Period pain: 3 root causes

Woman with period pain

Period pain affects up to 91% of women in the UK at some point in their lives. Learn about the 3 root causes and what you can do about them.

ARTICLE HIGHLIGHTS

  • What is period pain?
  • When do women typically experience period pain?
  • 3 underlying cause of period pain and what to do about it
    • High prostaglandins
    • High histamine
    • Hormone imbalances
  • Testing estrogen and progesterone for period pain
  • Recommendations to reduce period pain at home

What is period pain?

The medical term for period pain is primary dysmenorrhea. This is the term for painful periods caused by uterine contractions rather than other underlying conditions such as endometriosis

WHEN DO WOMEN TYPICALLY EXPERIENCE PERIOD PAIN?

Painful periods impact nearly all women at some stage in their lives. Typically period pains are worse in puberty and again during perimenopause due to the hormonal fluctuations and a tendency towards higher estrogen and lower progesterone at these times. 

On average, period pain can last 1-2 days, usually starting the day before or first day of bleeding. For others, it can last their entire period. 

The experience of painful periods can be very mild and experienced as small twinges, but can also be debilitating pain that impacts the normal functioning of daily life. In some cases, period pain can be accompanied by nausea, vomiting, bowel changes, headaches and dizziness or fainting. 

Period pain can have a great impact on work and school performance. One study found that more than 80% of women said they had continued to work or study while feeling unwell with period pain, and were less productive as a result. 

91% of women in the UK have experienced period pain at some point.

3 UNDERLYING CAUSES OF PERIOD PAIN

1. prostaglandins

The most common cause of primary dysmenorrhea is a chemical in the body called a prostaglandin. 

Prostaglandins are hormone-like chemicals released in all tissues of the body. When released from the tissues, they cause muscles of the uterus and blood vessels to contract – this muscle contraction and inflammation caused by the prostaglandins is what causes period pain.

We actually need prostaglandins. This is because they are a natural part of our immune system and play important roles in both stimulating our periods and promoting ovulation. 

Prostaglandins are released 3 times around ovulation. First to help with follicular maturation, second to help with the rupture of the follicle and egg release and third to help the formation of the corpus luteum. So they are are very important for our hormone health.

The problem lies in high levels of prostaglandins. 

SIGNS OF HIGH PROSTAGLANDINS

One of the signs of high prostaglandins is getting loose stool before and during your period! This is because prostaglandins cause other muscle contractions too, including inside your intestines.

HOW TO SUPPORT HEALTHY PROSTAGLANDIN LEVELS

Try eliminating dairy for 4 weeks.

Although giving up dairy can be hard initially, we recommend trying this for 4 weeks to see if it impacts your period pain. You will likely notice a difference after one month, but ideally three months is better, especially if you notice that it is helping. 

Why does giving up dairy support period pains? 

Dairy is a common food sensitivity food for people. Developing a sensitivity to dairy is very common in times of stress or after antibiotics. This means that dairy will be causing an inflammatory response and worsening levels of prostaglandins and therefore increasing pain. 

Interestingly you may still be ok with still having goat and sheep’s dairy, Jersey cow dairy and butter (as they are low in A1 Casein).

Try one of our dairy-free, hormone friendly recipes.

2. High histamine

Histamine is a chemical that is released in the body, also as part of the immune response. High histamine is a common cause of painful periods, as well as heavier periods and hormone imbalance too. 

SIGNS OF HIGH HISTAMINE

As well as suffering from period pain, you may also suffer from symptoms such as: 

  • Itchy eyes
  • Nausea
  • Skin rashes
  • Irritability
  • Anxiety
  • Food sensitivities
  • Loose stools
Tip for high histamine and period pain

possible causes of high histamine

It is important to figure out the root cause of high histamine – there can be many. Possible causes include:

  • High histamine intake in the diet
  • Excess estrogen (which proliferates histamine)
  • A genetic tendency to have poor clearance of histamine from the body (such as a SNP on the DAO or HNMT genes). 

Once we know where the problem lies for you, we can target this with supplementation and nutrition. 

How to reduce histamine levels

Try a low histamine diet. This means avoiding foods high in histamine such as avocados, chocolate, dried fruits, spinach, fermented foods, alcohol, eggplant and shellfish.  

Try this for at least a month, especially in the luteal phase (second half) of your cycle.

Learn more about the connection between histamine and hormones.

20% of women miss school or work due to their period pain

3. hormone imbalances

LOW PROGESTERONE

Progesterone is one of your most important sex hormones alongside estrogen. It is anti-inflammatory and when we have adequate levels of progesterone in the luteal phase (second half) of our cycles it can affect the regulation and synthesis of prostaglandins. 

To put this simply, progesterone can reduce prostaglandin levels in the body. 

Having adequate progesterone levels will also lessen other PMS symptoms such as mood changes, poor sleep and heavy periods too. 

low progesterone is key for period pain.progesterone is made as a result of ovulation

SIGNS & SYMPTOMS OF LOW PROGESTerone

Signs you may have low progesterone include:

  • Anxiety
  • Spotting
  • Heavy periods
  • Irregular periods
  • Poor sleep 
  • Bad PMS

Read more about low progesterone.

HOW TO SUPPORT LOW PROGESTERONE

Focusing on good sleep hygiene and balancing your circadian rhythm is important here.

