Dysmenorrhea—the medical term for painful periods—can take a toll on productivity, general wellbeing, and quality of life. While it's not often talked about openly, research shows that anywhere between 45 and 95% of women regularly experience dysmenorrhea.1
While medication is sometimes needed, there are several natural alternatives that have shown to provide meaningful relief in clinical settings. One of the most well-studied compounds is a common mineral that you're likely familiar with: magnesium.
How Magnesium Fights Dysmenorrhea & Painful Periods
Dysmenorrhea may be a symptom of magnesium deficiency due to its role in muscular regulation. G.E. Abraham first proposed a link between magnesium deficiency and PMS in 1956. He theorized that because magnesium plays a crucial role in controlling neuromuscular stimulation, it could also have a calming effect on the muscles of the uterus.2
Abraham's thesis made sense, as magnesium plays a key role in the transport of calcium and potassium ions across cell membranes. Without this process, muscles can’t contract or relax, and nerve impulses can’t move throughout the body.3
Many other researchers have since tested Abraham’s theory—with promising results.
For example, a double-blind clinical trial involving 126 women found that 250mg of magnesium significantly relieved PMS symptoms like muscle pain, back pain, headaches, depression, water retention, food cravings, and anxiety.4
“Overall, compared to chemical medications, magnesium is beneficial, low cost, and effective treatment for the symptoms of premenstrual syndrome”— Ebrahimi et al. 2012
Another small study reported similar findings, noting that when women took a magnesium supplement over the course of six months, dysmenorrhea progressively decreased with each cycle.5 Other research has shown that magnesium has therapeutic effects on back pain and lower abdominal pain, specifically during the second and third day of the cycle.6
In addition to relaxing muscles, magnesium may also relieve dysmenorrhea by reducing levels of prostaglandins—tiny compounds that have a hormone-like effect on the body. The production and release of prostaglandins in the uterus is the root cause of dysmenorrhea. When prostaglandins build up in the uterus, they cut off oxygen to the area. Because muscles need oxygen to function, depriving uterine muscles of oxygen causes painful muscle contractions.7
The prostaglandins that live in a painful uterus are called PgF2-alpha and PgE2. Levels of PgF2-alpha and PgE2 are low throughout most of the menstrual cycle, then rise sharply shortly before a woman’s period begins. Studies have found that women with dysmenorrhea produce 8 to 13 times more of these prostaglandins than women without dysmenorrhea.8
Magnesium is thought to inhibit the synthesis of these pain-causing prostaglandins. In one double-blind clinical trial, researchers gave magnesium to 25 women with dysmenorrhea. After six months, 21 of these 25 women showed a decline in dysmenorrhea symptoms. Throughout the study, researchers monitored PGF2-alpha in study participants' menstrual blood. The women who received a magnesium supplement produced half the amount of PGF2-alpha compared to women who received a placebo. These researchers concluded that magnesium is a "potential, natural opportunity to treat primary dysmenorrhea, which is widely free of side effects."9
As many women know too well, the effects of dysmenorrhea are not limited to the uterus. Due to natural hormone fluxes during menstruation, many people struggle with migraines before or during their period. Menstrual migraines are fueled by the drop in estrogen levels that happens just before the start of menstruation. Because they're hormone-driven, menstrual migraines frequently do not respond to the same medicines that work during the rest of the month, and are thus the most challenging to treat.10
Magnesium deficiency seems to be common in women with menstrual migraines. Some researchers speculate that, during attacks, migraine sufferers excrete excessive amounts of magnesium as a result of stress, resulting in low magnesium.11 Other researchers speculate that stress causes magnesium excretion, leading to low magnesium levels, which triggers a migraine.12 Either way, research shows that during migraine attacks, magnesium levels are reduced.13 A study involving 61 women with menstrual migraines found that the incidence of magnesium deficiency was 45% during menstrual attacks, compared to 15% during attacks that happen between cycles.14
Multiple studies report that magnesium supplementation is a reliable remedy for migraine headaches. Not only may magnesium supplements help relieve existing migraines, they may prevent migraines from happening at all. A double-blind, placebo-controlled study involving 24 women with menstrual migraines reported a significant reduction in the number of days they had headaches. They also reported less pain overall and improved premenstrual complaints.15 Another larger study involving 81 migraine stuffers also showed significant improvement. Those receiving magnesium supplements reported their attack frequency was reduced by 42%.16
