You probably learned growing up that experiencing pain during your period was "normal". But actually, this is under debate. Severe pain can be a sign of an underlying condition like endometriosis, fibroids, or PCOS. What about your run-of-the-mill cramps, though? It turns out those could point toward health problems as well.
There are two types of period pain: primary and secondary dysmenorrhea. Secondary dysmenorrhea is the kind of period pain that indicates an underlying condition. Primary dysmenorrhea is the kind that doesn't. However, even if it doesn't point toward any serious illness, primary dysmenorrhea could point toward suboptimal health, OB/GYN Eden Fromberg, DO, Founder and Director of Holistic Gynecology New York, tells Bustle. And if you make the changes necessary to eliminate it, you just might find that other aspects of your health improve as well.
"The normalization of female pain is an ongoing problem in general, and characterizing dysmenorrhea that is not severe as 'normal' is more of a social than a biological or medical assessment," she says. "It is this dismissal or minimization of the female phenomenological experience of pain that so often leads to women being treated for their psychological and emotional responses, dismissed, or treated with medications and surgical procedures that may blunt quality of life and compromise long-term well being."
If primary dysmenorrhea isn't normal, then, why is it so common? Mary Lou Ballweg, president and executive director of the Endometriosis Association, believes it largely has to do with poor diet, pollution, and other problems with our modern lifestyle.
To understand how this happens, we have to understand what causes period cramps. Regardless of whether they believe they're normal or not, most doctors (including the American College of Obstetricians and Gynecologists) agree that they come from chemicals called prostaglandins that determine how strongly your uterus contracts to get the blood out.
The thing with prostaglandins is, a number of factors can affect how many and what kinds you produce, which means you can reduce your period pain by controlling these factors. Here are a few of them, according to experts.
1. Heels (Yes, Heels)
"Wearing rigid, high-heeled shoes causes pelvic floor spasm and displacement of the uterus on its ligaments," Fromberg says. This can make the uterus's contractions more painful. Heels can also lead to tendonitis, wear away your foot's natural cushioning, and increase your risk of twisting or spraining your ankle.
Yet unfortunately, many women are pressured or required to wear heels for work. "I have patients who have debilitating menstrual cramps, but when I discuss with them that [heels can lead to period pain], they tell me that they work in a bank and cannot wear flat shoes," says Fromberg. This means an overhaul in workplace expectations is necessary to optimize women's health.
2. Period Supplies
It turns out the very products we buy to make our periods easier could actually be making them harder. Many pads and tampons contain harmful chemicals like PCBs and dioxin, says Fromberg. These compounds not only activate receptors involved in pain but also mimic estrogen, which can lead to an excess of prostaglandins.
Several studies have shown that dioxins contribute to menstrual pain. One study in Seminars in Reproductive Medicine, for example, found that when mice’s uterine tissue was exposed to dioxin, it blocked progesterone receptors involved in menstruation. And a whopping 71 percent of monkeys exposed to dioxin in another study in Fundamental and Applied Toxicology developed endometriosis, compared to 33 percent of controls.
3. Improper Breathing
It might sound funny that we wouldn't naturally know how to breathe correctly, given that breathing is a human instinct, but many of us subconsciously hold our breaths, take short or incomplete breaths, or engage the wrong parts of our bodies.
"There are widespread influences of breathing pattern disorders on physical and emotional health in general and the musculoskeletal system in particular," says Fromberg. "There is a connection between breathing pattern disorders and pelvic floor and low back dysfunction." To learn to breathe in a healthier way, Fromberg recommends pranayama, a form of yoga focused on breathing exercises.
4. Exposure To Xenoestrogens
The modern world is full of chemicals called xenoestrogens that mimic estrogen, and since estrogen leads to prostaglandin production, xenoestrogens lead to excess prostaglandin, says Fromberg. Xenoestrogens are found in pesticides, cosmetics, plastic water bottles and food containers, and bleaching agents like those in some pads and tampons.
To avoid these as much as you can, Fromberg suggests eating organic, screening cosmetics here before using them, using glass and stainless steel bottles and containers, and switching to one of the pad or tampon options listed above.
5. Inadequate Diet
This is a big one. Functional nutritionist Alisa Vitti, author of WomanCode and creator of the MyFLO period app and FLOliving.com, teaches women to minimize period problems through what they eat, and she tells Bustle that her clients' period pain is typically eliminated within two to three cycles after following the plans she creates for them.
These plans are based around minimizing the prostaglandin PgE2, which makes the uterus contract and can cause cramps, headaches, nausea, and diarrhea, and maximizing the prostaglandins PgE1 and PgE3, which counteract those contractions, reducing pain. "Your body has twice the capacity for providing pain relief as for causing you to experience period pain," says Vitti.
For example, an excess of Omega 6 (found in canola oil) and arachidonic acids (found in red meat and dairy) and a deficiency of Omega 3 (found in fish, nuts, and seeds) can lead to an excess of PgE2. Salmon, sardines, sesame seeds, and flax can help build up the painkilling prostaglandins.
"We have a culture that indoctrinates women from every institutional angle — religious, academic, medical, and pop cultural — to believe that she should be in pain, to expect to suffer," says Vitti. "So when that begins to happen, she believes nothing is wrong and worse, that no action is needed. Menstrual pain, however, is hormonal biofeedback from the body in response to diet and lifestyle factors and is the body's only way of asking for a response of support — a change in diet and lifestyle to restore balance and end the symptom."
If the majority of men were in pain every month, it would be considered a public health crisis. So, we should treat women's pain the same way. Whatever it is that causes menstrual pain, it's important to realize that it is preventable. If you're experiencing menstrual pain that you don't want to live with, talk to your doctor about potential underlying causes and how to implement changes to your lifestyle.