Natural solutions for teenage period pain
Period pain is the most common reason teenage girls give for missing school and it is the main gynaecological complaint at the doctors. This post explores why teenage girls may experience painful periods, and some natural solutions that may help relieve discomfort and empower them to love and look after their bodies.
HORMONES INVOLVED IN A NORMAL MENSTRUAL CYCLE
Before looking at the reasons for period pain, here’s a diagram to remind you of some of the hormones involved in a normal menstrual cycle.
From: The Women’s Guide to Herbal Medicine by Carol Rogers
CAUSES OF PAINFUL PERIODS
Period pain, medically known as dysmenorrhea, can be divided into two types: primary period pain – where there’s “no underlying pathology” causing the pain (50% – 90% of cases) and secondary – where the pain is caused by an underlying condition such as endometriosis, fibroids or pelvic inflammatory disease. This blog is all about primary period pain.
Congestive period pain
This pain often starts before the period begins; as the uterine lining (endometrium) thickens the uterus becomes engorged with blood and becomes larger and heavier. Congestive pain is often experienced as a sense of fullness and pressure in the lower abdomen, vagina and down the back of the legs (due to the pressure the uterus exerts on the sciatic nerves in the pelvic bowl).
Spasmodic period pain
As the period starts and menstrual flow begins, the pain can often become spasmodic. This is the type of pain most likely to affect young women and teenagers, and generally only occurs when ovulation starts to happen.
After an egg has been released from the ovary, the remaining corpus luteum secretes progesterone as it breaks down. After about two weeks the corpus luteum has degraded and progesterone declines. This stimulates the production of prostaglandins – that cause vasoconstriction of blood vessels in the endometrium and contraction of the uterus to help evacuate blood. The contraction limits oxygen to uterine muscle and causes pain.
Spasmodic pain usually lasts between 48 – 72 hours and can be accompanied by fever, nausea, shaking and sweating, fatigue, low mood and feeling generally unwell. Some people also experience constipation just before their period and then diarrhoea as the spasm in the uterus affects the colon.
Heavy bleeding, uterine position and pain
If the uterus is lying in a sub-optimal position (e.g. retroverted) or the endometrium is very thick then the uterus may need to contract more deeply (and more painfully) to evacuate the blood.
CONVENTIONAL MEDICAL APPROACHES
Non-steroidal anti-inflammatory drugs (NSAIDS) and the Combined Oral Contraceptive Pill (COCP) is the first line of defence recommended by NICE for period pain. The NSAIDS reduce the activity of an enzyme called COX-2, which in turn reduces the production of the prostaglandins (PGE2) considered responsible for spasmodic period pain.
The COCP inhibits ovulation, and consequently the production of a corpus luteum, progesterone and subsequent prostaglandin synthesis. It also modulates oestrogen production so that the menstrual flow is lighter and less pain is experienced.
However, there are risks associated with taking both NSAIDS (cardiac risk) and the contraceptive pill (depression) over long periods. The COCP does not always eradicate period pain as it also decreases levels of vitamin B1 in the body, a compound needed to reduce PGE2 production.
“Naturopathic medicine is non-invasive and gentle on the body. The naturopath works as facilitator, gently guiding the body back to homeostasis, restoring balance, always acknowledging the body’s own innate ability to heal itself” Leah Hechtman
Diet is always the first line of defence in naturopathic medicine, and this is particularly so for period pain. The foods we eat can affect the type of prostaglandins (PG) our bodies produce. Some foods stimulate the production of PGE2 that increase uterine contraction and pain and others stimulate the production of PGE1 and PGE3 that decrease these affects by relaxing the muscle of the uterus.
Foods to increase
Foods that increase the production of PGE1 and PGE3 / See research
- Flavonoid rich foods (especially flavonoid quercetin) decrease PGE2 production by inhibiting the action of an enzyme called COX-2. These foods include apples, onions, garlic, colourful berries (raspberries, blackberries, blue berries, cherries – great bought frozen and added to morning porridge), cruciferous vegetables (broccoli, cabbage, cauliflower), leafy green vegetables (kale, spinach, cavolo nero, spring greens). Try to steam or stir-fry vegetables to avoid damaging vital compounds.
- Essential fatty acids are involved in the production of PGE1 and PGE3 – dietary sources include: salmon, tuna, halibut and sardines as well as flaxseeds (grind and add to salads or porridge), pumpkin seeds, sesame seeds and sunflower seeds.
