Get rid of the cramps! Where period pains come from and how you can relieve them.

Do you feel cramps in your abdomen when you have your period? Do you feel unwell for a day or even several days? Then you're in good company: 50 to 95 percent of all people who menstruate regularly have experienced period pain (1, 2). This is the most common reason for sick leave during the teenage years (2). Don't panic: First, in many cases, the pain eventually subsides on its own. Second, there are many ways to relieve menstrual pain.

Causes of abdominal pain - What is to blame for the pulling, pressing, cramping?

If you know what kind of renewal program your uterus goes through month after month so that a child can eventually grow inside it, you probably know that a lot happens in your abdomen month after month. If the cycle is completed without a fertilized egg implanting, the top layer of your uterine lining is shed. This includes tissue, nutrients and blood. Everything together at the beginning of your period - this is sensible and healthy, but unfortunately sometimes painful.

Certain tissue hormones, the prostaglandins, are responsible for this. They are useful and necessary because they act on the blood vessels and muscles in your abdomen and cause your uterus to contract and relax again. This allows it to expel whatever it wants to get rid of, as quickly as possible with your period (2, 3).

Scientists believe that many women temporarily, or permanently, produce an excess of prostaglandins. Possible consequences: The uterus contracts particularly violently or the blood supply to the uterus is reduced for a time. Both cause pain. Symptoms such as nausea, headaches or dizziness can also occur.

To make matters worse, there are other factors that can further aggravate everything:

  • Negative stress, which is known to affect many processes in the body.
  • Lack of sleep, which increases sensitivity to pain
  • Magnesium deficiency, which increases the tendency to cramps
  • a naturally high sensitivity to pain

In addition, there are some diseases whose symptoms include severe pain during the period - first and foremost endometriosis or adenomyosis.

Doctors have a technical term for regular, severe menstrual pain: dysmenorrhea. In otherwise completely healthy women, the diagnosis is called primary dysmenorrhea; in women with diseases such as endometriosis, it is called secondary dysmenorrhea.

Whether primary or secondary dysmenorrhea, menstrual cramps have many faces. For some, they start immediately with the first menstrual period, menarche. Others experience the typical pain only after one to two years, because only then do they ovulate regularly and produce a corresponding amount of prostaglandins.

If you experience persistent, severe menstrual pain, you should make an appointment at your gynecologist's office soon. Your gynecologist can determine if there is a disease causing your cramps, i.e. whether you have secondary dysmenorrhea. Endometriosis is a particularly common diagnosis. In patients with endometriosis, the lining of the uterus has settled outside the uterus, for example on the peritoneum, the intestines or the ovaries. Experts estimate that 8 to 15 percent of all girls or women are affected. Endometriosis may be present from early adolescence or develop later in life, and the causes are still unclear (4). Adenomyosis is also often diagnosed in girls and women with severe menstrual pain. In this case, cells that should actually only be located inside the endometrium are also found inside the muscular wall of the uterus (5). Whether endometriosis or adenomyosis, the more uterine lining cells there are that can contract, the more likely your period will hurt a lot. Fortunately, however, there are some ways to treat adenomyosis and endometriosis. Period pain without an underlying condition is also treatable.

Your gynecologist or family doctor will find out what is behind your symptoms and possibly show you the way out of your period pain.

 

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Relieve period pain - Helpful treatment approaches for period pain.

When period pain is addressed with medication, certain painkillers have proven particularly effective: The non-steroidal anti-inflammatory drugs (NSAIDs) with active ingredients such as diclofenac, ibuprofen and naproxen.

What is special about the NSAIDs is that these painkillers intervene directly in prostaglandin synthesis. This means that fewer prostaglandins are produced, which can reduce pain. It is best to talk to your family doctor or gynecologist about this in advance to get advice on the medication that is suitable for you, the possible undesirable effects, and the dosage. The choice of painkiller will also be based on whether you have digestive problems, as non-steroidal anti-inflammatory drugs can increase them.

However, there is more you can do - supplementally or without medication at all - to relieve your menstrual cramps. Some methods have been very well researched, others have not yet been conclusively studied.

 

Inflammation down, well-being up! - What can help with cramping

You can try to regulate your prostaglandin production naturally. For example, by avoiding foods that are rich in arachidonic acid. Arachidonic acid is an omega-6 fatty acid that is actually beneficial, but in excess can contribute to the excessive production of prostaglandins. A lot of arachidonic acid is found in pork, for example, but other meats, eggs and dairy products also provide it (6). So just try to avoid this or at least eat less of it! And rely more on fish, linseed oil and algae, which as suppliers of omega-3 fatty acids, help to create a healthy balance of omega-3 and omega-6 fatty acids.

