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advertisement Probably the single most common "female" complaint of women of childbearing age is menstrual cramps or dysmenorrhea. Two types of dysmenorrhea exist: functional or psychiatric issues that cause menstrual cramps are considered primary dysmenorrhea. Organic or those related to physical problems such as endometriosis, PID, congenital defects in the pelvis, and polyps that cause cramps are considered secondary dysmenorrhea. According to Tori Hudson, ND professor of gynecology at the National College of Naturopathic Medicine, single women suffer more painful cramps than do married women, and this is probably due to hormonal fluctuations during pregnancy. There are also some risk factors for menstrual cramps or dysmenorrhea, and they are: those women who started menstruating at an earlier age, smokers and those who are overweight (which doubles their odds for longer and more painful episodes). How do these menstrual cramps occur? The pathophysiology behind it is a combination of several things. Namely the reduced flow of blood and therefor oxygen to the uterus as well as the release of compounds known as prostaglandins. Some prostaglandins are pro-inflammatory agents and the ones that play a part in dysmenorrhea are PGF2alpha and PGE2. These compounds rise precipitously just before a woman starts menses and it has been shown in studies that PGF levels were measured to be greater than 12 times the level in women with pain than those without pain. The rise in these prostaglandins may be related to the decline in progesterone just prior to menstruation. In states where there are steady levels of progesterone (as in pregnancy or while breast feeding) we usually do not see menstrual cramps. What types of therapies can combat these cramps? Traditionally physicians can control menstrual cramps by the use of anti-inflammatory agents such as Motrin (Ibuprofen) or Anaprox (Naprosyn) or by the use of hormones to regulate the surges of the ovarian hormones; in this case they are usually birth control pills. Other approaches that have been shown effective in mild to moderate cramps are what follows. Stress reduction and biofeedback have been shown to be effective in some women; this is particularly helpful with primary dysmenorrhea. Acupuncture, therapeutic massage and some homeopathic therapies have been helpful with secondary dysmenorrhea. Diet is of extreme importance and by eliminating pro-inflammatory foods that produce prostaglandins (diary and foods high in saturated animal fats) one can reduce the incidence and severity of episodes. Too much salt intake can cause fluid retention, which consequently causes bloating and increased cramping. A diet too high in carbohydrates may affect the absorption of some helpful B-vitamins and minerals thus contributing to cramping. Conversely increasing you intake of antispasmodic prostaglandins such as PGE-1 and PGE-3 series can be helpful. Foods high in PGE-1 & 3 are linolenic acid containing fish such as salmon, tuna, halibut & sardines. Plant sources of these good prostaglandins are flaxseed, pumpkinseed, sesame and also sunflower seed oils. Magnesium taken as a supplement or found in foods such as whole oats, barley and brown rice are effective in relaxing uterine muscles and reducing cramps. Don't forget fruits that are high in bioflavonoids and vitamin C, which carry anti-inflammatory properties may help. Always seek guidance from a knowledgeable healthcare provider if you suffer from dysmenorrhea. Oftentimes combinations of allopathic as well as complementary regiments are most effective. JP Saleeby, MD is medical director of the Saleeby Longevity Institute, an integrative medical practice in downtown Savannah, GA. Visit him on the web at www.longevity-institute.com or email him at jpsaleeby@aol.com. |
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