How Dong Quai Can Treat Dysmenorrhea & Painful Period Cramps

dong-quai-period-pain-cramps

What is Dysmenorrhea?

Dysmenorrhea is the clinical term for period pain. It’s a common—and often debilitating—gynecological condition that affects between 45% and 95% of menstruating women.1 Despite its high prevalence, dysmenorrhea is often poorly treated, and even disregarded, by health professionals and pain researchers.

While many menstruating women accept pain as a normal part of the cycle, it doesn’t have to be that way. Dysmenorrhea is treatable, and women have options for managing their pain. This article describes how herbs like dong quai offer a natural solution for reducing period cramps.  

Can Herbs Treat Painful Period Symptoms?

Currently, the most common pharmacological treatment for dysmenorrhea is non-steroidal anti-inflammatory drugs (NSAIDs) like Advil, aspirin, and Ibuprofen.2,3 Globally, NSAIDs are among the most frequently prescribed group of drugs.4,5,6

For the most part, NSAIDs do a good job at treating dysmenorrhea. It’s estimated they relieve period pain in about 80% of women.7 While effective, NSAIDs come with side effects. These include stomach pain, constipation, diarrhea, gas, heartburn, nausea, vomiting, and dizziness, though more serious side effects are possible.8

About 15% of women who suffer from dysmenorrhea do not respond to, or are intolerant to, drugs like NSAIDs. In these women, oral contraceptives (i.e. birth control) are often used as a second-line therapy.9 While these drugs can also be effective at reducing period pain, a large study confirmed the long-suspected linkage between oral contraceptive use and the risk of venous thromboembolismblood clots in deep, important veins.10

While NSAIDs have only been around for the last 100 years or so, various traditional Chinese medicines have been supporting health for centuries. The tradition is still alive today; approximately 60% of the world’s population is dependent almost entirely on plants as medication for all health problems,11 including menstrual disorders.12

Because plant compounds are known to be effective, many modern pharmaceutical drugs have an ancient herbal basis. When taken responsibly, herbs offer a natural alternative to pharmaceuticals with a lower risk of side effects.

dong-quai-menstruation-dysmenorrhea

Dong Quai History & Background

Also knows as tang-kuei, dang-gui, or Chinese angelica, dong quai a widely respected herb that’s been used throughout Asia for at least 2,000 years.13 It belongs to the Apiaceae family, which is closely related to parsley. It’s common, fragrant, and grows on the mainland of China, Korea, and Japan. It has a strong scent between that of celery and licorice. It tastes bittersweet and spicy, and has a warming affect on the body.14

Dong quai is said to appear more frequently in Traditional Chinese Medicine (TCM) prescriptions than any other herb. Its Chinese name, dang quei, literally means “state of return,” referring to its restorative powers.14

Most herbalists regard dong quai as the wonder herb for the female system. In Asia, dong quai is to women’s health what ginseng is to men’s. It’s a multi-purpose female remedy used in TCM to treat menstrual cramps, lack of menstruation, frequent menstruation, menopausal hot flashes, and balancing female reproductive processes.15,16,17

Most of the medicinal oils are found in dong quai’s roots. In fact, contemporary Chinese theories of TCM claim that different parts of the root are responsible for different effects: the head of the root stops bleeding, the middle of the root regulates blood and alleviates pain, and the tail portion eliminates blood stasis.14

Dong quai was first introduced into Western medicine in 1899. It was sold in liquid and tablet forms as a product called Eumenol, which was recommended in the treatment of menstrual disorders.14 Today, dong quai is regulated as a food supplement in the USA, but is classified as a medicine in Japan.18

dong-quai-period-cramps

How Dong Quai Alleviates Dysmenorrhea & Period Pain 

To appreciate why dong quai is helpful for dysmenorrhea, it’s helpful to understand what’s going on in the uterus during menstruation.

