Period pain and prostaglandins
Updated: Nov 6
The pain that can occur with menstruation is called dysmenorrhoea. It is common for menstruating women to have some mild pain for a few days each month. However, for some women, the pain is so intense that it frequently prevents them from carrying on with their usual activities. Severe pain may also come with other symptoms, including diarrhea, nausea, vomiting, headaches, and dizziness.
Primary and secondary dysmenorrhoea
Ordinary period pain, or primary dysmenorrhoea, comes just before or during the first few days of menstruation. This pain is usually caused by chemicals called prostaglandins, which are made in the lining of the uterus and cause contractions of the muscles and blood vessels. The level of prostaglandins peaks on the first day of your period and as bleeding continues, the amount of prostaglandins and pain decreases.
Secondary dysmenorrhoea is pain caused by a more serious disorder of the reproductive organs. This pain tends to get worse over time and it often lasts longer than ordinary menstrual cramps. Some causes of secondary dysmenorrhoea include endometriosis, fibroids, and adenomyosis.
Prostaglandins carry out their actions by acting on specific receptors, which are present in different organs throughout the body and high concentrations of prostaglandins are found in areas of inflammation. Prostaglandins can have a variety of inflammatory effects, including causing vasodilation (widening of blood vessels) as well as promoting allergic reactions and fever. Inflammation isn’t always bad though - it is one of the first steps to healing. It is prolonged inflammation that is problematic, as it may be associated with chronic pain and illness.
A poor diet, high in Omega 6 may play a role in promoting inflammation and increased prostaglandin production. Our bodies need Omega 6, as it is an essential fatty acid, however, we also need it to be in a balanced ratio with Omega 3. The normal western diet tends to be high in Omega 6 and low in Omega 3. Prostaglandins are synthesized from fatty acids, especially Omega 6 so if the ratio of Omega 6 to Omega 3 is too high, then chronic inflammation is more likely to occur.
Foods that are high in Omega 6 fatty acids include processed vegetable oils like sunflower, corn, canola and soybean oil, fast foods and other highly processed foods. Omega 6s are not all bad and are an important part of a healthy diet when eaten in the right amounts. Eating foods you are sensitive to (like dairy, wheat or sugar) can also increase inflammation in the body.
Women who struggle with dysmenorrhoea may also be deficient in magnesium, and a combination of magnesium and vitamin B6 (pyridoxine) may help to relieve PMS and pain symptoms. B6 is a cofactor for essential fatty acid conversion in the body and many other processes including more than 100 enzyme reactions. Magnesium and B6 are found naturally in leafy green vegetables, bananas, nuts and seeds. Some individuals may also benefit from taking these nutrients in supplement form.
American College of Obstetricians and Gynecologists. (2022). Dysmenorrhea: painful periods. https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods
Barcikowska, Z., Rajkowska-Labon, E., Grzybowska, M. E., Hansdorfer-Korzon, R., & Zorena, K. (2020). Inflammatory markers in dysmenorrhea and therapeutic options. International Journal of Environmental Research and Public Health, 17(4), 1191. https://doi.org/10.3390/ijerph17041191
Sarris, J., & Wardle, J. (2019). Clinical naturopathy: An evidence-based guide to practice (3rd ed.). Elsevier.
Briden, L. (2018). Period repair manual. MacMillan.