Dysmenorrhea

Donna Easto, C.H., H.C., M.H., Certified Herbal Educator

During my herbal training, I sometimes found it difficult to remember the different terms and definitions for common menstrual disorders.  It can be confusing, so I offer up the following as a guide to the disorders ending with ‘menorrhea’:

  • Amenorrhea:  Absence of menses
  • Dysmenorrhea: Painful menstruation
  • Hypomenorrhea:  Regular but scant menstruation
  • Oligomenorrhea: Infrequent menstrual cycles 
  • Oligohypermenorrhea:  Infrequent and heavy bleeding
  • Oligohypomenorrhea:  Infrequent and scant bleeding
  • Polymenorrhea:  Frequent menses (less than 21 days between)

Dysmenorrhea, difficult menstruation, presents itself in many ways.  The pain can be bearable or intense, come in waves or be constant, and it may radiate to the lower back and legs.  Pain can be accompanied by headache, backache, dizziness, nausea, vomiting, constipation and diarrhea.  If that isn’t enough, the pain and other symptoms can begin before menstruation starts and persist for the first three days of the period.  It’s the primary cause of absenteeism from school and employment.  Many women turn to analgesics and NSAIDs for relief.  If those don’t do the trick, conventional treatment depends on PGSIs (prostaglandin synthetase inhibitors) and oral contraceptives.  PGSIs act quickly to reduce pain; side effects may include GI upset, edema and skin rash.  Oral contraceptives also decrease prostaglandins; side effects may include weight gain and depression; they’re not recommended for women who smoke, have high blood pressure or have blood clotting issues.

Botanical treatments are highly effective for reducing pain and inflammation.  A herbalist will first determine the main features of the dysmenorrhea as congestive or spasmodic. Congestive is defined as having scant or difficult blood flow, pressure or dull aching in the pelvis and a spongy feeling in the uterus.  Spasmodic dysmenorrhea presents with spastic, cramping pain.  Dysmenorrhea is further divided into two types:  primary and secondary.  Primary happens with the onset of menstrual cycles, just before and through the first hours of menses.  It typically improves over time.  Symptoms of Secondary dysmenorrhea can occur during, after or before the menses. It first appears between twenty and forty years of age and typically worsens over time.

The goal when treating congestive is to relieve the congestion and improve pelvic circulation and tone.  The major herbs used may include ginger, yarrow, motherwort, red raspberry leaf.  The goal in treating spasmodic is to reduce spasms and pain.  The major herbs used may include cramp bark, black cohosh, Jamaican dogwood and pulsatilla.  An anti-inflammatory diet and supplementation with fish oils can be beneficial.

Next week we’ll take a deep dive into the botanicals and supplements used for dysmenorrhea.  Until then, here’s a simple recipe that may help: Analgesic-Antispasmodic Oil

Combine ½ teaspoon of Chamomile, Fennel, Caraway and Peppermint pure essential oils in four ounces of olive oil.  Store at room temperature.  Massage 1-2 tsp into the lower abdomen and cover with heat.  Be sure to first check for skin sensitivity on your inner wrist.

Next: Review of botanicals in dysmenorrhea

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