Dysmenorrhea May Be Exacerbated by Magnesium Deficiencies
As the fourth most abundant mineral in the human body, magnesium is a cofactor in more than 300 enzyme systems that regulate diverse biochemical reactions throughout the body. For example, magnesium plays a crucial role in energy production, muscle contraction, nerve function, and blood pressure regulation.17
Despite its importance, Americans generally do not do a good job of meeting their magnesium needs. Epidemiological studies show that those who eat Western-style diets meet only 30-50% of the Recommended Daily Allowance (RDA) of magnesium.18 National data from the report "What We Eat in America" show that 30-89% of women of reproductive age consume less than the Estimated Average Requirement (EAR) of magnesium.19 Americans eat less than half the amount of magnesium than they did 100 years ago.3
Researchers aren’t quite sure why magnesium intakes are declining so steadily. Some experts point to the increasing use of fertilizers that leach magnesium out of our food supply.3 Others point to the Western diets’ focus on processed foods rather than magnesium-rich foods like whole grains, beans, nuts, and dark leafy green vegetables.20
Many common drugs may also contribute to low magnesium levels. For example, some antimicrobial and antiviral drugs have been shown to increase the amount of magnesium lost in urine.3
If poor intakes aren’t enough, suboptimal magnesium levels may fly under doctors’ radar. Getting a good read on one’s magnesium levels is tricky. The vast majority of the body’s magnesium lives inside the cells or in bone21—places where you can’t simply stick a probe in and measure how much magnesium is in there. Doctors measure levels of most other nutrients by measuring the amount in the serum—the watery, protein-rich component of blood that doesn’t include red or white blood cells. However, less than 1% of the body’s magnesium is stored in serum. So while your doctor can test to see if your serum levels of magnesium are healthy, this number doesn’t tell us much about the other 99% of magnesium in your body.22, 23
Although full-blown magnesium deficiencies are rare, it’s quite possible that many Americans experience subclinical deficiencies that go undiagnosed. Early signs of magnesium deficiency include anxiety, lethargy, weakness, and loss of appetite.17 Symptoms of more developed magnesium deficiency include muscle spasms, migraines, depression, constipation, and importantly, premenstrual syndrome and dysmenorrhea.3
How to Add Magnesium to Your Diet
Looking to add more magnesium to your diet? The USDA has outlined several foods that provide around 20% or more of your daily value in a single serving.24
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Spinach, cooked — 1 cup: 39% Daily Value
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Swiss chard, cooked — 1 cup: 38% Daily Value
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Dark chocolate — 1 square: 24% Daily Value
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Pumpkin seeds, dried — 1/8 cup: 23% Daily Value
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Almonds — 1 ounce: 19% Daily Value
Registered Dietitians recommend taking a "food first" approach, and meeting nutrient needs by choosing a variety of nutrient-rich foods.25 However, only 30-40% of dietary magnesium is typically absorbed by the body. 26, 27 If meeting your magnesium needs with food alone is challenging, supplementation may be helpful. Research shows magnesium levels improve when a supplement is added to one's regimen.28
If your goal is to improve your magnesium levels, most stand-alone magnesium supplements will do. However, if your goal is to use magnesium to relieve period problems, a stand-alone magnesium supplement may not be the best approach. Conditions such as PMS are often best treated through multiple modes of action; relying on just one method of treatment, such as magnesium, may not be enough to make a difference in some people.
We formulated Steady Mood with the most effective nutrients and herbs for relieving the mood, brain, and body-related symptoms of PMS. Learn more here.
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. Abraham, G. Premenstrual tention syndrome. J Reporod Med 1956; 21(4): 123-27.
3. Gröber, U., Schmidt, J., & Kisters, K. (2015). Magnesium in prevention and therapy. Nutrients, 7(9), 8199-8226.
http://www.mdpi.com/2072-6643/7/9/5388/htm
4. Ebrahimi, E., Motlagh, S. K., Nemati, S., & Tavakoli, Z. (2012). Effects of magnesium and vitamin b6 on the severity of premenstrual syndrome symptoms. Journal of caring sciences, 1(4), 183. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161081/
5. Benassi, L., Barletta, F. P., Baroncini, L., Bertani, D., Filippini, F., Beski, L., ... & Tridenti, G. (1992). Effectiveness of magnesium pidolate in the prophylactic treatment of primary dysmenorrhea. Clinical and experimental obstetrics & gynecology, 19(3), 176-179.
http://europepmc.org/abstract/med/1451282
6. Fontana-Klaiber, H., & Hogg, B. (1990). Therapeutic effects of magnesium in dysmenorrhea. Schweizerische Rundschau fur Medizin Praxis= Revue suisse de medecine Praxis, 79(16), 491-494.
