Dysmenorrhoea (Painful Periods)

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Finding a good herbalist

Much of what's written in this article is entirely suitable for a person to work through themselves but, especially if things are quite bad, or you just know that you need further help, then there may be a great deal of benefit to you to go to whatever lengths necessary to find a good herbalist or truly holistic practitioner to guide you on to a safe and strong treatment program. There's a short write-up to suggest how you might go about finding such a person here

The chemistry of pain

An especially painful period (also called 'dysmenorrhoea' in medicine) obviously affects a great many women and I have worked with this issue many hundreds of times over the years including for women for whom their period is such an ordeal that they have to plan their life around the expectation of being in severe and debilitating pain for days at a time each and every month.

The classic type of pain is described as 'cramping' but many women experience their dysmenorrhoea as a sharp, burning, dull or throbbing pain. Some women feel they have to use large amounts of painkillers and/or anti-inflammatories to get through their dysmenorrhoea and are naturally worried about the effects these drugs could have on their long term health. Fortunately, there are some excellent herbal medicine options that can be very effective if used correctly; further details below.

Much of the pain of the period is actually caused by a lack of oxygen to the tissues involved. This lack of oxygen is in turn caused by strong cramping in the muscles of the uterus. These cramps are the result of substances known as 'prostaglandins' that are released by hormonal changes in order to shed the lining that has built up in the uterus.

Prostaglandins are powerful -- for some women they are already in circulation by the time ovulation has occurred and they can be experiencing pain long before their period starts. The changing levels of these potent chemicals can also give rise to other symptoms such as dizziness, nausea, fatigue, disturbed bowel function, sensitivity to noise or light, and headaches.


First aid for dysmenorrhoea

A little further on I talk about what I see as the three main causes of dysmenorrhoea and I urge anyone to closely consider these areas in relation to their personal situation because when we treat the cause of something we can find a lasting cure from it.

Having said that, in the here and now of today, you still have to deal with what can be a considerable ordeal so I want to start by describing several approaches that I have found to be extremely helpful for a great many women who have used them.

Cramp Bark

The first treatment for help right now is the one I personally use as the starting point for the majority of women I treat for dysmenorrhoea.

This great American Indian herb has earned its name for exactly what it is good for and there can be no doubt that Cramp bark can be a phenomenally good remedy to use for dysmenorrhoea --if -- it is used correctly! There is an art to using most herbs in a way that yields their true medicinal power and Cramp bark is a classic example of that fact.

I describe this in much more detail in the page devoted to Cramp bark but in summary it is about using small but frequent doses until you are clearly feeling both its relaxing and its pain-relieving properties. You do not take this herb on faith that it will help you tomorrow. You take it in the way that makes you feel it working today. Read here for more details.

I am often told by the woman who has used Cramp bark effectively that over time she needs less of it to get the same results and that after using it for a while her periods get significantly less painful overall. So, even though I am calling Cramp bark a first-aid herb, this is the sign that some true healing is happening under its influence.

Botanical drawing of Viburnum opulus (Cramp bark)


Herbal 'Astringents'

For periods that are painful, heavy and flooding there is an ancient technique using herbal astringents to help rapidly bind and ease the period. From my personal experience the three best herbs to help with this are Shepherd's purse (detailed info here), Lady's mantle (more here) and Raspberry leaf (more here). The following notes are copied directly from the article on Shepherd's purse and should give you a good idea of exactly how to make it work.

Alchemilla vulgaris (Lady's mantle)


Shepherd's Purse for excess bleeding

~ With the tincture of Shepherd's Purse:
The method to get Shepherd’s purse to work for this is to take it in small and frequent doses, until the bleeding has slowed down or stopped.

Mainly depending on the strength of the tincture 20 drops or 1 ml of Shepherd’s purse each time is usually enough but this can be doubled to 40 drops or 2 mls if necessary. I often use the Shepherd's purse at the same time as Lady's Mantle and may also combine some Raspberry leaf at the same time. For a combination of Shepherd's purse with Lady's Mantle and/or Raspberry leaf I recommend between 2-4 mls depending on the size and sensitivity of the patient

~ With the tea of Shepherd's Purse:
Make a strong tea by adding 2 large cups of freshly boiled water (approximately 1 litre) to 3-4 heaped tsps of Shepherd's Purse dried herb. Cover and allow the tea to steep for a good 20 minutes. Strain and allow to cool before drinking. The equivalent dose to 1 ml of the tincture will be between 50-100mls of the tea depending on the strength and freshness of the dried herb. It is very strong tasting no question but once it is seen to work the unpleasantness will surely be worth it.

Notes on Dosage

It is not correct that 'more is better' with herbal medicine and in fact often it is the reverse that 'less is more!' You have to spend time with herbs to understand them; they are much more a living medicine than are drugs. The first step is to feel them working, the second step is to get a sense of how often you need to use them and in what dose.

As soon as the treatment is obviously working you can stop it but if necessary you can take a dose every 1-2 hours -- up to 6 doses in a day. If you don't feel anything happening by the 2nd or 3rd dose then try taking the herbs at the higher end of the suggested dose range. They may be hard to take but they will not cause toxicity.

Many women feel this treatment working almost straight away but because it is not exactly a pleasant process it is tempting to stop the treatment too soon. Listen to your body to know what to do and how long to keep it up for. Each extra time you take a dose you increase the strength of the effect...

