglandins can also cause strong gastrointestinal contractions, which may be responsible for the diarrhea, nausea, and vomiting associated with severe menstrual cramps.

When a teenager experiences menstrual cramps, she may not feel up to socializing, going to gym class, or participating in her usual daily activities. Because most teenagers thrive on social contact, suffering through a day or two of menstrual cramps can be difficult.

A teenager who suffers severe pain during her menstrual period should see her health care provider for advice. Severe abdominal pain may be a sign of an ectopic pregnancy, pelvic inflammatory disease, endometriosis, ovarian cysts, pelvic adhesions, fibroid cysts, or endometrial cancer. A medical diagnosis is essential.

A young woman who experiences persistently irregular menstrual cycles, a change in the normal pattern of her cycle, or an unusual amount of blood loss should call her doctor. Irregular or changing cycles may indicate an endocrine problem. Prolonged or excessive bleeding can lead to anemia.

If your daughter is fitted with an intrauterine device (IUD) or is taking birth control pills and develops cramping, see your doctor to be sure that her symptoms are properly diagnosed.

Supplements and herbs

• Calcium/magnesium chloride: An excellent supplement to help alleviate cramping and muscle spasms. It helps to maintain good muscle tone. Magnesium increases the absorption of calcium in the body. Calcium/magnesium may also help in reducing breast tenderness. Some women have found that chewing calcium supplements during their period helps with pain control.
• Vitamin E: Good for reproductive organ health and function.
• Vitamin B complex: Helps to reduce premenstrual tension. In some instances, taking brewer's yeast has decreased the severity of menstrual discomfort, including depression. Some research suggests that menstruation may cause a functional deficiency of vitamin B6.
• Vitamin C with bioflavonoids: Help to strengthen blood vessels and capillary walls in the uterus.
• iron: Make sure if you suffer from heavy periods that you are not suffering from an iron deficiency.

• Chamomile is an herbal relaxant. Drink a cup of chamomile tea as needed.
• The Chinese herb dong quai helps to regulate the menstrual cycle by balancing female hormones. When taken for a few months, it will help alleviate cramping, particularly when taken in combination with red raspberry leaf. Begin by taking 40 drops of dong quai tincture, or dong quai and red raspberry leaf combination formula, twice daily, from Day 6 through Day 20 of the menstrual cycle (calculated from the first day of menstrual bleeding). Continue taking 40 drops, twice daily, for three weeks. If the cycle is irregular, take the herbs for two to three weeks out of every month, and repeat this program for at least three menstrual cycles. Do not take this remedy during the menstrual period itself, however.
• A hot ginger-tea compress placed on the lower abdomen helps to relax muscle cramping. Boil 6 ounces of fresh ginger root in 1 quart of water for fifteen to twenty minutes, and dip a washcloth or hand towel in the tea. You can either place the saturated cloth directly on the abdomen, or wrap it first with a dry cloth. Ginger is warming and increases circulation in the lower abdomen. This compress will feel like a deep heating rub.
• True cramp bark, a little-known botanical, is effective in treating menstrual cramps. Take 1 cup of true cramp bark tea, twice daily, for three days before the expected onset of the menstrual period, and 1 cup, three times daily, during the menstrual period if cramping occurs.
• Prepare a soothing herbal bath. Mix 1 quart of strong chamomile tea and 1 quart of ginger tea with warm to hot bath water, and enjoy a leisurely soak.
• Pasque flower: Good for all pain including uterine.
• Black haw: An antispasmodic especially good for uterine spasms.
• Blue cohosh: An antispasmodic that also has a steroidal component. This herb has been used by North American Indian women for generations to relieve menstrual cramping.
• Black cohosh: Helps with a number of uterine disorders.

What else you can do

• Don't become overweight. Women who are overweight suffer more from menstrual cramping.
• Exercise regularly. Women who are physically fit have a lower incidence or severity of menstrual cramps.
• Take a good vitamin and mineral supplement all month long, and prior to your period increase your intake of calcium and magnesium.

More useful herbs

• Calendula
• Lady's Mantle
• Partridgeberry
• Peppermint
• Sage
• Skullcap
• Valerian
• Wild Yam