http://europepmc.org/abstract/med/2349410
7. Hudson, T., N.D. (2008). Women's Encyclopedia of Natural Medicine: Alternative Therapies and Integrative Medicine for Total Health and Wellness. doi: 10.1036/0071464735
8. Galeao R. "La dysmenorrhea, syndrome multiforme." Gynecologie 1974: 25:125.
9. Seifert, B., Wagler, P., Dartsch, S., Schmidt, U., & Nieder, J. (1989). Magnesium--a new therapeutic alternative in primary dysmenorrhea. Zentralblatt fur Gynakologie, 111(11), 755-760. http://europepmc.org/abstract/med/2675496
10. https://americanheadachesociety.org/wp-content/uploads/2016/06/Menstrual-Migraine-Feb-2014.pdf
11. Durlach, J. (1976). Neurological manifestations of magnesium imbalance. Handbook of clinical neurology, 28, 545-579.
12. https://www.researchgate.net/profile/Alexander_Mauskop/publication/24187322_Role_of_magnesium_in_the_pathogenesis_and_treatment_of_migraine/links/557984a808ae75363756f14d.pdf
13. Gallai, V., Sarchielli, P., Coata, G., Firenze, C., Morucci, P., & Abbritti, G. (1992). Serum and salivary magnesium levels in migraine. Results in a group of juvenile patients. Headache: The Journal of Head and Face Pain, 32(3), 132-135.
http://onlinelibrary.wiley.com/doi/10.1111/j.1526-4610.1992.hed3203132.x/full
14. Mauskop, A., Altura, B. T., & Altura, B. M. (2002). Serum ionized magnesium levels and serum ionized calcium/ionized magnesium ratios in women with menstrual migraine. Headache: The Journal of Head and Face Pain, 42(4), 242-248.
http://onlinelibrary.wiley.com/doi/10.1046/j.1526-4610.2002.02075.x/full
15. Facchinetti, F., Sances, G., Borella, P., Genazzani, A. R., & Nappi, G. (1991). Magnesium prophylaxis of menstrual migraine: effects on intracellular magnesium. Headache: The Journal of Head and Face Pain, 31(5), 298-301.
http://onlinelibrary.wiley.com/doi/10.1111/j.1526-4610.1991.hed3105298.x/full
16. Peikert, A., Wilimzig, C., & Köhne-Volland, R. (1996). Prophylaxis of migraine with oral magnesium: results from a prospective, multi-center, placebo-controlled and double-blind randomized study. Cephalalgia, 16(4), 257-263.
http://journals.sagepub.com/doi/abs/10.1046/j.1468-2982.1996.1604257.x
17. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
18. Cordain, L., Eaton, S. B., Sebastian, A., Mann, N., Lindeberg, S., Watkins, B. A., ... & Brand-Miller, J. (2005). Origins and evolution of the Western diet: health implications for the 21st century. The American journal of clinical nutrition, 81(2), 341-354.
http://ajcn.nutrition.org/content/81/2/341.full
19. https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/0506/usual_nutrient_intake_vitD_ca_phos_mg_2005-06.pdf
20. Institute of Medicine (IOM). Food and Nutrition Board. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. Washington, DC: National Academy Press, 1997.
https://www.nap.edu/read/5776/chapter/1
21. Elin, R. J. (2010). Assessment of magnesium status for diagnosis and therapy. Magnesium Research, 23(4), 194-198.
https://www.ncbi.nlm.nih.gov/pubmed/20736141
22. Ismail, Y., Ismail, A. A., & Ismail, A. A. (2010). The underestimated problem of using serum magnesium measurements to exclude magnesium deficiency in adults; a health warning is needed for “normal” results. Clinical chemistry and laboratory medicine, 48(3), 323-327.
https://www.ncbi.nlm.nih.gov/pubmed/20170394
23. Jahnen-Dechent, W., & Ketteler, M. (2012). Magnesium basics. Clinical kidney journal, 5(Suppl_1), i3-i14.
https://www.ncbi.nlm.nih.gov/pubmed/26069819
24. U.S. Department of Agriculture, Agricultural Research Service. USDA National Nutrient Database for Standard Reference, Release 25. 2012.
https://www.ars.usda.gov/northeast-area/beltsville-md/beltsville-human-nutrition-research-center/nutrient-data-laboratory/
25. Marra, M. V., & Boyar, A. P. (2009). Position of the American Dietetic Association: nutrient supplementation. Journal of the American Dietetic Association, 109(12), 2073-2085.
http://www.eatrightpro.org/~/media/eatrightpro%20files/practice/position%20and%20practice%20papers/position%20papers/nsupplementation.ashx
26. Rude RK. Magnesium. In: Coates PM, Betz JM, Blackman MR, Cragg GM, Levine M, Moss J, White JD, eds. Encyclopedia of Dietary Supplements. 2nd ed. New York, NY: Informa Healthcare; 2010:527-37.
27. Fine, K. D., Santa Ana, C. A., Porter, J. L., & Fordtran, J. S. (1991). Intestinal absorption of magnesium from food and supplements. Journal of Clinical Investigation, 88(2), 396.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC295344/
28. Bailey, R. L., Fulgoni, V. L., Keast, D. R., & Dwyer, J. T. (2011). Dietary supplement use is associated with higher intakes of minerals from food sources. The American journal of clinical nutrition, 94(5), 1376-1381.
https://www.ncbi.nlm.nih.gov/pubmed/21955646?dopt=Abstract
This information is for educational purposes only and is neither intended to nor implied to be a substitute for professional medical advice. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
