On April 13, 2016, former First Lady Michelle Obama tweeted, “Why are girls still missing so many days of school because of their menstrual cycles?” Although she was referring to school-age girls, over 84% of women report menstrual pain sometime during their lifetime with over 40% reporting pain monthly (Grandi, 2012).
Like clockwork, most humans with a uterus experience what we call a “period” for three to seven days each month. This cyclic shedding of the lining of the uterus is a sensitive time that accompanies a number of changes to the female body. Although these symptoms differ per woman, the most reported is menstrual pain.
This pain can range from mild cramps to debilitating agony that can interfere with school, work and other activities.
Gynecologists describe menstrual pain as dysmenorrhea. Dysmenorrhea is classified into primary and secondary causes. Primary dysmenorrhea is cramping pain in the lower abdomen in the absence of identified conditions such as uterine fibroids or endometriosis.
Secondary dysmenorrhea is present when these disease processes are the primary causative factor for the cyclical pain. Regardless of the etiology of the pain, the traditional treatments for dysmenorrhea include non-steroidal anti inflammatory drugs (NSAIDs).
These are initial choice as they directly inhibit prostaglandin synthesis. Prostaglandins play a major role in uterine muscle contraction that results in period pain. Blocking these compounds should result in pain relief.
Based on current evidence, however, approximately 18% of menstruators do not respond to NSAID therapy (Oladosu, 2018). In addition, some people including those with peptic ulcer disease, uncontrolled hypertension, kidney disease, Crohn’s disease, Ulcerative Colitis and history of bariatric surgery among other conditions cannot tolerate NSAIDs.
These people and their providers must seek alternative solutions for the management of dysmenorrhea.
A small number of studies have investigated herbal supplements such German chamomile, cinnamon, Damask rose, dill, fennel, fenugreek, ginger, guava, rhubarb, uzara, valerian and zataria as alternative methods of cramp support. In addition, some non-herbal supplements including fish oil, melatonin, vitamins B1 and E and zinc sulfate have also been investigated. Most studies were limited in their applicable results as they had poor sample sizes or were of low quality. However almost no studies reported adverse effects. In addition, some studies, such as those for ginger, fenugreek, and vitamin B1, did show similar efficacy to NSAIDs.
Although much more research is warranted in the effectiveness of dietary supplementation for the primary management of dysmenorrhea, there are some promising products that provide a viable alternative for period cramp relief. Cramp Aid™ by De Lune is a research-backed product that combines a number of the aforementioned herbs and supplements in convenient vegan, gluten-free, non-GMO liquid capsules.
Using Cramp Aid in anticipation of menstruating can prevent a period cramp crisis while being gentle on the stomach.
While there may still be school-age girls and working people who miss school and work due to their menstrual cycles, products like De Lune Cramp Aid™ are an affordable, over-the-counter option.
About Dr. Arumala
As an Obstetrician-Gynecologist with a practice in Mansfield, Texas, Dr. Ruth Arumala provides evidence-based medical care to women of all ages at all aspects of their lives. Dr. Arumala specializes in the medical and surgical management of fibroids, PCOS, sexual dysfunction, pregnancy and menopause. In addition to private practice, Dr. Arumala serves on the executive board of Texas Health Mansfield, and as an Assistant Professor in Ob/Gyn at TCU-UNTHSC medical school in Fort Worth, TX.
Dr. Arumala has won several awards that demonstrate her exceptional clinical skills and service to her community. These include 2020 National Minority Quality Forum’s 40 Under 40 Leaders in Minority Health, 2020 Patient Preferred OBGYN/Menopause Specialist, 2020 Fort Worth Magazine “Top Docs” Tarrant County, Ob-Gyn, 2020 Texas Super Doctors Rising Stars, and 2020 Women in Medicine’s “Top ObGyn” Fort Worth.
Learn more about Dr. Arumala’s work:
Podcast: Pretty In Pink
YouTube: Medicine & Motivation with Dr. Arumala
Grandi G, Ferrari S, Xholli A, et al. Prevalence of menstrual pain in young women: what is dysmenorrhea?. J Pain Res. 2012;5:169-174. doi:10.2147/JPR.S30602
Oladosu FA, Tu FF, Hellman KM. Nonsteroidal antiinflammatory drug resistance in dysmenorrhea: epidemiology, causes, and treatment. Am J Obstet Gynecol. 2018;218(4):390-400. doi:10.1016/j.ajog.2017.08.108