Dysmenorrhea or What Are Intolerable Menstrual Pains?
Every menstruating individual knows this. When menstruation is about to start, most experience a more or less intense pulling and pressing in the lower abdomen. This can be noticeable for several days or hours until bleeding starts. Also, during the bleeding, especially during the first 1-3 days, these pains can intensify. 10-20% of girls and women suffer from such severe menstrual pains that they are severely restricted in their everyday life, to the extent that they regularly miss school or work.
Symptoms of Dysmenorrhea
Menstrual pains are described as stabbing, cramp-like, throbbing, or a dull constant pain. Common accompanying symptoms include back pain, headaches, and pains radiating into the legs, occasionally also constipation or diarrhea and a general feeling of malaise.
What Are Primary or Secondary Dysmenorrhea?
Primary dysmenorrhea occurs already at the first menstrual bleedings, while secondary dysmenorrhea develops over the years. The causes of secondary dysmenorrhea can be hormonal fluctuations, especially in the first years after the onset of menarche (first menstrual bleeding) or at the beginning of menopause. Other reasons can also be changes in the uterus, e.g., fibroids or polyps of the uterine lining.
What Helps With Severe Menstrual Pains?
If the pains are regularly very strong, organic causes should first be clarified with a gynecologist and in case of unclear abdominal pains also with a general practitioner or internist.
For symptomatic therapy, pain pills, called analgesics, are used. Initially, paracetamol or NSAIDs, which are non-steroidal anti-inflammatory drugs, are prescribed. NSAIDs have achieved good pain relief in 45-53% of cases1. There are many other pain relievers, but listing them here would be too long.
Hormonal contraceptives like the pill or hormonal IUDs also work effectively. These therapy options help well, but often have side effects.
Why Are Menstrual Pains Differently Intense?
Menstrual pains are subject to hormonal fluctuations within the female cycle. This is also dependent on our physical activity, stress, sleep quality, or even the micronutrients we consume with our daily diet. Hormonal fluctuations are common in adolescence, the time when the female cycle stabilizes. The same applies to the time of menopause. During this time, the activity of the ovaries decreases, hormonal fluctuations increase, and with them, the menstrual pains again.
Many women report in my consultation that they feel "like at 12 years old again". The period becomes irregular and significantly more painful.
What to Do About Severe Menstrual Pains if I Cannot Tolerate or Do Not Want to Take Painkillers or the Pill?
There are further supportive therapy options for severe menstrual pains from the field of integrative medicine, which is the combination of complementary and conventional medicine. Smaller studies have demonstrated efficacy in terms of pain reduction.
These treatments include Chinese phytotherapeutics, calcium, light therapy, acupuncture, pain trigger point therapy, to name just a few. In a further blog, I will elaborate on these therapy methods.
A small study2 showed an effect when taking 1000mg of calcium per day from the 15th day of the cycle until the start of menstruation. A trial with high-dose magnesium, e.g., 600 mg/day, can be conducted individually. But here too, it applies that these therapies should be discussed with a doctor beforehand.
Are There Home Remedies for Severe Menstrual Pains?
The best-known home remedy for menstrual pains is heat. A heating pad placed on the back or abdomen already helps quite well in many cases, but is not easily applicable in daily life or at work.
Another home remedy is exercise. I also recommend this home remedy. Half an hour of jogging or walking, a walk, or another physical activity often suffices to effectively reduce lower abdominal pains. Ultimately, exercise leads to increased blood circulation in the small pelvis, which can lead to relaxation. This advice does not help those menstruating who must sit in school or in the office or simply do not have the opportunity to freely schedule their time and move for half an hour.
Individual controlled studies describe a reduction of chronic lower abdominal pains or primary dysmenorrhea through transcutaneous electrical nerve stimulation (TENS)3.
Exercise or a TENS device causes the release of endorphins, which are our body's own little happiness messengers that influence our physical and psychological well-being and are therefore often referred to as the body's own drugs. These hormones participate in processes in the central nervous system and influence, among other things, the perception of pain. We have already written an informative article on this topic. Here you can learn more about "TENS Device for Menstrual Pain: Pain Relief and Application Tips".
The use of a small TENS device like ONEflow can thus also be counted among the home remedies for treating severe menstrual pains. It is easy to use, almost universally applicable, and without side effects. The principle of the TENS device causes relaxation of the muscles in the small pelvis and the adjacent muscular structures, thereby improving blood circulation to these structures and the release of the aforementioned endorphins.
Furthermore, some herbal remedies are available in pharmacies, such as chaste tree or yarrow. The list is very long. We will report on this in detail later. All home remedies have in common that everyone reacts differently and these remedies can simply be tried out and combined.
Sources
1 AWMF Guideline Endometriosis, status 2020
2 Zarei S, et al. Effects of Calcium-Vitamin D and Calcium-Alone on Pain Intensity and Menstrual Blood Loss in Women with Primary Dysmenorrhea: A Randomized Controlled Trial. Pain medicine (Malden, Mass) 2017;18:3-13
3 Bay HY et al. Effect of transcutaneous electrical nerve stimulation therapy for the treatment of primary dysmenorrhea. Medicine 2017;96: e7959
