Cramps?
While many women are plagued with
menstrual cramps every month, few
understand exactly what causes them, and
this is a problem in and of itself.
“Before you talk about remedies for cramps,
it is important to understand the cause of
them,” says Ramona Fasula, a Certified
Holistic Health Coach and CEO of Wellness
by Ramona. “I believe that understanding
the root cause of the condition is the first
step to fixing it.”
So what is the true cause of menstrual
cramps?
Dr. Kecia Gaither, a Maternal Fetal Medicine
Specialist and Director of Perinatal
Outreach at Montefiore Medical Center and
Albert Einstein College of Medicine in the
Bronx, explains what you might have
forgotten since 5th grade health: “Each
month, the uterine lining builds up in
preparation for pregnancy,” she says. “If no
fertilization occurs, the thickened uterine
lining is no longer required and as such is
shed; this shedding is the menstrual
process.”
Maybe you already knew that. But what you
might not have known is that when this
lining sheds, the uterus contracts to help
release it, and this is where cramps come
in. Simply stated, menstrual cramps are
caused by contractions in the uterus. “If the
uterus contracts too strongly, it can press
against nearby blood vessels and cut off
the supply of oxygen to the muscle tissues
in the uterus,” explains Fasula. “When the
oxygen supply is cut off, pain results.”
But not all women feel the same pain. Some
feel extreme pain, while others barely notice
it. Carina Parikh, MScN, MSiMR, a holistic
nutritionist at Kate Naumes, ND Holistic
Wellness, breaks this pain into two
categories, primary and secondary
menstrual cramps or dysmenorrhea.
“Primary dysmenorrhea represents
menstrual pain that is not associated with
any other conditions, while secondary
dysmenorrhea is a result of another medical
condition, such as endometriosis or
fibroids,” she explains. “Prostaglandin is a
chemical that causes the uterus to contract,
which causes the cramping feeling, so
women with higher levels of prostaglandins
tend to have more menstrual pain.”
So how can you know if you have more
prostaglandins? Usually, this tendency is
linked to one of a number of
factors. According to Gaither, a narrow
cervical opening could make it difficult for
the lining to pass. As Dr. Prudence Hall, a
Santa Monica, California gynecologist and
founder of The Hall Center explains, “A
woman’s cervix needs to open slightly to
allow the blood to pass, and the
contractions (cramps) needed to open the
cervix can be experienced in the same way
as mini labor contractions.”
Increased pain could also be linked to a
number of underlying conditions, including
fibroids, adenomyosis, imbalanced
hormones such as low thyroid, ovarian
cysts, reproductive infections,
endometriosis… all can lead to even more
painful periods. Stephanie Mazzanti, LCPC,
E RYT 200, Mind-Body Therapist at Cancer
Treatment Centers of America at
Midwestern Regional Medical Center,
highlights the importance of speaking to a
doctor if you think your cramps are worse
than usual, in order to rule out any of these
additional problems. “Pelvic ultrasounds
are needed to make a correct diagnosis,”
agrees Hall.
But if your period is extremely painful and
you’re not suffering from an additional
problem, the culprit could be multi-fold.
Khara Lucius, ND, FABNO, Naturopathic
Oncology Provider at Cancer Treatment
Centers of America at Midwestern Regional
Medical Center, says that risk factors for
the more than fifty percent of women who
report severe menstrual cramps include
being under 30, beginning to menstruate
before age 12, a BMI of under 20, and
family predisposition.
But within this group–and even without–
some people are even more at risk for
severe cramps. Tiffany Cruikshank (L.A.c.,
MAOM, RYT) is a health and wellness
expert and the founder of Yoga Medicine,
cites inflammation and low
magnesium, often associated with high
stress, as factors. Dr. Tanya Kormeili, MD,
FAAD, a Clinical Instructor at UCLA, agrees.
“In general, stress is the biggest culprit,”
she says.
Tansy M. Briggs, DOM, L.OM, speaking
from an Integrative Oriental Medicine point
of view, cites “nutritional deficiencies or
excesses” as well as mineral deficiencies as
some of the culprits that lead to
“stagnation,” a term in Eastern medicine
linked to the absence of blood circulation,
which is seen as a root cause for many
health issues, including menstrual cramps.
With this understanding of the core
problems that cause menstrual cramps, we
can much more easily find natural remedies
to cramping.
1. Diet is Key
You likely noticed one common theme
amongst our experts: inflammation,
nutritional deficiencies, and even stress are
all major culprits, and all can all be
affected by diet. And while we know the
first thing you want to do when you get
your period is hunker down with some
chocolate and pizza, the worse you eat, the
worse you’ll feel.
Keep Away from Inflammatory
Foods
“Fats are precursors to some of the
chemicals involved in making the uterus
contract,” explains Gaither. “Therefore,
theoretically decreasing the fat content of
the diet may play a role conversely in
decreasing menstrual pains.”
But not all fats are bad guys. Parikh’s
suggestions of what to eat to keep period
pains at bay include adding more omega-3
fatty acids and vitamin D to your diet,
which can help decrease the levels of
prostaglandins in the system and can be
found in salmon, eggs, and dark leafy
greens.
The fats you’re going to want to avoid are
animal fats, which can cause inflammation.
Fasula explains that the main problem is
the highly inflammatory Standard America
Diet. “It is severely lacking in anti-oxidants
and important nutrients that prevent and
control inflammation, which is the
underlying cause of most diseases.” She
calls for adding anti-inflammatory foods to
your diet, including tomatoes, olive oil,
nuts, fatty fish, berries and citrus.