Throughout the month, the lining of the uterus grows a thick mucous membrane to prepare for the possibility that an egg might be fertilized and nestle in. Blood vessels grow throughout the mucous membrane to nourish a potential embryo with blood and nutrients.

At the end of the cycle, if a fertilized egg hasn’t settle in, the uterus ditches its mucous membrane. The uterus’s powerful muscles rhythmically contract and relax, which detaches the membrane from the uterine wall. Some of the blood vessels in the membrane open up, which leaks blood into the uterus and produces a period.19

In traditional herbal medicine, the tone of the uterine muscles matters. Recall that the uterus is a mostly-muscular organ capable of serious contractions (case in point: childbirth). For the easiest menstrual flow, it’s important that the uterus be adaptable—it must relax and contract at the right moments to shed its mucous membrane in the least painful way possible.

If the uterus is hypotonic (i.e. too limp and languid), the woman may experience heavy bleeding. If the uterus is hypertonic (i.e. too stiff and rigid), it may be difficult to begin menstruating on time. In either case, improving the uterine tone tends to normalize and regulate menstruation.16

Research shows that women with dysmenorrhea have higher levels of overall uterine activity compared to women without period pain. Resting uterine tone, intrauterine pressure, and frequency of uterine contractions are all increased in women with dysmenorrhea.20,7

Research also shows that these strong uterine contractions are associated with lack of blood flow to the uterus. Because blood delivers oxygen, cutting off blood flow starves the uterus of the oxygen it needs to function properly, resulting in painful cramps.21

Dong quai seems to help manage dysmenorrhea by regulating uterine contractions. It exhibits the unique ability to cause an initial increase in uterine contractions, followed by relaxation.22 Some uterine contractions are necessary to effectively shed the mucous membrane, yet relaxation is important for maintaining a healthy blood flow to the uterus.

Because dong quai regulates the uterus’s muscular rhythms, it improves the timing of the menstrual cycle.23,16 This explains why dong quai has been used for thousands of years to treat periods that come too frequently, as well as those that don’t come frequently enough.

While there are several herbs that regulate uterine tone, dong quai is one the most potent. The unique mix of volatile oils found in dong quai’s roots block the action of epinephrine and histamine—compounds that regulate muscle contraction—causing the uterus to relax.14

Researchers also think that ferulic acid—the major organic acid in dong quai—lends some powerful health benefits.24 Ferulic acid is an antioxidant and anti-inflammatory agent that possesses antimicrobial, anti-carcinogenic, and anti-hyperlipidemic properties.25,26,27,28,29 Ferulic acid is also a potent anticoagulant, thus improving blood flow. In traditional Chinese medicine, this process prevents a condition called “stagnant blood”.30,16

Why De Lune?

Thousands of years of ancient wisdom tells us that dong quai is effective at relieving period pain. However, conditions like dysmenorrhea are often best treated through multiple modes of action. Relying on just one method of treatment, such as dong quai, may not be enough to eliminate period pain in some women.

Instead, a multifaceted supplement, such as De Lune, may be most effective at treating dysmenorrhea. De Lune combines a variety of powerhouse herbs and nutrients that have been shown to reduce period pain and improve PMS symptoms, including organic dong quai.

References

1. Proctor, M., & Farquhar, C. (2006). Diagnosis and management of dysmenorrhoea. BMJ: British Medical Journal, 332(7550), 1134.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459624

2. Harel, Z. (2006). Dysmenorrhea in adolescents and young adults: etiology and management. Journal of pediatric and adolescent gynecology, 19(6), 363-371.
http://www.jpagonline.org/article/S1083-3188(06)00241-5/abstract

3. Zahradnik, H. P., Hanjalic-Beck, A., & Groth, K. (2010). Nonsteroidal anti-inflammatory drugs and hormonal contraceptives for pain relief from dysmenorrhea: a review. Contraception, 81(3), 185-196.
http://www.contraceptionjournal.org/article/S0010-7824(09)00445-4/abstract

