Period pain can be bad. Excruciatingly, unforgivably, even-worse-than-the-remake-of-Jumanji bad.
Men also fall victims to period pain. No, I’m obviously not saying that men experience cramps, but they do get affected by them.
I’m not talking about when a girl is pissed off at her boyfriend because she is on her period, neither. I’m talking about the whole economy. As the University of California San Diego points out here, period pains are the most common cause of missed work and school hours amongst women.
To show what this in numbers, this AAFP article states that 600 million work hours and over 2 billion dollars in productivity are lost annually in the U.S. due to dysmenorrhea (fancy talk for severe period cramps).
When it comes to menstrual pain remedies, we all know the usual suspects – the NSAIDs (OTC anti-inflammatory drugs like ibuprofen). Though they are effective for pain relief, NSAIDs may have serious negative side effects when taken regularly, as we have discussed in numerous other articles of ours.
Therefore, we won’t talk much more about NSAIDs, except to compare their efficacy to that of other natural menstrual cramp remedies. Let’s get on with the list.
Heat therapy, or the application of a heating pad, wrap, patch, etc., is definitely not an unknown menstrual pain remedy. What is surprising about it, however, is that there’s evidence heat therapy may actually be more effective than NSAIDs.
Studies Suggesting Heat Therapy Over NSAIDs:
1. Samantha R. Murray, Philadelphia College of Osteopathic Medicine, conducted a study to determine whether heating patches or over-the-counter NSAIDs (Ibuprofen 400 mg or Acetaminophen 500 mg) provided greater relief in menstruating women 18 years and over. Though a unanimous answer was not achieved, two of the three trials concluded that heating patches provided greater relief than the pain meds.
2. In another trial, 344 evaluated participants were selected to compare orally taking Acetaminophen (though this time 1000 mg) and applying a heating wrap, in order to determine which of the two is better at relieving pain and decreasing cramps, tightness, and decreasing fatigue for women with dysmenorrhea. The study concluded that the heating wrap produced better results across the board.
3. In this study, 81 women were given different combinations of treatment. Ibuprofen or placebo tablet (dummy pill, which is ideally identical in shape, size, and color as the real treatment) was combined with a heated or an unheated patch. Needless to say, the combination of a dummy pill and an unheated patch did the worst. When they compared the combo of a heated patch plus ibuprofen to the combo of an unheated patch plus ibuprofen, the result showed that the heated patch plus ibuprofen caused relief to kick in 47% faster than the unheated patch plus ibuprofen, though the percentage of pain relief was pretty similar in both combinations.
More and higher quality research is necessary before we can confidently conclude that heat therapy is more effective than NSAIDs when it comes to reducing pain. However, we do have a solid amount of evidence to assume that heat therapy may, indeed, decreases menstrual cramp pain.
As we talked about in our article, Heat Therapy for Pain Relief – Is it Effective, the regular use of NSAIDs may result in mild-to-severe side effects. Many of us have already experienced one of the mild side effects of the anti-inflammatory drugs – an upset stomach. It seems counter-intuitive to reduce period pain, only to replace it with a stomach ache caused by NSAIDs.
Heat therapy is mentioned as a treatment for period cramps by the following medical schools:
- University of Maryland Medical Center
- University of California San Diego
- San Diego State University
- University of Rochester
- Northwell University
If you would like to try relieving your period pain with a heating pad, check out our heating pad review page, to make sure you get a reliable heating pad from the first try.
Many articles online recommend numerous kinds of vitamin supplements for cramps. However, not all types of vitamins correlate with menstrual pain relief. Let’s see what specific types of vitamins are relevant to the issue at hand.
Vitamin D (D₃)
In this Italian study, 40 women (ages 18-40) were carefully selected in order to examine the effectiveness of cholecalciferol (a type of Vitamin D) on menstrual pain relief. All patients reported experiencing at least four consecutive painful periods in the last six months. Additional requirements for the patients were that they are all healthy and that none of them had taken any medications or dietary supplements of any kind six months prior to enrollment.
The patients were split into two groups of 20. One group was given a single dose of cholecalciferol five days prior to the expected beginning of their period, while the other was given a placebo.
The Vitamin D group showed a significantly greater decrease in pain, compared to the placebo group, during the entire two-month duration of the study.