You might even want to veer even closer to
a plant-based diet to stave off pains.
According to Gaither, “Some small studies
have looked at implementing vegan or
plant-based diets and have noted that those
women employing these diet changes
experienced decreased volume of menstrual
flow and the pain that goes along with
it.” Lucius agrees, citing research linking a
low-fat, vegetarian diet to reduced
menstrual cramps.
And you’ll also want to keep certain things
off the menu, including sugar. According
to Susi Roos, RN, MDiv, Mind-Body
Therapist at Cancer Treatment Centers of
America at Midwestern Regional Medical
Center, sugar is a source of chronic
inflammation in the body and can therefore
lead to more painful cramps.
Up Your Intake of Useful
Minerals and Vitamins
“Magnesium is a key nutrient for preventing
water retention, which is known to
contribute to menstrual pain, so eating
foods such as bananas, pumpkin seeds, and
dark leafy greens can also help with this,”
explains Parikh. And Christina Major, a MS
Holistic Nutritionist and Herbalist and the
Health Recovery Expert of Crystal Holistic
Health says that foods rich in both
magnesium and vitamin A are even better.
She suggests planning plant-based meals
with magnesium-rich green, leafy
vegetables, and vitamin A-rich yellow and
orange vegetables. And Hall reminds us
that chocolate is also high in magnesium,
so you have a good excuse to indulge in
your square or two of dark chocolate during
your period.
But, that’s not all.
“Brassica vegetables, such as broccoli,
cabbage, kale, cauliflower and Brussels
sprouts contain carbon-3-inositol, which
helps regulate estrogen activity and can
ease bloating and menstrual discomfort,”
says Parikh.
Alexandria Callahan, MA, LPC, R-DMT,
GLCMA, Mind-Body Therapist at Cancer
Treatment Centers of America at
Midwestern Regional Medical Center
suggests “foods with a bit of spice,” which
she says “can assist in warming the
abdominal area to ease cramp discomfort,”
though she notes that some spicy foods can
cause indigestion, which can make the
problem worse, so proceed with caution.
New York Naturopath Dr. Serena Goldstein,
ND also suggests seed cycling as an
option. She recommends alternating ground
flax, chia or pumpkin seeds and sesame or
sunflower seeds throughout your cycle: in
the first half of the cycle, combine 1-2
tablespoons of ground flax, chia or pumpkin
seeds with a tablespoon of quality fish oil;
in the second half of the cycle, combine 1-2
tablespoons of ground sesame or sunflower
seeds with 1-2 grams of evening primrose
oil. “Each set of seeds promotes the proper
hormones that are prevalent throughout the
cycle, and provide the fiber and nutrients
needed to also help the body metabolize
hormones,” she says. In finding this
balance, you may be able to reduce
cramping.
What to Avoid
As for what to avoid, the answer may sound
simple, and yet for many, it’s a shocker:
sugar, processed foods, and anything with
preservatives can all make cramping worse,
no matter how convinced you are that
greasy fries or a sugary candy bar will help.
Lucius cites a study where certain bad
dietary habits like skipping breakfast,
eating more fast food or processed foods
were linked to increased cramping, and
Parikh highlights the importance of
avoiding salty foods, which can increase
water retention and thus menstrual pain.
Parikh also warns against any foods that
contain a higher ratio of omega-6 fatty
acids as compared to omega-3s, such as
vegetable oils, corn, soybean oil, or
margarine.
The jury’s still out on caffeine, though some
experts say to avoid it. Parikh explains that
“the caffeine can promote water retention
and disrupt your digestive system even
more. The same goes for alcohol.” Lori
Kenyon Farley, a Certified Nutrition
Consultant specializing in wellness, fitness
and anti-aging and one of the experts
behind ProjectJuice.com, agrees. “It causes
blood vessels to constrict, which can cause
increased cramping,” she says. “If you are
prone to cramping, avoid coffee for a week
prior to your period for best results.”
And when you’re avoiding animal fats, don’t
forget about dairy. Accoridng to Parikh,
“Dairy products contain arachadonic acid,
which is a substance in your body that is
converted into prostaglandins.” And as you
know by now, prostaglandins are a big no-
no if you don’t want pain during your
period.
2. Take your Multi-vitamin
We know remembering to take your one-a-
day can be a tough task, but come period
time you’ll want to be religious about it –
and you may want to add a few more to the
mix.
Cruikshank highlights a few important
vitamins to be taking, including magnesium
and B vitamins. “You need to take them
daily to see the results,” she says.
Both can of course be integrated via your
diet, but Cruikshank says she usually
recommends vitamin B supplements as
well. “For the oils, the amount that is
needed to influence this is usually easier to
take in a pill form,” she says. “But hemp oil
or fish or fish oil can also be a good source
for good fats as well as trying to decrease
bad fats.”
Fasula suggests upping your intake of
brown rice during your period, as it
contains B6 and may prevent bloating, as
will zinc and calcium.
3. Do Some Light Exercise
You’re bloated, in pain and just want to veg
out… but a bit of exercise may help solve
your pain problem.
According to Farley, aerobic exercise
provide natural pain relief. “The increased
blood flow and the endorphins help
counteract the prostaglandins and reduce
cramping.” Gaither even compares these
endorphins to a “natural morphine.”
But Parikh concedes that exercise can seem
impossible when you’re feeling a great deal
of pain, and she therefore suggests low
impact activities like walking or yoga, which
“are still great for helping fight menstrual
pain and are easier to do when you are
feeling unwell.”
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