  • Sleep quality: Sleep hygiene refers to a set of practices to support good sleep. Try turning off screens and half the lights in your house 1-2 hours before bed to support melatonin production. 
  • Balance your circadian rhythm: Go to bed at the same time every night and wake up at the same time everyday. This simple foundational change can make the biggest difference to your hormone health, weight, energy and stress levels. 

There are many specific supplements that we can recommend in a one-to-one consultation to support progesterone but it is first vital to understand if that is what your body actually needs – this is why testing is so important. 

If you’re interested in testing, browse our hormone packages to see which test is right for you. 

high or unopposed estrogen

A second common hormone imbalance is high or unopposed estrogen. High estrogen levels can increase both prostaglandins and histamine.

signs of high or unopposed estrogen

Some common signs of high or unopposed estrogen include: 

  • Period pain
  • PMS
  • Tender breasts
  • Weight gain
  • Mood swings
  • Histamine symptoms
  • Heavy periods

how to reduce high or unopposed estrogen

Supporting estrogen detoxification is the best way to ensure healthy estrogen levels. Some of the most easy and accessible ways to support estrogen detoxification are through daily stool movements, gentle exercise, drinking enough water and increasing cruciferous vegetable such as broccoli, cauliflower and kale each day.

Read more about estrogen detoxification.

Another easy way to reduce high or unopposed estrogen is to cut out or significantly reduce alcohol.

Alcohol can cause major hormone imbalance through disturbing healthy detoxification, disrupting sleep and causing blood sugar imbalance. It can also increase histamine and prostaglandin levels, worsening period pain. 

Try removing alcohol for at least 4 weeks and see if it makes a difference.

TESTING ESTROGEN AND PROGESTERONE for period pain

It is very important to understand what your actual hormone levels are before embarking on a plan to support your body. This ensures that you are working with what is actually happening in your body and not guessing. 

All of our FUTURE WOMAN hormone tests assess your reproductive hormones estrogen, progesterone and your androgens, as well as their metabolites. This means we get a good understanding of your estrogen detoxification pathways as well. 

We usually recommend the Classic Hormone Test for anyone experiencing period pain.

Classic Hormone Test

Test your hormones easily at home.

Easy changes to help with period pain

Here are four recommendations to reduce period pain at home.

1. Supplement with magnesium to reduce period pain

Magnesium has a role in over 300 enzymatic processes in the body and it is useful from everything to pain relief, estrogen detoxification, progesterone support, mood, sleep and more! 

This amazing mineral can reduce uterine contractions and prostaglandins so it is well worth trying when you are suffering in the moment but also long-term as prevention of period pain.

Magnesium glycinate is what we recommend as the glycinate has an added benefit of not only being a very well absorbed source, but also it means the magnesium is attached to glycine which is very calming for the brain so is great for sleep and mood support too.

2. incorporate ginger and turmeric into your diet

This next one is super easy and accessible. Simply add some ginger and turmeric into your next smoothie, or even better add a chunk of ginger into a cup of hot water and enjoy as a soothing tea. 

Ginger reduces cramping and spasms and turmeric reduces uterine contractions via relaxation of the muscles, while also reducing prostaglandin levels. 

3. CBD OIL for period pain

The endocannabinoids in CBD oil bind to endocannabinoid receptors in the body and help to modulate stress, sleep and pain pathways in the body. CBD is not only anti-inflammatory but it also supports the immune system and the nervous system, making it a great option when you are suffering from period pain. 

4. SUPPORT OMEGA-3 BALANCE

The last suggestion addresses one of the most common causes of high prostaglandins which is an imbalance in the omega 3 to omega-6 ratio. 

Omega-3 fatty acids are anti-inflammatory, for example foods like fatty fish, olive oil and avocados, whereas omega-6 can be inflammatory and create an environment for increased prostaglandins. Omega 6 sources are seed oils like canola oil, corn oil,  sunflower oil, processed foods and fast food. 

Try to boost foods like olive oil, hemp seeds, flaxseeds, fatty fish and avocados (if you don’t have a histamine problem!) to help support period pain.

If you are struggling with period pain, it is important to address the underlying root cause for you, in order to ensure you are taking the right supplements and nutritional advice for your body and hormonal picture. 

Browse our FUTURE WOMAN hormone tests.

TOP 3 takeaways for period pain

  • The main causes of period pain are high prostaglandins, high histamine, low progesterone and high estrogen. 
  • It is important to make the foundational changes first, such as removing alcohol, removing dairy, managing stress and supporting healthy estrogen detoxification. 
  • Testing is the next best step after implementing the foundational changes – it can reveal exactly what is happening with your hormones as well as your estrogen detoxification. 

REFERENCES

Barcikowska, Z., Rajkowska-Labon, E., Grzybowska, M. E., Hansdorfer-Korzon, R., & Zorena, K. (2020). Inflammatory Markers in Dysmenorrhea and Therapeutic Options. International journal of environmental research and public health, 17(4), 1191. https://doi.org/10.3390/ijerph17041191
 

Ferries-Rowe, E., Corey, E., & Archer, J. S. (2020). Primary Dysmenorrhea: Diagnosis and Therapy. Obstetrics and gynecology, 136(5), 1047–1058. https://doi.org/10.1097/AOG.0000000000004096

Sadeghi, N., Paknezhad, F., Rashidi Nooshabadi, M., Kavianpour, M., Jafari Rad, S., & Khadem Haghighian, H. (2018). Vitamin E and fish oil, separately or in combination, on treatment of primary dysmenorrhea: a double-blind, randomized clinical trial. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, 34(9), 804–808. https://doi.org/10.1080/09513590.2018.1450377

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