Herbal Treatments for Period Pain

Period pain (also known as dysmenorrhoea, menstral pain or menstrual cramps) affects up to 50% of menstruating women. For one in five of these women, the pain is severe enough to interfere with the ability to function normally for one to three days of each month.

Primary dysmenorrhea (functional dysmenorrhea) is caused by uterine contractions that are too strong and which occur too frequently. Between contractions the uterine muscle does not relax properly and there is unusually high "resting tone". The end-effect is a reduction in the amount of blood flowing through the uterine muscle and this is responsible for the painful periods. Most women with primary dysmenorrhea describe the pain as continual, dull, background aches or a sense of heaviness. This is accompanied by cramping pain. The pain is usually central and located in the lower abdomen. The pain usually commences at the beginning of the period and intensifies as the flow becomes heavier.

Secondary dysmenorrhoea occurs when period pain is caused by another complaint, usually endometriosis or pelvic inflammatory disease (PID).

Herbs that Regulate the Muscular Activity of the Uterus

False Unicorn (Chamaelirium luteum), Blue Cohosh (Caulophyllum thalictroides), Dong Quai (Angelica senensis) and Raspberry Leaf (Rubus idaeus) may be helpful for treating period pain. These herbs are believed to regulate the muscular activity of the uterus and to help to initiate contractions of the uterus that are regular, rhythmic and more orderly.

Anti-Spasmodic Herbs

Cramp Bark (Viburnum opulus), Blue Cohosh (Caulophyllum thalictroides), Mexican Wild Yam (Dioscorea villosa), and Peony Root (Paeonia lactiflora) help to alleviate period pain that is crampy and which comes in intermittent waves of pain. They are also useful for the vomiting and diarrhoea that sometimes accompanies period pain. These herbs are more effective when taken to stop the onset of spasms, rather than to treat pain that has already started and should be taken several days before the onset of the period. Blue cohosh is most appropriate when the spasms are localized in the cervix, resulting in acute crampy pain with very little flow of blood.

Herbs that Increase the Strength of Uterine Contractions

Mugwort (Artemisia vulgaris) can increase the strength of contractions of the uterus. It helps to increase the expulsive activity of the uterus and to start the menstrual flow. It is particularly useful for period pain that is dull and congestive and which occurs in conjunction with periods that are slow to commence.

Relaxing Herbs (Nervines>

Valerian (Valeriana officinalis), Peony Root (Paeonia lactiflora), Blue Vervain (Verbena officinalis) and German Chamomile (Matricaria recutita) are all useful for treating the anxiety and tension that often accompanies period pain.

Herbs that Regulate Prostaglandins

The usual cause of primary dysmenorrhoea is elevated production of short-acting fatty acid hormones named leukotrienes and prostaglandins. These leukotrienes are highly inflammatory compounds that produce the pain and increased blood clotting that occurs in dysmenorrhea. The prostaglandins and leukotrienes that are produced in excess in women with period pain are derived from polyunsaturated fatty acids in the diet.

A number of herbs have been demonstrated to reduce the production of the prostaglandins and leukotrienes that are implicated in period pain. These herbs include ginger (Zingiber officinale) and capsicum (Capsicum annum).

Herbs that Regulate Hormones

Herbs that regulate hormone levels can alleviate period pain in some cases. Regulating hormone levels is believed to exert an indirect effect on the prostaglandins and leukotrienes that are implicated in period pain. The most valuable of these hormone regulators is chaste berry (Vitex agnus-castus). It is most useful for period pain that occurs in conjunction with premenstrual syndrome (PMS). Black cohosh (Cimicifuga racemosa) helps to regulate oestrogens levels and mimics the function of the "good" oestrogen named oestriol.

Bilberry

Bilberry is an effective anti-inflammatory that has been demonstrated to reduce the symptoms of dysmenorrhoea.

In a double-blind, placebo-controlled study, thirty women with long-standing primary dysmenorrhea were treated with bilberry extract for three days before and during menstruation. Bilberry significantly reduced symptoms such as pelvic and lumbosacral pain, mammary tension, headache, nausea, and heaviness of lower limbs.

The Take-Home Message

A suggested strategy for women wishing to use herbal treatment to alleviate period pain could include the following readily-available herbs:

• Ginger (Zingiber officinale): 1,000 - 4,000 mg per day. It reduces the over-production of toxic prostaglandins and leukotrienes that are a principal feature of period pain.
• Chaste berry (Vitex agnus-castus): dosage varies according to the product used. It helps to regulate the hormones that are involved in period pain.
• Black cohosh (Cimicifuga racemosa): 1.5 - 6.0 ml per day. It helps to regulate the hormones that are involved in period pain.
• Bilberry (Vaccinium myrtillus): 460 mg per day of a product containing 25% anthocyanidins. This is one of the few herbs that has been demonstrated in clinical studies to lessen period pain.
• False unicorn (Chamaelirium luteum): 6 - 15 ml per day. It regulates the muscular activity of the uterus.
• Dong quai (Angelica senensis): 1 - 4 ml per day. It regulates the muscular activity of the uterus and helps to initiate contractions of the uterus.
• Raspberry leaf (Rubus idaeus): 1.5 - 6.0 ml per day. It regulates the muscular activity of the uterus.
• Cramp bark (Viburnum opulus): 3- 12 ml per day. It alleviates the spasms and cramps of period pain.
• Mexican wild yam (Dioscorea villosa): 1,500 - 6,000 mg per day (or 1.5 - 6.0 ml per day of fluid extract). It alleviates the spasms and cramps of period pain.
• Mugwort (Artemisia vulgaris): 1.5 - 6.0 ml per day. It increases the strength of contractions of the uterus.
• Valerian (Valeriana officinalis): 750 - 3,000 mg per day. It reduces the pain, anxiety and tension of dysmenorrhoea.