Your Period Shouldn't Be Painful
CRAMPS!!! They’re the worst, am I right?
What’s unfortunate is that at least HALF of you out there are nodding in agreement, suffering through painful periods yourselves, every month. Some studies suggest that between 5 and 20% of women experience periods so painful that they interfere with daily life—missing school, calling out from work, or skipping social activities. Painful periods may be common, but they aren’t normal, and even severe dysmenorrhea is both preventable and treatable in the vast majority of cases. Periods shouldn’t be painful. Period.
Where do cramps come from? Your uterine lining builds up every month in anticipation of a fertilized egg looking to snuggle up and implant. Once your body determines you are not pregnant this time around, it gets to work expelling that lining—out with the old, in with the new. Cramps are caused by contractions of your uterus—a muscle—in its effort to clean house. After your period, the cycle starts all over again, with your body building up a fresh lining to welcome next month’s potential embryo.
Now, I’ve said that cramping isn’t normal and I stand by that statement, but your uterus is a muscle and it is contracting during your period. This is normal. You may experience a sensation associated with those contractions during the first few days of your cycle, but it should not be painful, and it certainly shouldn’t interfere with your life.
If a woman comes to see me and reports mild cramping for a day or so that responds well to conservative measures like a heating pad or a few ibuprofen, do I worry? No. Could she be totally symptom-free? Most likely. Must she be totally symptom-free to consider herself healthy and balanced? Not necessarily. A practitioner of Chinese medicine will take mild cramping under consideration as we assess the rest of the woman’s physical, mental, and emotional make-up.
On the other hand, if a woman comes to me and reports her cramps are bad enough to regularly miss school or work, this is a problem that needs to be addressed. Even if you’ve had bad cramps since you first started menstruating, even if this is “normal” for you, even if you’ve been evaluated and your Western doc say there is nothing medically wrong and/or there’s nothing they can do about it, cramps like this are not normal and always call for further scrutiny. If your moderate to severe period pain is new, or is worsening, or is changing over time, this definitely merits investigation. Painful menstrual cramps are a sign of a system in distress. While the particular distress signal of dysmenorrhea only has the opportunity to show itself strongly once a month through the rhythm of your cycle, the underlying issue is in fact present all of the time—and it may be responsible for other symptoms that you’ve been ignoring, or thinking are no big deal or completely unrelated.
TYPES OF DYSMENORRHEA
Dysmenorrhea is often split in to two types: primary and secondary.
Primary dysmenorrhea is a painful period that’s not linked to any particular gynecological “disorder”—no endometriosis, no fibroids, no discernible masses, no signs pointing to any other identifiable cause via western diagnostic tests. In these instances most women are told to simply endure, that this is normal and they need to accept that they will likely have painful periods throughout their lives. Chinese medicine thinks this approach is bonkers.
Secondary dysmenorrhea is painful menstruation that we can link to a more tangible “cause.” In other words, the pain is considered “secondary” to an underlying, identifiable gynecological issue. These include endometriosis, adenomyosis, fibroids, sexually transmitted infections (STIs) or pelvic inflammatory disease (PID), adhesions, ovarian cysts, IUD birth control, miscarriage
WHAT TO DO ABOUT IT?
It’s always good to check with your primary care provider so you know, from a western perspective, what may (and may not) be contributing to your painful periods. Chinese medicine understands that there are many possible imbalances that can lead to painful cycles; after a thorough intake we should be able to match your symptoms to a particular pattern of disharmony, and then treat that disharmony with the appropriate acupuncture and herbs.
There may be times when drugs or surgery are the best avenues to pursue. That said, if you can safely postpone drugs or surgery and are interested in an approach that may resolve your dysmenorrhea on a deeper level, Chinese medicine has extraordinary tools to balance your cycle, your hormones, and your body, regardless of the “cause” of your dysmenorrhea.
