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| Photo: Forest and Kim Starr |
Most adults know just how painful and debilitating menstrual pain can be for a woman at times. If you are a man and you don’t know this, then you should.
We are talking about painful cramping pain, which can be accompanied by fatigue and heavy bleeding, and sometimes even nausea, back pain and headaches.
Painful menses can occur for a woman at any time in her life. But there are a number of things that can cause a rash of painful menses.
Major causes of menses pain
Premenstrual pain is often what is called Primary Dysmenorrhea. This is frequently what is experienced among younger women. Primary dysmenorrhea is thought to be caused by contractions in the uterus by imbalances in the body’s levels of prostaglandins. Prostaglandin imbalance produces restrictions in microvessels that feed the uterine muscle with nutrients and oxygen. The result is a uterine muscle cramp.
Surging or imbalanced prostaglandin levels can be caused by stress, a lack of sleep, a poor diet, a lack of exercise and other factors.
Another cause of menses pain is the development of endometrium in other regions outside the uterus. The endometrium is the lining of the uterus, but when this lining develops around the ovaries, Fallopian tubes, or even the bladder and pelvic floor – and further onto related organs – it can cause especially painful menses. This is diagnosed as Endometriosis.
Now should the endometrium settle within the uterine muscle – called Adenomyosis – this can also result in painful cramping during menses.
These cases of displaced endometrium often take place in women over the age of 30, but they can also occur in younger women.
Uterine fibroids are another cause for painful menstruation. Approximately 80 percent of women will have fibroids by the age of 50 years old. Fibroids can result in not only painful menses, but the passing of clots during menses. This can be scary for a woman, yet many have them. There are a number of treatment options for this, of which ultrasound is the least invasive.
Mechanical contraceptives such as IUDs can also cause painful menses. This is especially the case with copper IUDs, which continually release copper.
Another potential cause of painful menses can be a sexually transmitted infection and the potential of Pelvic Inflammatory Disease later on. STDs can create scar tissue with their damage. This scar tissue can become inflamed during or prior to menses.
Painful menses can also occur as a result of an structural issue within the uterus or Fallopian tubes and ovaries. Structural issues include septate uterus, unicornuate uterus and uterus didelphys. These can cause blocked flow of menses, producing increased cramping and pain.
Ginger root for premenstrual pain
For well over 5,000 years, traditional medicines have been utilizing Ginger (Zingiber officinale) for pain. We’re talking all types of pain here. From pain related to sore muscles to pain related to headaches. Whatever the pain is, Ginger has been used to treat pain.
I discuss the use of Ginger – along with a number of other natural pain-relieving strategies – in detail in “Arthritis – the Botanical Solution“:
This also goes for painful menstruation. Ginger root has been a primary medicine for menses pain among Ayurvedic medicine, Kampo medicine, Traditional Chinese Medicine and others.
And for good reason. Because Ginger really works. Studies have in fact, shown that Ginger naturally suppresses prostaglandin levels. Yet it does this without the typical side effects of NSAIDs, which is to also suppress mucosal membrane secretions. This of course, relates directly to NSAIDs’ link to ulcers and other gastrointestinal issues.
At any rate, researchers from Indiana University School of Nursing and the University of Wisconsin-Madison’s School of Nursing investigated the research on the use of Ginger for the treatment of painful menses. They found several studies that tested raw ginger, and conducted a Cochrane Analysis to calculate its usefulness.
The researchers found six studies that met the criteria for a Cochrane meta-analysis. Together, the researchers were able to calculate just how well Ginger can treat menses pain.
The studies used either the visual analogue scale for pain or VAS – or a five or four-point scale. The later of which being verbal multidimensional scoring system, also called VMS. These allowed the researchers to measure the pain reduction produced by the Ginger.
Three of the studies compared Ginger to a placebo, and two of the studies compared Ginger to an NSAID (nonsteroidal anti-inflammatory drug).
The meta-analysis calculation of these six studies found that that Ginger effectively reduces menses pain. The two studies that compared Ginger to NSAIDs found that Ginger reduced menstruation pain comparably to NSAIDs. These included mefanamic acid (Ponstan) and ibuprofen (Motrin) – both common NSAIDs prescribed for severe menses pain.
In December of 2015, another research group – this one from Korea’s Hoseo University – also investigated the Ginger research for menses pain. They found seven studies that met their criteria. Once again, they concluded that Ginger relieves menses pain:
“Collectively these Randomized Clinical Trials provide suggestive evidence for the effectiveness of 750–2000 milligrams ginger powder during the first 3–4 days of menstrual cycle for primary dysmenorrhea.”
A look at some of the studies
In one of the studies analyzed, medical school researchers studied 150 students who had primary dysmenorrhea. They were divided into three groups. One group was given 250 milligrams of Ginger powder four times a day for three days at the start of menstruation. The second group was given 250 milligrams of mefenamic acid on the same regimen and the third group was given 400 milligrams of ibuprofen on the same schedule.
The researchers found that the Ginger reduced menstruation pain similarly to the two NSAIDs. The pain reduction was the same across all three groups.
Another study tested 120 women with primary dysmenorrhea. They gave half 500 milligrams of Ginger powder three times a day for the first three days of the menstrual period. The other half received a placebo.