What is even more impressive is that 40% of the placebo group were also given NSAIDs because they couldn’t bear the pain, yet the Vitamin D group still showed categorically greater relief.
In a two-month study, 240 high school females were divided into four groups. One group was given a placebo treatment, while the other three were given respectively Vitamin B1 100mg/day, fish oil 500mg/day, or both. All three study groups showed significantly reduced pain (and pain duration) associated with menstruation, though the authors of the trials recommended the use of Vitamin B1 over fish oil.
Some Vitamin B1 rich foods are:
- Green peas
- Brussel sprouts
- Romaine lettuce
- Breakfast cereals
- White Rice
In this study, the subjects were split into two groups. One group was given 200 units of Vitamin E and the other a placebo pill, twice a day. The treatments started two days prior to their expected menstruation date and the treatments continued throughout the first three days of bleeding.
Some Vitamin E rich foods:
MASSAGE AND ESSENTIAL OILS
Every woman has tried massaging her belly when experiencing bad period cramps. Maybe it helped you, maybe it didn’t. Getting a massage from someone who knows what they’re doing, however, appears to be more consistently helpful.
Who would have thought, right?
In this Korean study, 85 women participants were evaluated in order to determine whether massage therapy brought any menstrual cramp relief. Forty-two women were treated with massage (in this case the massaging style was Kyung Rak), while the others received no treatment at all (which is a bummer, since a sham treatment would have improved result accuracy). Nonetheless, the results showed that massaging can bring significant relief for menstrual pain.
Aromatherapy Massage (w/ Essential Oils) vs. Regular Massage
Oil plays a big part in most, if not all, massages. Can different oils have a different impact, though?
Ninety-five nursing students in Egypt participated in a study designed to compare aromatherapy abdominal massage (or a belly massage with essential oils) to non-aromatherapy (placebo oil) abdominal massage for menstrual cramp relief.
The students were randomly divided into two groups; 48 students were given a massage with essential oils
(a mixture of cinnamon, clove, rose, and lavender in a base of almond oil), while the other 47 students received the same massage but with a placebo oil (almond oil).
The pain was assessed on a scale of 0 to 10. The pain scores which the patients reported in both groups before receiving any treatment were:
|Aromatherapy Massage Group||Placebo Oil Massage Group|
|Pain on 1st day of period before any treatment||6.7||6.8|
|Pain on 2nd day of period before any treatment||5.5||5.3|
|Pain on 3rd day of period before any treatment||4.1||3.9|
|Total duration of pain||24.6||23.1|
After the first phase of the study, the results were as follows:
|Aromatherapy Massage Group||Placebo Oil Massage Group|
|Pain on 1st day of period after treatment||5.8||6.8|
|Pain on 2nd day of period after treatment||4.3||5.4|
|Pain on 3rd day of period after treatment||2.7||3.8|
|Total duration of pain||18.6 hrs||23.1 hrs|
In the second phase of the study, they switched the oils in the two groups and pretty much the same results were observed.
They also evaluated the effects both treatments had on bleeding. Seventeen patients in the first, and sixteen patients in the second group, reported excessive bleeding. After two days of treatment, only six patients were still bleeding excessively in the first group, while in the placebo group, the number of women with excessive bleeding remained in the double digits – 12.
What’s particularly interesting about this study, however, is in the placebo group. If you look at the data of the before and after treatment, just for patients in the placebo group, you will notice that it’s nearly identical. So, the massage, even with placebo oil didn’t show any effect.
What does this mean?
We can’t be certain, but what we do know is that the massaging in the trial was done by a “researcher”, as the study says, and not a masseuse. Therefore, a very reasonable assumption to make is that the essential oils (especially the particular mix used in the study) may bring you menstrual pain relief when self-massaged at home, or without even being massaged at all.
TEA AND HERBS
Tea is amazing! It’s soothing and tasty, and it finds a spot in the daily routine of a lot of people.
If you are not a big tea drinker, or just not a fan of the particular kinds of tea in the list below, the herbs can obviously be ingested or applied in other various forms.
Most of the treatments practiced in the trials below were done through the use of tablets. This may be because of the poor taste of some of the herbs. It’s more likely, however, that the tablets are much easier to use to create a blinded study (when the patients aren’t supposed to know what they are taking, in order to prevent biases). We, however, prefer the real thing over a tablet, whenever possible.