SELF CARE FOR DYSMENORRHEA
Moderate to severe dysmenorrhea will likely require the aid of a trained provider, particularly if your symptoms stem from something on the “secondary dysmenorrhea” list. Mild to moderate symptoms, however, may be well managed by diet and lifestyle interventions, alone. For many women, getting back to the basics of sleep, nutrition, exercise, mindfulness, hydration, and play goes a long way.
Get regular sleep. Sleep is when your body can finally take care of itself, unencumbered by the daily demands you place upon it during your waking hours. Honor your body by honoring that time. Treat your bedtime like an appointment you wouldn’t dare miss. Keep consistent sleep and wake times whenever possible to support hormone regulation and regulation of all the other systems in your body.
Optimize your digestion. Your food can only nourish you if your body is properly absorbing it. If digestive distress is a chronic struggle, seek out professional help. Acupuncture and Chinese medicine can be enormously beneficial; other modalities have their own, sometimes more appropriate interventions. Interview providers and find a good fit.
Eat real food. Every day we’re bombarded with some new health craze around food. Bottom line, in the words of the brilliant food journalist Michael Pollan: Eat. Real. Food. Sounds simple, right? But it’s far less common than you think—and not always easy. Eat quality food. Eat a wide range of of seasonal and organic foods. Limit processed foods, snack foods, refined sugar, alcohol and coffee, and increase your fiber intake. We can *all* benefit from this advice, but it’s particularly important if you suffer from hormone imbalance. If you’d like to go deeper, a skilled practitioner of Chinese medicine will have dietary suggestions specific to you and the support your individual system needs.
More specifics on what to curb:
Quit the caffeine: I know! I also love a good cup of coffee in the morning, but caffeine constricts blood vessels—including those supplying blood to the uterus. This makes it a no-go if you’re trying to resolve your cramps. At least consider reducing your caffeine intake during the second half of your cycle.
Avoid the alcohol: Coffee AND alcohol?! I know!! We know alcohol inhibits hormone regulation—the opposite of what we’re aiming for. If you’re serious about managing your cramps on your own, skip it, at least during the second half of your cycle.
Red meat and dairy: To be clear, red meat and dairy are not inherently bad. Assuming the meat and milk are from pastured, organic cows, there are some folks for whom one or both can be absolute positive game-changers in terms of their health—not so much if you’re prone to cramps. Red meat and milk contain a substance known as arachidonic acid that stimulates prostaglandins and intensifies cramps. If you’re craving iron pre-menstrually (or menstrually), and prone to cramping, better to reach for plant-based sources like chickpeas, beans, and lentils.
Move your body in a joyful way: The endorphin release and increased oxygenation to the uterus that comes with exercise will help relieve your cramps. Walk, run, stretch, breathe, lift, dance, laugh, love. Your body was meant to be fully inhabited. Find a way to move it that lights you up and makes you smile. Repeat often.
Reduce stress: Stress creates constriction in the body, which interferes with circulation, which creates stagnation, which contributes to menstrual pain. Stress-management and stress-relief should be a lifelong pursuit. It will help with your dysmenorrhea—and with your everything else.
Practice mindfulness: We hear this all the time, but what does it mean? Incorporating mindfulness into your daily life doesn’t have to be a huge (stressful) undertaking. Do you brush your teeth every day? Drive your car every day? Wash your dishes every day? Turn on your computer every day? Make a habit of punctuating the start of any recurring event with a moment of attention. All you need is a pause and a slow deep breath. Be still. Notice that you are doing what you’re doing. We throw our attention mindlessly out into the world all day, every day. Start to pepper your day with brief moments of drawing that attention back into your body, back in to the right now. If you’re unsure of where to start, start there.
IN CONCLUSION
The good news is in alleviating your dysmenorrhea we are also course-correcting your body, more generally. Why should you care? The more optimally your body is functioning in any given moment, the more likely it is that we’ve staved off larger health issues that might have otherwise accumulated over time. Try some of these recommendations, find a team of practitioners to help support you in health journey, free up the energy currently bound up in managing your menstrual pain, and get out there and live your best life.
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