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Period Pain


There are 2 types of period pain:
Primary Dysmenorrhea: where the uterus is healthy but behaving abnormally. The contractions are too strong and too frequent; between the contractions the uterus is not relaxing properly but is constantly tense restricting blood flow through the muscle.

Secondary Dysmenorrhea: where the pain is secondary to or caused by an underlying condition such as endometriosis or pelvic inflammatory disease: PID.

Symptoms
Period pain varies enormously from woman to woman and from period to period. Usually it is described as a constant, dull, dragging or heavy ache with spasms of cramping pains. It is located in the centre of the lower abdomen, occasionally radiating to the back or down the thighs. Many women describe the sensation as though "everything will fall out". It may start prior to the period but usually starts with the flow of blood, intensifying as the period becomes heavier or when there are clots. Sometimes there is nausea, vomiting, diarrhoea or headaches with it. Often women are constipated prior to their period which will exacerbate the pain, as irritable bowel syndrome does as well. The bowel and uterus share a similar nerve supply so spasms in one system will inflame the other.

Causes
  • Inflammatory prostaglandin excess causes inflammation, irritation and constriction of tissues. Women with period pain have been shown to have higher levels of inflammatory PG (fried oils and animal fats) and low levels of anti-inflammatory PG (Omega 3 oils)
  • Hormonal imbalance: relative oestrogen excess to progesterone. At the end of the cycle, progesterone can drop off too early and oestrogen can be too high which is inflammatory and causes excessive contraction of the uters
  • Genitourinary infection - subclinical PID should be ruled out or treated accordingly with antibiotics
  • Nutrient deficiencies: magnesium primarily is required to relax spasming muscles including the uterus
  • Endometriosis or adenomyosis
  • Stress causes inflammation, tension in the muscles as well as the uterus exacerbating period pain
  • Strenuous physical activity during menstruation increases muscle contraction and tension; regular exercise is associated with a lower risk as exercise decreases rate of oestrogen production and insulin resistance as well as relieving stress and tension
  • Caffeine, junk food and alcohol consumption increase inflammatory chemicals in the body and leech nutrients out of the body
  • Constipation and irritable bowel syndrome will exacerbate period pain and vica versa.

Diagnosis is via exclusion of other conditions. A pelvic examination may be performed by your doctor. It is important to seek advice if the pain changes, suddenly begins for the first time, is one-sided only, occurs with pregnancy, usual pain controls are no longer adequate, new symptoms accompany it eg. vomiting, diarrhea, pain worsens at the end of period, occurs with pressure, bowel motions or sexual activity, a fever or discharge accompany it.

Naturopathic Perspective
Dietary and lifestyle changes are essential for successful treatment and for prevention of period pain long term.
Herbal medicines and nutritional supplements are individually prescribed to:
  • Balance hormones, ensure normal menstrual flow and uterine function
  • Decrease constriction of blood vessels and muscular spasm, thereby decreasing pelvic congestion and pain
  • Improve liver function which breaks down and removes excess oestrogen, other hormones and toxins
  • Calm and nourish the nervous system and the adrenal glands to cope with chronic pain and anxiety as well as balance mood swings
  • Regulate bowel habits and decrease constipation as the hormones are removed from the body via the bowels so constipation exacerbates the pain and hormonal imbalance. Anthraquinone laxatives should not be used as they will cause reflex spasm in the organs of the pelvic cavity. Painkillers with codeine will aggravate constipation.

You will be referred to your doctor or GP for extensive blood tests unless these have already been done. Please bring in a copy of any recent test results with you to your consultation.

Claudette provides comprehensive advice regarding lifestyle factors covering exercise, stress management, creativity, personal hygiene products, environmental factors, pain relief packs and referrals to complementary and supportive therapies.

Using the work of Christiane Northrup, author of Women's Bodies Women's Wisdom, and the work of Vianna Stibal, ThetaHealing(R), the emotional connections to period pain are discussed so as to create healthy boundaries in all areas of your life. Claudette's supportive approach makes this journey towards optimum health and balance rewarding and empowering.