Fennel, or Foeniculum vulgare, is a part of the same family as the carrot, celery, and parsley, and is believed to have anti-inflammatory and analgesic (pain-relieving) effects.
There have been several studies suggesting the effectiveness of fennel as a menstrual cramp remedy. For example, in this placebo-controlled trial, 50 subjects of ages 15-24 were split into two groups of 25; one group is treated with fennel and the other with a placebo. Amongst the patients in the fennel group, 52% stated the treatment as excellent, 20% reported as moderate and 28% as slight or no effect on pain. In contrast, amongst the placebo group, 8% reported excellent effect, 48% moderate and 44% stated the treatment has a slight or no effect.
Ginger is a relatively popular remedy in the women’s health department, as it is used to treat many different conditions.
In order to find out if menstrual pains are one of them, let us check out this trial, in which two groups of 35 patients each were treated with ginger or placebo for their cramps. The patients in the ginger group reported pain relief of almost 50% by the second day, while the placebo group barely noted any relief.
In this Indiana University School of Nursing Review, the authors review numerous trials regarding the efficacy of ginger for period cramp relief. They found all of the trials showed evidence ginger is indeed beneficial for this purpose.
One hundred and twenty-two girls of ages 18-25 with similar dysmenorrhea symptoms and age of their first period were split into two groups in this crossover study (when the patients receive a sequence of different treatments).
The patients in one of the groups were given three peppermint oil capsules a day for three days after the start of their period. The next month they received no treatment and, in the third month, the patients received a 250 mg Mefenamic acid capsule every eight hours for three days. The patients in the second group received the same treatment but in reverse order.
The results of the study showed that the Mefenamic acid and the peppermint capsules had almost the same effect on menstrual cramp relief (the mef. acid reduced pain only by 0.30 more on a scale of 0 to 10). The peppermint showed dramatically better results when it comes to nausea and vomiting decrease, which only the unluckiest experience during their period. The peppermint showed no signs of a decrease in bleeding, though.
In this Iranian trial, 76 patients were randomly divided into two groups of 38, cinnamon tablets decreased pain by 55% by the 48th hour after the intervention, while in the placebo group, the pain decreased by only 28% by that time.
In addition, only one patient in the cinnamon group reported excessive bleeding by the second day, while nine patients in the placebo group still had that problem. The number of patients with excessive bleeding was the same in both groups (12) before the initial treatment.
As we already mentioned, Vitamin B1 was found slightly superior to fish oil supplements, but fish oil supplements demonstrated evidence of being an effective menstrual pain remedy, nonetheless.
In the trial we already referenced in the Vitamin B paragraph, a group of 60 patients were given a single dose of 500 mg fish oil on the first day of their period for two consecutive months. By the second month, their menstrual pain intensity was down by 59% compared to prior to the treatment. As we already said, the Vitamin B1 group reported slightly better results, but the greatest relief was observed in the group which combined fish oil and Vitamin B1 (decrease in pain intensity of almost 70%).
WHAT TO AVOID
The University of Maryland Medical Center, as well as numerous other sources, advise avoiding alcohol, coffee, and tobacco, as these are believed to worsen symptoms of dysmenorrhea.
UMM also recommends staying away from refined foods like:
Trans-fatty acids found in commercially-baked goods are also to be avoided. Examples of these are:
- French Fries
In addition to the menstrual pain remedies already mentioned in this article, UMM recommends drinking six to eight glasses of water a day and exercising for 30 minutes, five days a week, for period cramp relief.
Further and higher quality research is required in order label the effectiveness of the menstrual pain remedies above as a scientific truth. This is not something which is only true regarding the research on period cramp remedies, either. Unfortunately, a big percent of all clinical trials, regardless the subject, do not provide high-quality evidence and cannot be used to draw final conclusions. If you want to read more on the subject, check out the article “Why Most Published Research Findings Are False” by the Stanford professor, John P.A. Ioannidis.
However, there’s definitely enough evidence (and enough pain) to make one seriously consider trying out some of the menstrual pain remedies listed above. As always, if you decide to do so, please contact your doctor to make sure the specific remedy/ies you wish to implement are right for you. The heating pads are a personal favorite of ours, though certain types of Vitamins and herbs may have the support of more concrete evidence.