- B-Vitamins (especially vitamin B1, B3 and B6) are used in our bodies to produce PGE1 and PGE 3 – food sources include: wheat germ, whole grains, fish, beans, eggs, yeast extract (marmite & vegemite), brewers’ yeast and molasses.
- Zinc is involved in the production of PGE1 and PGE3 – dietary sources include: fish, pulses, nuts, seeds and ginger.
- Magnesium plays a role in reducing PGE2 synthesis – dietary sources include: leafy greens, nuts, seeds, whole grains and avocado.
Foods to decrease / avoid
Foods that increase production of PGE2
- Dairy products (cheese, butter, milk, ice cream, yoghurt) contain high amounts of arachadonic acid that gets converted by our bodies to PGE2 – the pro-inflammatory, spasmodic prostaglandins.
- Saturated fats also stimulate the production of PGE2s. Dietary sources are mainly from meats but avoid coconut and palm oil too. Whilst chicken and turkey are lower in saturated fats than red meats (pork, lamb and beef) they are actually higher in arachadonic acid – that gets converted to PGE2.
- Sugar consumption has not been linked directly to period pain. However if sugary foods (or refined carbohydrates) form a large part of your diet it may mean your diet is deficient in other areas, as sugary foods (or foods high in refined carbohydrate) are often nutritionally poor.
It is almost always better to derive nutrients from diet rather than from supplements (see above ideas for good foods to eat), but sometimes supplements can be useful to manage a crisis situation whilst dietary changes are put in place. An independent health food shop is the best as they can help you find the supplement right for you.
- B complex (all B vitamins) high-dose combination, preferably activated forms
- Magnesium 400 – 800 mg/day
- Omega-3 fish oils – 1080 mg/day EPA and 720mg/day DHA
- Zinc 50 mg/day
Sleep and relaxation
Both good sleep (teenagers need about 9 – 9.5 hours good sleep per night) and relaxation have been found to improve period pain.
Exercise helps to increase circulation to the pelvic area and uterus and can therefore help with period pain. It is usually best to avoid impact exercise (such as running) just before and during the first day of your period, as the uterus is heavier than normal.
SELF-CARE / THERAPIES
Massage and warmth
Many studies have shown that abdominal massage and spinal manipulation can help relieve period pain. This may be due to its ability to increase circulation to the uterus and reduce pelvic congestion. Hot water bottles and heat packs also increase circulation to the area and help to reduce spasm.
We offer Arvigo® massage a warming, gentle manipulation of the abdomen, back and sacrum that increases circulation (blood, lymph and nerves) to the uterus and helps to realign the position of the uterus. The massage uses aromatherapy oils (clary sage, ginger, lavender and chamomile) and takes place on a heated couch, with warm towels and a heat pack placed over the uterus.
We also show you how to massage your abdomen yourself so that you can continue the beneficial effects of massage at home.
Herbal medicines have been used for thousands of years to help with period pain. They gently reduce uterine cramps, increase circulation to the uterus and have an analgesic effect. They generally only need to be taken in the few days around the start of your period.
We are Medical Herbalists and can guide you on whether herbal medicine could be right for you. If your symptoms are caused by an underlying pathology such as endometriosis, pelvic inflammatory disease or fibroids we may be able to help you with these too.
Some of the herbs we use are as follows – and we always support the herbal prescription with dietary and lifestyle advice and massage where requested.
- Cramp bark (Viburnum opulus)
- Black Haw (Viburnum prunifolium)
- Wild Yam (Dioscorea villosa)
- Fennel (Foeniculum vulgare) see research
Prostaglandin-inhibiting herbs / anodynes
- Turmeric (Curcuma longa)
- Ginger (Zingiber officinale)
- Jamaican Dogwood (Piscidia erythrina)
Warming herbs (if you are inclined to poor circulation)
- Ginger (Zingiber officinale) – make a strong tea by grating the fresh root (you can leave on the skin) and pouring over just boiled water, steep for 10 minutes see research.
Acupuncture is a branch of Traditional Chinese Medicine and has been shown to be useful in reducing period pain. We don’t offer acupuncture but we know a few good therapists – see the resources page of our website for details.
Feel free to contact us to find out how we can help you.