4. Frölich, J. C. (1997). A classification of NSAIDs according to the relative inhibition of cyclooxygenase isoenzymes. Trends in Pharmacological Sciences, 18(1), 30-34.
https://www.sciencedirect.com/science/article/pii/S0165614796010176

5. Warner, T. D., Giuliano, F., Vojnovic, I., Bukasa, A., Mitchell, J. A., & Vane, J. R. (1999). Nonsteroid drug selectivities for cyclo-oxygenase-1 rather than cyclo-oxygenase-2 are associated with human gastrointestinal toxicity: a full in vitro analysis. Proceedings of the National Academy of Sciences, 96(13), 7563-7568.
http://www.pnas.org/content/96/13/7563.short

6. Bianchi M. Are all NSAIDs other than ‘coxibs’ really equal? Trends Pharmacol Sci 2004; 25:6 – 7.


7. Dawood, M. Y. (2006). Primary dysmenorrhea: advances in pathogenesis and management. Obstetrics & Gynecology, 108(2), 428-441.
https://journals.lww.com/greenjournal/Abstract/2006/08000/Primary_Dysmenorrhea__Advances_in_Pathogenesis_and.29.aspx

8. https://www.fda.gov/downloads/Drugs/DrugSafety/ucm089162.pdf

9. Iacovides, S., Avidon, I., & Baker, F. C. (2015). What we know about primary dysmenorrhea today: a critical review. Human reproduction update, 21(6), 762-778.
https://academic.oup.com/humupd/article/21/6/762/628858

10. Manzoli, L., De Vito, C., Marzuillo, C., Boccia, A., & Villari, P. (2012). Oral contraceptives and venous thromboembolism. Drug safety, 35(3), 191-205.
https://link.springer.com/article/10.2165/11598050-000000000-00000

11. Al-dalain, S., El-kutry, M. S., & Ibrahim, H. S. (2008). Inhibitory effect of aqueous extracts of barley and fenugreek on ulcer induction in rats. World Appl Sci J, 5(3), 332-9.
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.388.6751&rep=rep1&type=pdf

12. Yassin, S. A. (2012). Herbal remedy used by rural adolescent girls with menstrual disorders. J Am Sci, 8(1), 467-73.
http://www.jofamericanscience.org/journals/am-sci/am0801/065_7998am0801_467_473.pdf

13. Hirata, J. D., Swiersz, L. M., Zell, B., Small, R., & Ettinger, B. (1997). Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial. Fertility and sterility, 68(6), 981-986.
https://journals.lww.com/obgynsurvey/Citation/1998/05000/Does_Dong_Quai_Have_Estrogenic_Effects_in.21.aspx

14. McKenna, D. J., Jones, K., & Hughes, K. (2002). Botanical medicines: the desk reference for major herbal supplements. Psychology Press.
https://books.google.com/books?hl=en&lr=&id=XYFMOzKsQr0C&oi=fnd&pg=PR9&dq=Botanical+Medicines:+McKenna,+D.+J.,+Jones,+K.,+%26+Hughes,+K.+(2002).+Botanical+medicines:+the+desk+reference+for+major+herbal+supplements.+Psychology+Press.&ots=efkt1bXpjf&sig=lyhvwEhEf-0wLizaksTz_aYyfQE#v=onepage&q&f=false

15. Page, R. L., & Lawrence, J. D. (1999). Potentiation of warfarin by dong quai. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 19(7), 870-876.
https://onlinelibrary.wiley.com/doi/abs/10.1592/phco.19.10.870.31558

16. Hudson, Tori. Women's Encyclopedia of Natural Medicine: Alternative Therapies and Integrative Medicine for Total Health and Wellness (Kindle Locations 12132-12133). McGraw-Hill Education. Kindle Edition.
https://www.amazon.com/Womens-Encyclopedia-Natural-Medicine-Alternative/dp/0071464735

17. https://www.webmd.com/vitamins-supplements/ingredientmono-936 dong%20quai.aspx?activeingredientid=936&activeingredientname=dong%20quai

18. Suzuki, N. (2004). Complementary and alternative medicine: a Japanese perspective. Evidence-Based Complementary and Alternative Medicine, 1(2), 113-118.

19. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072454/#i562.s2

20. Åkerlund, M. (1979). Pathophysiology of dysmenorrhea. Acta Obstetricia et Gynecologica Scandinavica, 58(S87), 27-32.
https://obgyn.onlinelibrary.wiley.com/doi/abs/10.3109/00016347909157786

21. Altunyurt, S., Göl, M., Sezer, O., & Demir, N. (2005). Primary dysmenorrhea and uterine blood flow: a color Doppler study. The Journal of reproductive medicine, 50(4), 251-255.
http://europepmc.org/abstract/med/15916208

22. HARADA, M., SUZUKI, M., & OZAKI, Y. (1984). Effect of Japanese Angelica root and peony root on uterine contraction in the rabbit in situ. Journal of pharmacobio-dynamics, 7(5), 304-311.
https://www.jstage.jst.go.jp/article/bpb1978/7/5/7_5_304/_article/-char/ja/

23. Zhiping H, et al. (1986). Treating amenorrhea in vital energy-deficient patients with Angelica sinensis. Journal of Traditional Chinese Medicine (3): 187–90.
http://www.cnki.com.cn/Article/CJFDTotal-ZYYW198603008.htm

24. Chao, W. W., & Lin, B. F. (2011). Bioactivities of major constituents isolated from Angelica sinensis (Danggui). Chinese medicine, 6(1), 29.
https://cmjournal.biomedcentral.com/articles/10.1186/1749-8546-6-29

25. Sakai, S., Ochiai, H., Nakajima, K., & Terasawa, K. (1997). Inhibitory effect of ferulic acid on macrophage inflammatory protein-2 production in a murine macrophage cell line, RAW264. 7. Cytokine, 9(4), 242-248.
https://www.sciencedirect.com/science/article/abs/pii/S104346669690160X

26. Yan, J. J., Cho, J. Y., Kim, H. S., Kim, K. L., Jung, J. S., Huh, S. O., ... & Song, D. K. (2001). Protection against β‐amyloid peptide toxicity in vivo with long‐term administration of ferulic acid. British journal of pharmacology, 133(1), 89-96.
https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1038/sj.bjp.0704047

27. Ou, L., Kong, L. Y., Zhang, X. M., & Niwa, M. (2003). Oxidation of ferulic acid by Momordica charantia peroxidase and related anti-inflammation activity changes. Biological and Pharmaceutical Bulletin, 26(11), 1511-1516.
https://www.jstage.jst.go.jp/article/bpb/26/11/26_11_1511/_article/-char/ja/

28. Ronchetti, D., Impagnatiello, F., Guzzetta, M., Gasparini, L., Borgatti, M., Gambari, R., & Ongini, E. (2006). Modulation of iNOS expression by a nitric oxide-releasing derivative of the natural antioxidant ferulic acid in activated RAW 264.7 macrophages. European journal of pharmacology, 532(1-2), 162-169.
https://www.sciencedirect.com/science/article/pii/S0014299905013397

29. Kan, W. L. T., Cho, C. H., Rudd, J. A., & Lin, G. (2008). Study of the anti-proliferative effects and synergy of phthalides from Angelica sinensis on colon cancer cells. Journal of ethnopharmacology, 120(1), 36-43.
https://www.sciencedirect.com/science/article/pii/S037887410800408X

30. Yang, T., Jia, M., Mei, Q., & Shang, P. (2002). Effects of Angelica polysaccharide on blood coagulation and platelet aggregation. Zhong yao cai= Zhongyaocai= Journal of Chinese medicinal materials, 25(5), 344-345.
http://europepmc.org/abstract/med/12583194