You know what really cramps a gal’s style? Being bed bound with the cord of a heating pack strangling the midsection. Cramps are no joke and anyone who tries to convince you otherwise deserves to know it’s the equivalent of having a gang of feral animal clawing out your insides. Yeah.

It sometimes feels nearly impossible to avoid reaching for things of the Advil, ibuprofen, aspirin variety, but this can be frustrating for those who like to deal with their pain naturally. Furthermore, some studies have recently suggested that the use of regular NSAIDs (non-steroidal anti-inflammatory drugs) may harm the gut microbiome, and in turn cause dysbiosis (too little good bacteria and too much bad bacteria) ( 1 ). In fact, one study reported that NSAID users had a different gut microbiome profile than that of non-users, as did users of specific types of NSAID (e.g. ibuprofen and naproxen) ( 1 ).

So how can we keep both our guts and our sanity’s happy? There are a few things to incorporate and a few things to eliminate.

WHAT TO ADD TO YOUR DIET:

GINGER

Research has shown that ginger contains carbohydrates, free fatty acids, amino acid, proteins, and gingerols, which all have anti-inflammatory, antioxidant, and antiemetic (preventing an upset tummy) effects ( 2 ).

In one study, female high school students experiencing pain during menstruation were given  ginger powder, zinc sulfate, or a placebo. What the studied showed was the decrease of menstrual pain after taking ginger vs. the students who took zinc sulfate or the placebo. (our chocolate bar with ginger and honey is lookin’ rull good right about now.)

In another study, a higher dose of ginger was dispensed. Results showed a significant difference in the severity and duration of pain between ginger and placebo groups when the ginger supplement was given two days before the onset of menstruation and continued through the first three days ( 3 ).  

ZINC SULFATE

Another study tested Zinc Sulfate supplementation and found that in the first month, the duration of pain was significantly lower in the zinc group compared with the placebo group.  Some foods high in zinc are lamb, grass-fed beef, chickpeas, cacao, cashews, oysters (any excuse to eat oysters is a good excuse), yogurt+ spinach.

FENNEL

results from a study showed that fennel didn’t only prove to reduce pain, but In addition, after 1, 2 and 3 months use of taking it via pill form, pain significantly decreased. It also showed to decrease the length of the period after 1 and 3 months of use. ( 5 )

CINNAMON

in One study, Participants were either given Ibuprofen or cinnamon. They reported less severity and duration of pain in ibuprofen and cinnamon groups than placebo groups. However, the average pain severity in the Ibuprofen group was significantly less than cinnamon and placebo groups. So cinnamon is not as effective as ibuprofen BUT definitely better than nothing ( 6 ). (i don’t know about you, but we’re still sprinkling that stuff on everything)

OMEGA-3 FATTY ACIDS

to test whether adding omega-3 fatty acids to their diet made a difference, women stopped taking omega-3 for a week and were given a placebo for 3 months. after 3 months’ treatment, the mean pain severity score was markedly reduced among women who received omega-3 fatty acids, and remained high for those receiving the placebo ( 7 ). 

Foods Highest in Omega-3s:
Flax Seed/Flax Seed Oil
Salmon
chia seeds
Walnuts
Oysters
Mackerel
Spinach
Pasture raised egg

VITAMIN B1

Another study looked at combining an omega-3 with a B1 supplement. In this study, girls were randomly assigned to 1 of 4 schedules: a B1 tablet, a fish oil capsule, a mixture of both fish oil capsules and vitamin B, or placebo for two months.  The daily supplement was vitamin B1 (100 mg/day and fish oil pearl 500 mg/day), taken as a single dose starting at the beginning of the menstrual cycle and continued for 2 consecutive months. The results showed that intensity of pain in all three experimental groups (vit B1, fish oil and both of them) had significant difference with placebo group and intensity of pain had reduced. Best results were in the combination therapy group ( 8).

Foods Highest in Vitamin B1:
Trout
Sunflower Seeds
Macadamia Nuts
Green Peas
Acorn Squash
Asparagus
Navy Beans
Eggs
Whole Grains
Spinach
Orange
Cantaloupe

CURCUMIN

Turmeric is not specifically recommended as an agent for managing pain from cramps, though it is an overall anti-inflammatory agent (which is awesome while on your period). It inhibits inflammation through its ability to suppress NF-kB (which is an inflammatory pathway in the body). It has been suggested as a treatment for colitis, chronic neurodegenerative diseases, arthritis, and cancer. The usual dosage of standardized turmeric powder is 400–600 mg taken three times per day ( 15 ). (another reason to add some yellow fairy dust to your avocado toast in the morning. )

MAGNESIUM

The higher the estrogen or progesterone, the lower the magnesium. During the second half of the menstrual cycle, when both estrogen and progesterone are elevated, magnesium plummets.Increasing dietary and supplemental magnesium can help relieve PMS-related symptoms, such as headaches, bloating, constipation, low blood sugar, dizziness, fluid retention and sugar cravings. If you’re doubled over in agony when you get your period, consider taking magnesium before it arrives.