In addition, you can take care of your magnesium supplyby eating foods such as bananas, nuts, broccoli, whole grain bread or dietary supplements (7). This can help make your period pain more bearable.

 

There are other herbal foods that women with abdominal pain really swear by. Ginger, for example, has anti-inflammatory, warming and nausea-fighting properties. To make yourself a ginger tea, pour boiling water over several fresh slices of the tuber, let the brew steep for ten minutes and then enjoy. Juice and capsules containing the active ingredients from ginger also show positive effects. A review from India found that ginger preparations reduce menstrual pain as well as painkillers and significantly better than placebos (8).

 

Home remedies for period pain - life hacks for your well-being

Not only ginger decoction, but also herbal teas can make a valuable contribution to greater well-being. The herbs chamomile, goose cinquefoil, fennel and yarrow have proven to be antispasmodic. Lemon balm  and lavender are also said to give serenity. Preparations of black cohosh and lady's mantle are considered hormone-regulating and thus helpful against period pain (9).

Make sure that the ingredients are of good quality and always prepare fresh teas with boiling water.  Please ask the pharmacist or phytotherapist of your choice about the most suitable method of application, the best time and the dosage.

Alternatively, or as an accompaniment, heat has circulation-increasing and antispasmodic properties thatcan help you to get through painful hours and days. Just try out what feels particularly good to you: hot water bottle, heat pad, cherry stone pillow, full bath ... There are even studies that speak for the effectiveness of various heat applications (10).

What else do you feel like? Exercise or lying on the sofa? Many actually use their favorite sport to distract themselves and support the circulation of their whole body, thus including the uterus. Sports that are found to be enjoyable despite menstrual cramps include yoga, gymnastics and running, according to studies (11). You alone decide the pace and dose!

When it comes to menstrual pain, don't let anyone tell you what you should or shouldn't feel, or what is normal and what is not! Allow yourself time for yourself and be as good to yourself as possible. And whenever the pain is too much for you, ask for medical help and trust that you will feel better soon.

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Sources:

  1. Iacovides S, et al: What we know about primary dysmenorrhea today: a critical review, Human Reproduction Update 2015, 21(6):762–778, https://doi.org/10.1093/humupd/dmv039
  2. Bartley J: Dysmenorrhö bei jungen Mädchen, korasion 2013. https://www.kindergynaekologie.de/fachwissen/korasion/2013/pathophysiologie-und-therapeutische-optionen/
  3. Deutsche Apotheker-Zeitung (DAZ) 2001, Nr. 31, S. 34, (online) 29.07.2001, https://www.deutsche-apotheker-zeitung.de/daz-az/2001/daz-31-2001/uid-1168
  4. https://www.endometriose-vereinigung.de/was-ist-endometriose.html
  5. Hutmacher J, et al.: Gynäkologie 1/18, Schwerpunkt; www.rosenfluh.ch/gynaekologie-2018-01/die-adenomyose
  6. https://www.lecturio.de/magazin/arachidonsaeurederivate/
  7. https://www.medizin-transparent.at/regelschmerzen-magnesium/
  8. Negi R, et al: Efficacy of Ginger in the Treatment of Primary Dysmenorrhea: A Systematic Review and Meta-analysis. Cureus. 2021 Mar 6;13(3):e13743. https://dx.doi.org/10.7759/cureus.13743
  9. Bühring U, Girsch M: 10 Heilpflanzen in der Frauenheilkunde. Aus: Praxis Heilpflanzenkunde. Thieme 2016; https://dx.doi.org/10.1055/b-0036-137700
  10. Graz B, et al: Dysménorrhée: patience, pilules ou bouillotte? [Dysmenorrhea: patience, pills or hot-water bottle?]. Rev Med Suisse. 2014;10(452):2285-8. https://www.revmed.ch/revue-medicale-suisse/2014/revue-medicale-suisse-452/dysmenorrhee-patience-pilules-ou-bouillotte
  11. Carroquino-Garcia P, et al: Therapeutic Exercise in the Treatment of Primary Dysmenorrhea: A Systematic Review and Meta-Analysis, Physical Therapy, Volume 99, Issue 10, October 2019, Pages 1371–1380, https://doi.org/10.1093/ptj/pzz101
  12. Firstpost-Artikel vom 20. Dezember 2019: https://www.firstpost.com/health/11-tried-and-tested-home-remedies-for-period-pain-from-women-who-swear-by-them-7799171.html