Why do your periods hurt so much?

Period Pain_Natural ways to relieve it_by Hormone Specialist and London Nutritionist Kay Ali

Photograph by Danny G.

We’ve all been there. Curled under bed sheets with a hot water bottle pressed to our tummies while we pant, moan and grit our teeth waiting for those excruciating cramps to pass. Period pains are no joke. And they're also not normal.

You might be surprised to hear that, contrary to what our mothers told us, stomach cramps are not just part of experiencing our monthly cycle. Far from it in fact. We don’t have to grit our teeth and just bear it. Healthy periods are pain-free; and I’ve got a long list of women I’ve helped that can vouch for that.

So why are your periods painful? It’s got something to do with a little hormone-like chemical called prostaglandins. We actually need them. They help contract and relax our muscles, control our blood pressure, dilate our blood vessels and manage inflammation. More to the point, they support ovulation, trigger our uterine lining to contract helping us bleed every month and even induce labor. In fact, prostaglandins are so important that almost every cell in our body makes them. Why then, do they cause us so much pain?

Quote from Hormone specialist and London Nutritionist Kay Ali about prostaglandins and period pain

While we need prostaglandins, too much is a problem. Clinical studies show that the more prostaglandins you make, the more intense your menstrual cramps are. It’s the primary cause of dysmenorrhea. A really good sign that your cramps are a result of high levels is if you notice a sudden change in your bowel movements the day before or the first day of your period. Your stools will get very, very loose. So, it’s not surprising then that you’ve got to get the balance just right; too little and too much isn’t quite right for this Goldilocks hormone.

Here’s what you can do to help reduce your levels and ease your stomach cramps:

1. Eat more oily fish

Oily fish helps relieve period cramps_by Hormone Specialist and London Nutritionist Kay Ali

Photograph by Gregor Moser.

We make prostaglandins from an Omega 6 fatty acid called arachidonic acid. Often levels get too high if we eat too much of this polyunsaturated fat. Eating too little of Omega 3 too can also be a problem. That’s because both these essential fatty acids compete with one another for the same binding site. In science talk we call it the COX-1 enzyme. It’s important because this enzyme converts your Omega 6 to prostaglandins. This means by increasing your Omega 3s you can help slow down this conversion, effectively managing excess prostaglandin production.

Your best sources of Omega 3 are from wild oily fish like sardines, mackerel, anchovies, herring and salmon. You want to be eating 4 portions every week! While you can find Omega 3 in plant alternatives like walnuts, soy, flax and chia seeds, their concentration doesn’t come anywhere near what you get from oily fish.

My clients report a significant improvement after supplementing with Omega 3 fish oil too. However, it’s important you opt for brands that are independently certified pure and fresh to avoid any environmental contaminants.

2. Increase anti-inflammatory foods in your diet

Photograph by The Creative Exchange.

Anti-inflammatory foods like ginger have been shown to help alleviate period cramps. In fact, one small study found that a minimum of 1000mg of ginger was just as effective as pain killers in relieving menstrual cramps. While you can increase your consumption of ginger in your diet through teas, soups, healthy curries and stir fries, I’ve found that supplementing with ginger is more effective as it allows you to achieve a therapeutic dose.

3. Consider a magnesium supplement

Magnesium supplement helps relieve period cramps_By Hormone specialist and London Nutritionist Kay Ali

Photograph by The Tonik.

Ah, magnesium. It’s been a life saver on many occasions! Much like ginger, magnesium has been shown to be more effective than the placebo group in relieving period cramps. I typically recommend 300mg a day, with scope to increase the dose in the days leading up to your period depending on your symptoms. You can reach 300mg through your diet alone, if you pay particular attention to what you’re eating. Almonds, spinach, black eye beans and kale are some of your best sources. However, if you choose to supplement too, it’s important you work with a practitioner who can monitor your doses (safety first, my friends).

There are so many different types of magnesium on the market. I recommend you stay away from magnesium citrate if you’re taking it purely for stomach cramps. This is because it’s very effective in loosening your stools, which tends to be an issue already with high prostaglandins. A much better option is magnesium bisglycinate. It is highly absorbable and won’t get you dashing to the loo.

4. Get a food intolerance test

If you find that nothing has helped you alleviate your cramps, you may need to go on an elimination diet. I’ve found with some of my clients unknown food intolerances can increase inflammation, driving hormonal imbalance. Particularly, estrogen dominance. Too much estrogen in the body can also lead to period pain.

A food intolerance test will tell you which foods your immune system is reacting to, that you should limit or avoid for a period of time, while supporting your gut. Typically you can reintroduce these foods at a later date and monitor whether your symptoms are triggered. In which case, it’s best to avoid long term. I’ve found that dairy and gluten are common culprits. If you can’t access a food intolerance test, maybe try a 30 day dairy and gluten free diet and see how you get on.

Hormone specialist and London Nutritionist Kay Ali shares her Hormonal Harmony checklist