In our house, periods seem to be a big DEAL. My teenage step-daughter will often exclaim, “LEAVE ME ALONE! IT’S SHARK WEEK!” Her brother will then respond by backing away slowly with a wide-eyed expression and retreating to a safe location until he feels it is safe to speak to her again. We have bottles of ibuprofen for our wicked cramps and “girl materials” stashed in every car. If I happen to mention that “Aunt Flo” is going to be visiting, my husband suddenly wonders if he is going to have to try and figure out what he should say when my tears come out of nowhere, or if a seemingly unprovoked ginger snap might be in his near future. My 7-year-old son starts interviewing me in a very invasive way and wants very detailed anatomic and physiologic descriptions as to why girls have to put bloody things in the trash can. He then informs me that he is very glad he is not a girl, and that he never wants to have a baby (resulting in me having to explain why he does not ever need to). Fear not, men of the house, there is hope! You (and your female housemates) do not have to suffer every month.
Most women (myself included) have suffered physical and emotional symptoms in the days before their periods. Sometimes the symptoms are mild, but sometimes they can be quite disruptive, causing us to miss work or school. Some of the emotional symptoms can be quite severe, resulting in feelings of worthlessness, exhaustion, irritability, and in the worst cases, suicidal ideation. Many women feel that the unpleasantness of their monthly guest is just something that they have put up with. However, you need not fear Aunt Flo. Many methods are available to tame her into submission, and give you your life back on these days prior to your period.
Many physiologic and biochemical causes can underlie a diagnosis of PMS or its most severe counterpart, Premenstrual Dysphoric Disorder. Many women who suffer from these conditions have anatomical abnormalities, are more sensitive to the actions of their hormones, have dysregulation of their nervous system, or increased levels of inflammatory chemicals their blood stream. As I am sure those of you who already suffer with this are aware; it is connected to stress. The stress hormones can exert effects on the nerve endings responsible for cramps and the receptors in the brain regulating our moods. Interestingly, women who have a history of trauma have more severe symptoms of PMS. I noticed this in my own life when I started having incredibly severe cramps after enduring the stress of my mother’s death.
Several traditional treatments are available for the treatment of PMS including anti-depressants, anti-anxiety medications for the treatment of severe anxiety prior to the onset of menses, birth control to regulate the hormones involved, and anti-inflammatories for pain relief. However, for those who suffer side effects from these treatments or want a more natural approach, there are several integrative therapies that can help alleviate the symptoms. Here are a few of my favorites:
Magnesium: Up to 80% of the population is deficient in this mineral, and supplementing with it can help many of the symptoms of PMS. This supplement is a powerhouse when it comes to alleviating many of the seemingly unrelated symptoms in one pill. Magnesium can help with anxiety and sleep, which are often altered around the menstrual cycle. It can also assist with preventing migraine headaches, which are notoriously caused by swings in hormonal levels in some women. It also acts as a muscle relaxant, and can help with cramps. For women who have either diarrhea or constipation problems during their cycle, magnesium in different forms can treat these ailments as well.
Calcium: Calcium supplementation is particularly helpful in adolescents with symptoms of PMS. When used in combination with Magnesium it can be particularly helpful for cramps. Teenage girls would benefit from higher intakes of calcium in the form of food, but may benefit from a supplement for cramps as well.
Vitamin B6: This vitamin is involved in the formation of several hormones in the brain that are involved in mood regulation. Drops in neurochemicals such as serotonin, dopamine, and norepinephrine can be part of the mood changes that are common to those who suffer with PMS.
Chasteberry: Vitex agnus castus has been used for centuries for the treatment of menstrual disorders. It can help regulate a cycle that is irregular, and often helps with mood symptoms prior to the onset of menustration. It does take about 3 cycles to notice a full effect. Personally, this herb is my go-to for mood regulation because after using it myself I hardly notice Aunt Flo hinting at her arrival at all.
Ginkgo: Ginkgo biloba has been studied for its mood benefits in PMS. It also has shown some benefit in symptoms of bloating and breast tenderness.
This super-star vitamin is incredibly important for so many things. Women need it for their bones, and it is also shown to be low in those that struggle with depression. Low levels are even correlated with obesity. In women who suffer from PMS, Vitamin D is often very low when tested. Its positive effects encompass mental symptoms as well as physical symptoms of cramping.
Pine Bark: Oh how I love pine trees…..
OH wait, not those pine trees….the bark of the French Maritine Pine Tree can be useful as an anti-inflammatory. Inflammatory chemicals are produced at high levels in those that suffer from menstrual cramps. It acts as a muscle relaxant and can ease painful menstruation.
Ginger: (I know….what is ginger NOT good for? I am not sure.) This potent anti-inflammatory has anti-spasmodic activity as well. This means that it can relieve the symptoms of uterine contractions, naturally. Ginger is safe, well-tolerated, and inexpensive. You can easily make a tea and combine it with honey to make a very effective therapy.
Essential oils: Lavender and Clary Sage, in combination with other oils can make a very effective treatment when massaged into the painful areas. I make this myself at home and keep it by my bed in case of emergencies. It has really cut down on the amount of ibuprofen that I have to take. (Apparently it is not just me because my step-daughter likes to swipe it for herself).
Aunt Flo doesn’t not have to be your enemy. You can work with her and use many integrative treatments to make your period much more tolerable. Although society would have us believe that women should just suffer through it, and that it is just part of life, no woman should needlessly suffer this way. Conventional medicine and Integrative medicine have an arsenal of tools to help with these symptoms and help you regain days out of your month.
Integrative Medicine practitioners are trained to help you with both traditional and natural therapies for your condition. This article does not constitute medical advice, nor it is meant to diagnose or treat any condition. See an Integrative Medicine practitioner near you for individualized advice.
Dr. Erin Fenstermacher is a Board-Certified Internal Medicine Physician and Fellowship-Trained Integrative Medicine Physician with a practice in Albuquerque New Mexico as well as a Telemedicine practice available in other states.