Aug 31, 2017

TRANSCRIPT

Dr. Jones: You or someone in your house has painful menstrual cramps. What can you do without going to the drugstore or seeing a professional? This is Dr. Kirtly Jones from Obstetrics and Gynecology at University of Utah Health and this is The Scope.

Announcer: Covering all aspects of women's health, this is the Seven Domains of Women's Health with Dr. Kirtly Jones on The Scope.

Dr. Jones: Menstrual cramps seem to be a uniquely human problem, well female human problem. Of course, part of that is because only primates have a menstrual cycle. Other animals have other biology and don't have nearly as many cycles and even other primates, chimpanzees and gorillas, don't seem to bleed as much or suffer cramps as much as we do.

About two weeks after ovulation if we don't become pregnant, the hormones from the ovary that would have supported an early pregnancy, progesterone or pregnancy, starts to fall and the uterus makes another local hormone called prostaglandins that causes the uterus to cramp, the blood vessels to constrict, and push out the old uterine lining to make way for the new with a bunch of blood that doesn't really seem necessary.

So what can you do right now? A hot but not too hot water bottle on your lower abdomen can be soothing or on your back if you primarily feel the cramps in your back. This was used by our mothers and probably their mothers. It doesn't really heat up your uterus but thermally stimulating the skin can distract other nerve pathways involving pain. Using this principle, a new take on an old device called a transcutaneous nerve stimulator that's been used for chronic back pain, might be useful for period cramps. But we're talking about right here and right now in a hot water bottle or a hot towel and a plastic bag is available to everyone but remember not too hot. Many women get in a hot bath tub and find this is helpful.

Well, what else right now? Well, believe it or not, exercise helps period cramps. Get out and move. A vigorous walk or ride or jog actually decreases the perception of menstrual pain for many women. Of course, if you never do these things, doing them now could be more painful but it will distract you from your cramps. Women who exercise regularly have less perception of menstrual pain, so for right now get up and move and if that doesn't work for you, go get that hot water bottle.

For women who have menstrual periods regularly, there are some habits that may decrease your pain. Some studies have found that decreasing fat in the diet significantly decreasing fat and particularly animal fat can lead to less painful periods. It won't work for you today, but it could be helpful for your next period.

Now personally and scientifically, I wouldn't say that supplements, substances you get in a pill at the health food store, are natural, but some studies found that fish oil decreased the intensity of menstrual cramps. It takes a lot of fish oil, about five pills a day.

A Danish study found that fish oil in combination with vitamin B12 worked better than other oils or placebo. Interestingly the women in the study were women who were chosen because they had bad period cramps. These women had low levels of omega-3 fatty acids in their diet compared to other Danish women. So all of the recommendation for decreasing period cramps is to decrease that in the diet, it may be all about the kinds of fat, less omega-6 from animal and dairy fats, which are associated with inflammation and prostaglandins and more omega-3s from nuts, fish, and seeds, which are anti-inflammatory.

Taking supplements may feel natural to some women but what's in the supplement may not be natural at all and they may contaminant, so be careful. The best choice may come down to dietary choices of low sugar and fat diets with seeds, nuts, and beans as the carbs and healthy oils and fish for the fat.

Of course the category of over-the-counter medicines called NSAIDs, non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen, all work to stop the production of prostaglandins, which cause the cramps. But we're talking about home remedies today.

Remember aspirin was originally isolated from willow bark and teas made from the bark of trees in the willow family have been used by many indigenous peoples to treat pain. Some herbal teas that claim to help period cramps may have some of these substances in them.

So these are some of things you try at home and a few options from the health food store and from the pharmacy section of your grocery store. But two things to consider, if your periods never used to be painful when you were younger and now are increasingly painful or heavy, it's important to see your clinician. Some diseases in the pelvis like endometriosis or fibroids in the uterus can grow and lead to increasingly painful periods.

In medicine we divide painful periods into two categories -- primary painful dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea refers to the menstrual cramps that started in early teen hood, the periods were always painful. The good news about primary dysmenorrhea is it gets better as women get older or maybe we just cope with it better.

Secondary dysmenorrhea means you didn't use to have cramps when you were younger and now you do. Secondary dysmenorrhea if it interferes with your daily activity, warrants a visit to your gynecologist.

Lastly if your painful periods interfere with your life and your home remedies and over the counter remedies aren't working, we as gynecologists have some options that are very helpful. Give us a call and thanks for joining us on The Scope.

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