Dysmenorrhea: Is period pain normal?  

Period Health

Did you know that TCM can treat painful periods?

We all have known someone who suffers every month when their period comes around (or maybe we are that person, cue heating pad and canceling plans). Period pain is so common that it is commonly mistaken as “normal”.  This year the Cleveland Clinic reported that more than half, about 60%, of people with a uterus experience period pain. Other studies conclude numbers as high as 80 – 90% of the menstruating population experience period pain – this still should not be confused with “normal”.

We can define period pain by its medical term – dysmenorrhea, meaning discomfort or pain during the menstrual period that may present as cramps, pelvic pain, low back pain, breast pain, headaches, fatigue, diarrhea, nausea and even vomiting. 

 To further define these unpleasant sensations, we can categorize them as Primary dysmenorrhea or Secondary dysmenorrhea: 

  1. Primary dysmenorrhea: pain that begins before or during the first day of your period, it is not debilitating and begins to decline within 1-2 days. This dysmenorrhea resolves on its own, or if needed with an NSAID like ibuprofen. 
  2. Secondary dysmenorrhea: intense pain or cramps that continue for a longer duration of time. This may start before your period and continue after your period has ended. These are the type of cramps that can keep you from living your life (ie. going to work or school), and are not resolved with ibuprofen. 

Primary dysmenorrhea is caused by an increase in prostaglandins as the uterus sheds its lining – the prostaglandins trigger an inflammatory response. Blood vessels and muscles of the uterus contract, resulting in a cramping sensation, looser stools and sometimes headaches. — It’s important to note that a mild sensation is natural during menstruation – our body is going through a process and it is okay to feel some of these changes, to a certain extent. 

On the other hand, Secondary dysmenorrhea may be indicative of an underlying condition like endometriosis, adenomyosis or uterine fibroids. 

As far as treatment is concerned: Western medicine offers NSAIDs like ibuprofen, or birth control to help manage these symptoms. However, this does not solve the root cause of our period pain, but rather it acts as a temporary bandage. 

“For a normal period to occur, blood must be abundant and move adequately. Proper movement of blood relies on the free flow of (liver) qi,” (Maciocia, 2011, p. 255)

Here’s where we come in. Through the lens of East Asian Medicine, dysmenorrhea can be caused by many patterns. Most commonly s t a g n a t i o n  will play a role in each of the patterns, whether it be stagnation of: blood, Qi, or cold in the uterus and meridians. The key idea here is stagnation – a lack of proper flow. In other words, things become “stuck”, and this affects us systemically.  

With the use of acupuncture, herbal medicine, and lifestyle changes, we can unblock this stagnation to alleviate dysmenorrhea and other premenstrual symptoms.  A common herbal formula we prescribe for this condition at Be + Well is Gui Zhi Fu Ling Wan ie. Cinnamon Twig & Poria Pill. This formula helps to warm the acupuncture channels and move stagnant blood.  As always, our treatments and herbal formulas are individualized, and this formula is not for every single person with painful periods. It is critical to consult a licensed Traditional East Asian Medicine practitioner in regards to herbal medicine. 

There is plenty of research supporting acupuncture for relief from menstrual pain. 

According to a 2018 Randomized control trial, regular acupuncture treatment significantly reduced all variables of dysmenorrhea: pain, menstrual cramps, headache, dizziness, diarrhea, faint, mood changes, tiredness, nausea and vomiting in the study group compared with those in the control group, (Shetty, et al., 2018). The study group received 20 minutes of acupuncture, for 15 days per month, for three months. 

A more recent 2023 study observed how the brain responds to acupuncture in people with primary dysmenorrhea, highlighting which parts of the brain are affected and how this relieves pain. 

The study indicated that acupuncture treats PD by regulating endocrine and analgesic substances, modulating immune-inflammatory responses, improving uterine blood flow and reducing oxidative stress,” (Chen et al., 2023). In other words, acupuncture naturally aids the body in reducing pain, inflammation, stress and improves blood flow. 

If you or someone you know is struggling with painful periods, then Be + Well Acupuncture is here to help. We offer individualized treatments plans which include acupuncture, herbal medicine, lifestyle modifications to help restore easy, normal periods. 

To book an appointment, please visit us online or give us a call at (760) 705-4432.

References: 

Chen, B., Guo, Q., Zhang, Q., Di, Z., & Zhang, Q. (2023, February 18). Revealing the central mechanism of acupuncture for primary dysmenorrhea based on neuroimaging: A narrative review. Pain Research and Management. https://www.hindawi.com/journals/prm/2023/8307249/ 

Maciocia , G. (2011). Obstetrics and Gynecology in Chinese Medicine (Second). Churchill Livingstone . 

professional, C. C. medical. (2023). Dysmenorrhea: Painful periods, causes & treatments. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/4148-dysmenorrhea 

Shetty, G., Shetty , B.,  Mooventhan, A., (2018, April 12). Efficacy of acupuncture in the management of primary dysmenorrhea: A randomized controlled trial. Journal of Acupuncture and Meridian Studies. https://www.sciencedirect.com/science/article/pii/S2005290117302066 

The American College of Obstetricians and Gynecologists. (n.d.). Dysmenorrhea: Painful periods. ACOG. https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods#:~:text=Dysmenorrhea%3A%20Discomfort%20and%20pain%20during,tubes%2C%20and%20other%20pelvic%20structures.