Many women experience painful cramps with their period every month. Despite being very common, intense pain during periods is not actually “normal”. It is absolutely normal to have some kind of sensation with your period. Typically some discomfort in your lower abdomen or pelvis, and in your low back. This commonly starts the day before your period, and may last a day or two. But, oftentimes women experience moderate to severe levels of pain, which can cause them to miss work, school, or other regular activities. On top of that, your monthly cycle may bring other symptoms like bloating, diarrhea, nausea, vomiting, headaches, dizziness, backache, leg pain, among others . Why does this happen? What is it that makes that time of the month so painful? Let’s find out.
With every cycle, your uterus is preparing for the possibility of pregnancy. If an egg is not fertilized, the inner lining of the uterus (called the endometrium) starts to break down in order to be expelled. Your body uses inflammation and signalling molecules, such as prostaglandins, to facilitate this process . This will stimulate the uterus, which is a muscle, to contract and expel the lining. This is where the pain usually happens.
Period cramps, medically called dysmenorrhea, are classified into two causes: primary or secondary. Secondary dysmenorrhea means secondary to a disorder in the reproductive system, like endometriosis, adenomyosis, fibroids, pelvic inflammatory disease, among others . Primary dysmenorrhea means it is pain caused by the menstruation process itself, and is generally attributed to an overabundance of prostaglandins and inflammatory mediators . Prostaglandins are small hormone-like molecules that are made of arachidonic acid, a polyunsaturated acid from the omega-6 family . In the uterus, prostaglandins are responsible for a narrowing of the blood vessels to the endometrium and for stimulating the uterus to contract . This is important to allow the shedding and expulsion of the endometrium. However, an overload of prostaglandins can cause excess narrowing of blood vessels that supply the uterus muscle itself, causing a decrease in oxygen to the muscle and creating pain . Additionally, the higher the levels of prostaglandins, the more uterine contractions that occur, which can cause an abnormal amount of uterine contractions.  And to top it all off, prostaglandins are also suggested to play a role in the onset of the additional symptoms noted above .
That being said, it’s important to remember that prostaglandins play a pivotal role in the entire process of menstruation. Though they are needed to facilitate this process, a surplus can cause undesirable symptoms.
Prostaglandins are an essential part of the inflammatory response . Our bodies use inflammation regularly as a tool to help repair tissues, fight infections, and regulate normal body processes like menstruation . Once this process has reached its goal, the inflammation subsides. However, if the body is not able to successfully repair/fight/regulate the targeted area, the inflammatory process will continue in order to allow it to do so . The presence of inflamed tissues signals the body to create more prostaglandins, which will continue to perpetuate the inflammatory process. If this carries on for a long period, it can become chronic inflammation . In light of this pathway, it is possible that underlying inflammation in the body can contribute to an overabundance of prostaglandins seen in painful periods. However, a lifetime of chronic inflammation can lead to several diseases such as heart disease, diabetes, rheumatoid arthritis, and even cancer .
Several aspects of everyday living can contribute to inflammation, including infections, chronic illness, autoimmune conditions, nutrition, lifestyle, environmental irritants, among many others. Addressing the causes of inflammation, and adding to your body’s own anti-inflammatory pathways can be beneficial to prevent long-term impacts. Having good nutrition to provide vitamin and minerals, and anti-inflammatory nutrients and like omega 3 fatty acids are all good places to start. Ensuring adequate sleep, exercise, and managing stress can always help.
Your period is an important part of your overall health, and can be a source of information of how your body is doing. Pain is one of the ways our bodies communicate with us, telling us that something is going on. It’s important to find out what is causing yours and how to support your unique body through it. So talk to your doctor, or naturopathic doctor, for a plan for your period cramps.