 

VALERIAN

Because cramping is thought to be caused by increased contractions, valerian works by blocking calcium channels and opening potassium channels, therefore inhibiting these contractions.  Beyond cramps, valerian is also known to help with headaches and aiding in sleep ( 9 ). brewing up some valerian root tea or adding the leaves to your salad is an easy way to add it to your diet.

 

ESSENTIAL OILS

Abdominal aromatherapy massage with essential oils significantly reduced the pain score of cramps. One study reported that massage with lavender plus mixed oils (cinnamon, clove, rose, and lavender oils diluted with sweet almond oil) significantly reduced pain. It was also reported that massage oil with mixed oils (lavender, clary sage, and rose oils diluted with almond oil) significantly reduced pain. ( 10 ). Time to add these to your self-care ritual, moon mamas.

 

BORON

 studies show that participants who consumed boron supplementation noticed that the severity and duration of pain were significantly lower in the boron group than in the placebo group, implying that boron supplementation can reduce the severity and duration of menstrual pain through exerting anti-inflammatory effects ( 11 )

Since this recommendation is only 10mg/day, it seems only fitting to give a shout out to some boron food sources:

Raisins: 4.51 mg per serving
Almond: 2.82 mg per serving
Hazel Nuts: 2.77 mg per serving
Avocado: 2.06 mg per serving
Peanut Butter: 1.92 mg per serving
Brazil Nuts: 1.72 mg per serving
Red Kidney Beans: 1.4 mg per serving
Dates: 1.08 mg per serving

 

HONEY

Did you know that honey can lead to the same amount of pain relief as an nsaid (advil, etc)? Studies showed that in the first 3 days of menstruation, Honey and the NSAID led to the same amount of pain relief in women with pain during menstration. Honey is suggested to be used for pain relief due to its lower side effects and pharmacological complications. ( 12 )

WHAT TO REMOVE FROM OR LESSON IN YOUR DIET:

INFLAMMATORY FOODS:

These put your body in an even more intense state of inflammation when it’s already pretty inflamed.

Try to steer clear of:
Omega-6 Fatty Acids
(Vegetable Oils like canola, safflower, grapeseed, soybean, margarine, and shortening)
Saturated and Trans Fats
Processed foods
Refined Carbohydrates
Processed Sugar overload
Soda and excess sugars.

Instead, reach for:
Whole Foods
anti-inflammatory spices like curcumin, flaxseed, fiber, leafy greens, blueberries, tea (matcha is the most nutrient-rich green tea)
fermented vegetables and traditionally cultured foods (kefir, natto, kimchee, miso, tempeh, pickles, sauerkraut, olives)
shiitake mushrooms
Garlic
Herbs
Spices
omega-3 fatty acids // good fats
(think fish, avocado, olive oil, olives, chia seeds, flax seeds)
magnesium sources (dark chocolate, banana, avocado, and almonds to name a few!)

 

CAFFEINE

The research is still not in for this, but in some, caffeine acts as a vasoconstrictor. When the blood vessels constrict, in turn making cramps worse.

SUMMARY OF RECOMMENDED DOSING BASED ON THE LITERATURE:

250 mg of ginger ( 2 )
50-220 mg of zinc sulfate ( 2 / 4 )
2 days before onset of period: 500mg ginger root powder and continue for first 3 days of period (this is a good brand and 1 capsule contains 500mg) ( 3 )
30g fennel ( 5 )
420 mg of cinnamon ( 6 )
daily: omega-3 supplement – 180 mg EPA and 120mg DHA) ( 7 )
vitamin B1 (taken with omega-3): 100mg/day ( 8 )
valerian: 255 mg powder valerian root ( 9 )
lather up with lavender oil ( 10 )
boron: 10 mg per day – try to get from food ( 11 )
adopt an anti-inflammatory, whole foods diet
limit caffeine intake

References

( 1 ) Rogers, M.A.M. & Aronoff, D.M. (2016). The influence of non-steroidal anti-inflammatory drugs on the gut microbiome. Clinical Microbiology and Infection, 22(2), 178.e1-178.e9. doi: 10.1016/j.cmi.2015.10.003