Capsella bursa-pastoris (Shepherd's purse)


Heat treatments

I am sure all women know that applying heat may be good first-aid for dysmenorrhoea and I have to assume that just about every woman who has ever had a really painful period has at some point tried to find out for herself whether using heat to relieve her cramps has helped or not.

Especially if you are one of the ones who do feel that heat helps then I want to make mention of two herbs that are likely to take something good and make it even better.

The first is the herb Ginger which, if taken in enough of a dose (usually best in the form of a tea of Ginger or drops of a Ginger tincture) for you to actually feel in your core when you take it may give you a substantial amount of relief from pain. Ginger is easy to obtain and use and is an entirely safe herb to try in this regard -- further details here.

Lastly the great (albeit usually under-estimated) Chamomile can be tremendously soothing for pain. This healing herb can help when taken internally and it may also help a great deal as an external compress. A hot compress and a medicinal strength Chamomile can be done with ease and simplicity -- read further here.

Zingiber officinale (Ginger root)



For some women taking extra magnesium can make a night and day difference to how painful or long-drawn out their periods can be. I think that some people are 'magnesium-responders' -- others just aren't. In my own experience a person either clearly, rapidly responds to magnesium or they don't.

I often give supplemental magnesium to try for dysmenorrhoea but if the woman does not have an excellent response to it during the first period they are using it then I would be highly unlikely to recommend they tried it a second time.

The right dose is obviously vital with any medicine, -- a good 200mg of elemental magnesium per day is the safe but effective level you need to try if you are going to give this mineral a fair go (note that you will need to read the label closely to see how much of the product you are trying is the element of Magnesium as it is always bound with something else (e.g. an aspartate, citrate etc.) that can make it look like you are taking far more Magnesium than you actually are.

If you do feel that you respond well to magnesium then you should certainly consider adding more magnesium-rich foods to your diet. Minerals, like vitamins, always work the best when you have them in food.


Deeper causes and their treatments

There are three main causes for bad and chronic dysmenorrhoea. There are cross-overs between each of them and each can require a different approach to work towards a cure.

Premenstrual Syndrome

The premenstrual syndrome (PMS) obviously affects a great many women and for some their primary issue with PMS is one of very painful periods.

PMS is such a major cause of dysmenorrhoea that it is extremely common for women to be prescribed the oral contraceptive to simply stop ovulation -- along with all its subsequent hormonal changes.

I am very sympathetic to people in pain and do not have a judgemental mind-set about what people do in order to get away from it but it has to concern us that we are really very new to altering our hormones with drugs as radically as we have been doing in just the last couple of generations.

I know when I started my practice in 1989 that almost every woman I met of menopausal age was on HRT (hormone replacement therapy) but now it is extremely rare to meet any women on it because we have discovered that it greatly increases the risk of certain types of cancer, heart disease and stroke.

It is true that most PMS is indeed triggered by oestrogen levels rising too high in relation to progesterone but there are other ways to effectively help smooth out that imbalance without having to resort to completely stopping the process with drugs. I have written in depth about PMS and ways to help it with herbs and diet in an article here. If you know yourself that your dysmenorrhoea is part of a hormonal imbalance in general then this is the place I suggest you start.



One study using a surgical technique to investigate the lining of the womb (laparoscopy) showed that nearly two thirds of young women with painful dysmenorrhoea had some degree of endometriosis.

Endometriosis is also obviously profoundly affected by hormonal levels and many of the strategies for treating PMS are just as likely to help in this area as well.

I write more about this on the article on endometriosis here but something I want to mention right away is how critical it can be to get the bowel healthy when it comes to getting on top of endometriosis.

If you have endometriosis and also a tendency to a bloated abdomen over and above what happens premenstrually then you may need to consider the possibility that you have something called 'dysbiosis' which is basically an overgrowth of bad bugs in your body.

Research has shown that dysbiosis can be a key driver to endometriosis and I have certainly seen in practice how a combination of the right herbs and dietary changes can bring about a dramatic improvement in the painful periods that have come with it, more info here.



In terms of treating the painful periods that can come with fibroids I would especially encourage you to look into the berries of Vitex (info here) and the leaves of Lady's mantle (info here).

Likewise the suggestions in the article on PMS (again linked here) about reducing oestrogen and helping to raise progesterone levels are likely to help (fibroids are sometimes referred to as 'oestrogen-bubbles')

I have seen small fibroids with their associated excess bleeding and dysmenorrhoea respond beautifully to holistic medicine but this can be a particularly tricky problem to resolve if the fibroids have grown past a certain size. I think that surgery should be the last option but if the fibroids are too large to have a realistic hope of shrinking then a surgical option may be the best one so long as it is available. I talk about this in some more depth in my article on fibroids here


Constitutional Health Note

Finally, you might benefit from learning about your constitution to know what kind of foods, herbs, exercises etc. will work especially well for your health in general as well as what might potentially help you with period health. I have found that women from all constitutional types can suffer from painful periods but the cool & damp Bears are the most likely to have endometriosis whilst the cool & dry Elephant/butterflies are the most likely to have fibroids and both the hotter constitutions are especially prone to various kinds of PMS. Of course these are just generalisations based on observable patterns but in any case there is a brief introduction to this great subject here and a more detailed section on working out which constitution you are here.

Please understand that I cannot personally advise you without seeing you in my clinic.
This living 'book' is my labour of love so, wherever you are, I wish you peace & good health!



© 2011 R.J.Whelan Ltd