The researchers found that the Ginger group experienced significantly less pain and had a reduction in pain duration compared to the placebo group.
Ginger also helps relieve menses-related mood issues
In another study, doctors tested 70 female students between 18 and 35 years old in a three-month long double-blind, placebo-controlled trial. The women had regular menstruation cycles and were not taking medications, but they each had at least five symptoms of PMS during their normal cycles.
The researchers utilized questionnaires that queried 19 different premenstrual symptoms based on the DSM-IV diagnostic testing. The testing gauged the severity of PMS symptoms including mood issues such as anxiety, sadness and depression, together with backaches and abdominal pain issues, weight gain, stiffness, nausea and others.
The researchers divided the 70 students into two groups. The first group was given 250 milligrams of ginger in a capsule twice a day for seven days before and through three days after menstruation. The second group was given the same protocol but with matching placebo capsules.
Both groups’ PMS symptom severity scores were calculated before and after each of the three months. The researchers found that while both groups averaged between 106 and 110 points on the PMS severity testing at the beginning of the study, the ginger group scored significantly lower on all PMS symptoms at the end of each month.
After one month, the ginger group’s scores averaged 51, while the placebo group averaged 105.7. After three months, the ginger group’s scores averaged 49 while the placebo group averaged 107. After the third month, the ginger group’s scores average 47 while the placebo group averaged 106.
These trends were also evident for mood symptoms. Both groups scored between 37 and 39 in the beginning. The placebo group’s mood scores were 13.4 after the three months while the placebo group’s mood scores were 38.4 after the three months.
Behavioral symptom score differences were more dramatic. Both scored between 25 and 26 in the beginning. At the end of the three months, the ginger group scored 10.8 while the placebo group’s scores were 25.6.
Physical symptoms alone were also significantly lower for the ginger group. After three months the ginger group’s scores were 22.7 while the placebo group’s scores were a little over 42.
Another study tested 150 female students who took 1) a ginger; 2) zinc sulfate; or 3) a placebo.
This study found that severity of pain scores were significantly lower among both the ginger and the zinc sulfate groups, and ginger and zinc sulfate had similar reduction in pain scores.
Columbia review compares Ginger with other natural options
In a review by the Columbia University College of Physicians and Surgeons, 33 different studies related to natural options for premenstrual symptoms were reviewed along with 58 other women’s health studies. They found ginger was among the better performing natural remedies, with success relating to nausea.
Researchers from Israel’s Technion-Israel Institute of Technology reviewed 18 studies and found that ginger was found helpful in the treatment of hyperemesis gravidarum – a condition condition characterized by vomiting and nausea.
Ginger’s ability to treat general pain has also been proven in clinical research. Medical researchers from the UK’s University of Exeter reviewed eight clinical studies that included 481 persons. They found that while not all the studies were not as rigorous as they would have liked, they did indicate ginger’s ability to reduce different forms of pain.
Ginger’s pain-relieving abilities also come without the risk of those disorders related to NSAIDs as mentioned above. These include damage to the mucosal membranes of the stomach and intestines, linked with increased intestinal permeability (leaky gut syndrome). Ginger’s bioactive mechanisms are numerous. Ginger contains over 400 medicinal compounds.
REFERENCES:
Chen CX, Barrett B, Kwekkeboom KL. Efficacy of Oral Ginger (Zingiber officinale) for Dysmenorrhea: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine, vol. 2016, Article ID 6295737, 10 pages, 2016. doi:10.1155/2016/6295737
Ozgoli G, Goli M, Moattar F. Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. Journal of Alternative and Complementary Medicine, vol. 15, no. 2, pp. 129–132, 2009.
Rahnama P, Montazeri A, Huseini HF, Kianbakht S, Naseri M. Effect of Zingiber officinale R. Rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial. BMC Complementary and Alternative Medicine, vol. 12, article 92, 2012.
Khayat S, Kheirkhah M, Behboodi Moghadam Z, Fanaei H, Kasaeian A, Javadimehr M. Effect of treatment with ginger on the severity of premenstrual syndrome symptoms. ISRN Obstet Gynecol. 2014 May 4;2014:792708. doi: 10.1155/2014/792708.
Kashefi F, Khajehei M, Cher MT, Alavinia M, Asili J. Comparison of the Effect of Ginger and Zinc Sulfate on Primary Dysmenorrhea: A Placebo-Controlled Randomized Trial. Pain Manag Nurs. 2014 Feb 19. pii: S1524-9042(13)00118-5.
Fugh-Berman A, Kronenberg F. Complementary and alternative medicine (CAM) in reproductive-age women: a review of randomized controlled trials. Reprod Toxicol. 2003 Mar-Apr;17(2):137-52.
Ben-Arye E, Oren A, Ben-Arie A. Herbal medicine in womens’ life cycle. Harefuah. 2006 Oct;145(10):738-42, 782.
Terry R, Posadzki P, Watson LK, Ernst E. The use of ginger (Zingiber officinale) for the treatment of pain: a systematic review of clinical trials. Pain Med. 2011 Dec;12(12):1808-18. doi: 10.1111/j.1526-4637.201
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