( 2 ) Kashefi, F., Khajehei, M., Tabatabaeichehr, M., Alavinia, M., & Asili, J. (2014). Comparision of the effect of ginger and zinc sulfate on primary dysmennorrhea: A placebo-controlled randomized trial. Pain Management Nursing, 15(4), 826-833. doi: 10.1016/j.pmn.2013.09.001

( 3 ) Rahnama, P., Montazeri, A., Huseini, H.F., Kianbakht, S., & NAseri, M. (2012). Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: A placebo randomized trial. BMC Complementary and Alternative Medicine, 12(92), doi: 10.1186/1472-6882-12-92

( 4 ) Zekavat, O.R., Karimi, M.Y., Amanat, A., & Alipour, F. (2015). A randomized controlled trial of oral zinc sulphate for primary dysmenorrhoea in adolescen females. Australian and new Zealand Journal of Obstetrics and Gynecology, 55, 369-373. doi: 10.1111/ajo.12367

( 5 ) Ghodsi, Z. (2014). The effect of fennel on pain quality, symptoms, and menstrual duration in primary dysmenorrhea. Journal of Pediatric and Adolescent Gynecology, 27(5), 283-286. doi: 10.1016/j.jpag.2013.12.003

( 6 ): Jaafarpour, M., Hatefi, M., Khani, A., & Khajavikhan, J. (2015). Comparativeeffect of cinnamon and ibuprofen for treatment of primary dysmenorrhea: A randomized double-blind clinical trial. Journal of Clinical and Diagnostic Research, 9(4), QC04-QC07.

( 7 ): Rahbar, N., Asgharzadeh, N., & Ghorbani, R. (2012). Effect of omega-3 fatty acids on intensity of primary dysmenorrhea. International Journal of Gynecology and Obstetrics, 117(1), 45-47. doi: 10.1016/j.ijgo.2011.11.019

( 8 ): Hosseinlou, A., Alinejad, V., Alinejad, M., & Aghakhani, N. (2014). Effects of fish oil capsules and vitamin B1 tablets on duration and severity of dysmenorrhea in students o high school in Uremia-Iran. Global Journal of Health Science, 6(7), 124-129. doi: 10.5539/gjhs.v6n7p124

( 9 ): Mirabi, P., Dolatian, M., Mojab, F., & Majd, H.A. (2011). Effects of valerian on the severity and systemic manifestations of dysmenorrhea. International Journal of Gynecology and Obstetrics, 115, 285-288. doi: 10.1016/j.ijgo.2011.06.022

( 10 ): Sut, N. & Kahyaoglu-Sut, H. (2017). Effect of aromatherapy massage on pain in primary dysmenorrhea: A meta-analysis. Complementary Therapies in Clinical Practice, 5-10. doi: 10.1016/j.ctcp.2017.01.001

( 11 ) Nikkhah, S., Dolatian, M., Naghii, M.R., Zaeri, F., Taheri, S.M. (2015). Effects of boron supplementation on the severity and duration of pain in primary dysmenorrhea. Complementary Therapies in Clinical Practice, 21 (2), 79-83. doi: 10.1016/j.ctcp.2015.03.005

( 12 ) Amiri Farahani, E.L., Hasanpoor-Azhgdy, S.B., Kasraei, H., & Heidari, T. (2017). Comparison of the effect of honey and mefenamic acid on the severity of pain in women with primary dysmenorrhea. Archives of Gynecology and Obstetrics. doi: 10.1007/s00404-017-4409-6

( 13 ) Behbani, B.M., Ansaripour, L., Akbarzadeh, M., Zare, N., & HAdianfard, M.J. (2016). Comparison of the effects of acupressure and self-care behaviors training on the intensity of primary dysmenorrhea based on McGill pain questionnaire among Shiraz University students. Journal of Research in Medical Sciences, 21, 104. doi: 10.4103/1735-1995.193176

( 14 ) Rakhshaee, M.S. (2011). Effect of three yoga poses (cobra, cat and fish poses) in women with primary dysmenorrhea: A randomized clinical trial. Journal of Pediatric & Adolescent Gynecology, 24, 192-196. doi: 10.1016/j.jpag.2011.01.059

( 15 ) Maroon, J.C., Bost, J.W., & Maroon, A. (2010). Natural anti-inflammatory agents for pain relief. Surgical Neurology International, 1, 80. doi: 10.4103/2152-7806.73804

( 16 ) Dean, C. (2011). The Magnesium Miracle. New York, NY: Ballantine Books.