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', obviously affects a great many women including those 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 each and every month.

Most of the pain is caused by a lack of oxygen to the tissues, in turn caused by cramping in the uterine muscles These cramps themselves are the result of substances called 'prostaglandins' that occur through hormonal changes that are happening in order to shed the lining that has built up in the uterus.

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

Fortunately, there are several traditional herbal medicines that will help if used correctly; more below.


First aid for dysmenorrhoea

Later in this article, the three main causes of dysmenorrhoea, PMS, endometriosis, and fibroids are discussed in more detail because, if one or more of these are in the picture, then they must be given attention to achieve a lasting result, but of course it is understood that this will be a process that will take time.

In the meanwhile, in the here and now, there are several 'first-aid' approaches that have been seen to be extremely helpful for a great many women

Cramp bark

The first treatment for help right now is the great Native American herb Cramp bark, which earned its name for one simple reason, it really is very good at helping relieve cramps. Cramp bark can be especially helpful for dysmenorrhoea if, and this is a big if, it is used correctly!

There is an art to using many herbs in a way that yields their virtue and this is very true of Cramp bark. This is described in more detail in the page devoted to Cramp bark however, in summary, it's about using small and frequent doses until the woman is palpably feeling both its relaxing and its pain-relieving properties. This is not a herb you take in the hope that it will help you later, you take it in a way that makes you feel it now.

Many women who use Cramp bark to good effect report that they start needing less of it to get as good results and that, after using it for a while, that her periods get significantly less painful overall. Therefore, even though we are describing Cramp bark a first-aid herb, for some women there is obviously a deeper healing happening under its influence, read more about it here.

Botanical drawing of Viburnum opulus (Cramp bark)


Herbal 'Astringents'

For periods that are painful, heavy and flooding there is an ancient technique to help ease the period using a class of herbs known as 'astringents'.

Three of the best of all astringent herbs are Shepherd's purse (detailed info here), Lady's mantle (more here) and Raspberry leaf (more here).

Alchemilla vulgaris (Lady's mantle)


Shepherd's Purse for excess bleeding

The following notes are from the article on Shepherd's purse.

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 but once it is seen to work the unpleasantness tends to fade into insignificance.

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 & Ginger

All women know that applying heat may help with dysmenorrhoea and will have tried for herself whether using heat, for example via a hot water bottle or wheat bag, has relieved her cramps or not.

If you are a woman who definitely benefits from heat then you should also try taking a strong dose of Ginger to see if this helps you further. If you take enough Ginger to really feel it in your core, then you may get a substantial amount of relief from pain. Ginger is safe, easy to get and easy to use, more details including some Ginger tea recipe suggestions here.

Zingiber officinale (Ginger root)



For some women, taking extra magnesium can make a marked difference to how painful their periods can be. It appears that a person either clearly and quite rapidly responds to magnesium or they don't, but the only way to know is to try and see.

200mg of elemental magnesium per day is the level you would need to take to do a trial of this, Note that you must 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 seem like you are taking far more Magnesium than you actually are.

If you do feel that you respond well to magnesium then you consider adding more magnesium-rich foods to your diet because minerals, like vitamins, work best in their most natural form.


Deeper causes and their treatments

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.

Most PMS is triggered by oestrogen levels that are rising too high in relation to progesterone but there are other ways to effectively help this without using drugs to completely stop the process, more here.



One study using a surgical technique, laparoscopy, to investigate the lining of the womb, 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.

Also note that, if you know you have endometriosis but also have a marked 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', i.e. an overgrowth of bad bugs in your body, which can be a key driver for endometriosis itself, more on the subject of dysbiosis here and a more detailed article on endometriosis here



For treating painful periods associated to fibroids, it is especially recommended to look into using the berries of the herb Vitex, more info here, and the leaves of Lady's mantle, more here.

Likewise the suggestions in the article on PMS linked above about reducing oestrogen are likely to help fibroids, sometimes referred to as 'oestrogen-bubbles'

Small fibroids that are associated to excess bleeding and dysmenorrhoea have been seen to respond very well to herbal medicine but but if the fibroids are too large to have a realistic hope of shrinking then surgical options should also be considered if they are available, this is all discussed further 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.

There is a brief introduction to the 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