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The most common menstrual complaints reported by women are painful periods. But, that’s not supposed to be normal. According to studies, up to 93% of women of reproductive age have painful periods. And because it’s so common, it is easily brushed off as normal. But just because something is common, doesn’t make it normal at all!

The most common menstrual complaints reported by women are painful periods. But, that’s not supposed to be normal. According to studies, up to 93% of women of reproductive age experience painful periods. And because it happens so frequently, it is simply seen as normal. But just because something is common, doesn’t make it normal at all!


On the first or second day of your period, mild cramping in the lower back or abdomen is usual. However, it is not normal for the pain to be debilitating or to keep you from your normal daily activities.

Dysmenorrhea refers to the pain related to menstruation in medicine. Dysmenorrhea can have a huge impact on women’s lives, leading to restrictions on daily activities, lower academic performance in adolescents, poor quality of sleep, and mood disorders like anxiety and depression… And this should never be brushed off as being “normal.”


Primary dysmenorrhea and secondary dysmenorrhea are two categories for dysmenorrhea. Secondary dysmenorrhea is typically caused by an underlying condition such as endometriosis or adenomyosis. If you suffer from dysmenorrhea, it is important to work with your healthcare provider to identify the root of the issue to ensure you receive appropriate treatment.

If you’ve been diagnosed with endometriosis, you see my previous post about the condition here.

Primary dysmenorrhea is common among menstruating women. The prostaglandis causes this pain experienced during our periods. In other words, this is the oversecretion of chemical messengers that are released at the end of every cycle. This now causes the uterine tissue to contract to release the uterine lining—so to bring on each period.

Studies show that the more prostaglandins you have, the worse your cramps will be. Women with primary dysmenorrhea have higher levels of prostaglandins leading to more intense uterine contractions and, therefore, more cramping and pain.


Conventionally, non-steroidal anti-inflammatories (NSAIDS), like ibuprofen, naproxen, and aspirin, are the recommended treatment for cramps. These work because they block prostaglandin production. However, NSAIDs also inhibit ovulation which can lead to hormonal imbalances that can exacerbate painful periods, and create new symptoms!

When ovulation doesn’t occur, progesterone levels remain low which produces an estrogen dominant state, meaning cramps, PMS, heavy bleeding, tender breasts, etc. So, instead of relying on NSAIDS, let’s discuss other ways to get to the bottom of painful periods.



Here are a few simple strategies for helping to manage dysmenorrhea:


  • Studies show that it is equally effective as ibuprofen in treating pain due to its anti-inflammatory and anti-spasmodic properties
  • One can start taking ginger 3 days before the onset of menses until 3 days into the period to increase its effectiveness


  • Some take magnesium supplements during the month to prevent dysmenorrhea and at the onset of pain
  • Women in some trials of magnesium experienced a reduction in period pain and a lowering of prostaglandins in their blood
  • I have patients take magnesium every night and increase the dose right before their period starts
  • Magnesium can also help to regulate the bowels to help eliminate excess estrogen, but be careful not to overdo the magnesium, as it can lead to loose stools – if you get loose stools with magnesium supplements, choose a form over an oxide or citrate


  • Fish oil is high in omega-3 fatty acids, which are potent anti-inflammatory, and they work by altering prostaglandin production
  • Higher dose of 2g daily of Omega-3’s have been shown to reduce menstrual pain


  • Melatonin is not only a sleep hormone, it is an antioxidant, anti-inflammatory, and has analgesic properties, thereby reducing pain
  • When melatonin levels are high, it lowers uterine contractile force and craming. Meaning, prostaglandin production decreases


  • One to four days before the start of bleeding, take zinc to prevent menstrual cramps. Its effects may be due to its antioxidant and anti-inflammatory actions in the uterus
  • Zinc is also a key nutrient for a number of hormone receptors and proteins that contribute to healthy, balanced mood and immune function


  • To reduce cramping, avoid inflammatory foods like: refined sugars, gluten, conventional dairy products, refined vegetable oils, processed grains, poor quality meats and processed meats (like cold cuts, hot dogs, cured meats, etc.), alcohol and caffeine.
  • Identify and remove food sensitivities – possible with elimination diet or by having a blood test that identifies foods you may be reacting to
  • Consume foods high in omega-3 fatty acids that can help decrease prostaglandin production, like wild-caught fish like salmon, sardines, mackerel, etc
  • Ensure you are eating enough fiber – at least 30g daily – to help bind excess hormones and ensure proper elimination


  • Regular aerobic exercise is a well-known treatment for decreasing painful periods
  • Exercise increases blood flow to the pelvis and stimulates the release of endorphins which have an analgesic effect, reducing the severity of menstrual cramps


  • Acupuncture can significantly reduce dysmenorrhea. It works both physically and energetically, addressing the acute painful sensation, while also harmonizing the systems of the body to prevent dysmenorrhea
  • I recommend weekly acupuncture sessions for at least 2 - 3 cycles to see the full benefit



  • Practice stress reduction – women who report high levels of stress are twice as likely to experience painful periods
  • Weight management – those who are overweight have higher levels of inflammation
  • Avoid smoking – smokers have a higher risk of developing dysmenorrhea.
  • Less alcohol consumption – you can experience higher levels of pain when you drink too much alcohol
  • Get regular exercise
  • Eat a balanced, whole foods diet – grab a copy of my FREE hormone balancing meal plan here

    It is important to understand why you are experiencing menstrual pain and if there are no underlying disorders, there are many lifestyles, dietary and supplemental interventions that can help you ease period pain so that you don’t have to dread that time of the month! With any of the above treatments, give yourself at least three cycles to determine the benefit. If there are no substantial improvements in pain, it is time to determine if there is something else going on.

    To pain-free periods,

    Dr. Bronwyn

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