Period pain: 3 root causes and what to do about them

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:

  • The medical term for painful periods is primary dysmenorrhea.
  • Painful periods are typically worse in puberty and again in perimenopause due to hormonal fluctuations occurring at this time.
  • Period pain can be accompanied by other symptoms such as nausea, vomiting, bowel changes, headaches and dizziness or fainting.
  • Prostaglandins are the most common cause of period pain. They cause muscle contractions and inflammation that results in pain.
  • High histamine is another common cause of period pain. Signs of high histamine include rashes, food allergies, itchy skin, anxiety and period pain.
  • Hormonal imbalances like low progesterone and high oestrogen can also contribute to period pain. Testing is important here to understand if this is happening for you.
  • Foundational changes to support pain free periods include: cutting out dairy, reducing histamine, prioritising good sleep and ditching alcohol.
  • Some easy tips to incorporate at home include magnesium, turmeric, ginger, CBD oil and omega-3 foods.

What are painful periods?

The medical term for painful periods 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 oestrogen 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. ARE Prostaglandins contributing to your period pain?

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.
Prostaglandins 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 prostaglandins are super for our hormone health and are not the enemy!
 
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 your intestines!
 
What foundational changes can you make 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? 
Well dairy is a common food sensitivity food for people (we can even test this in your genes). 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).

2. is High Histamine causing your period pain?

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. 

So what are the 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, and loose stools. 

Tip for high histamine and period pain
Test don’t guess

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

Possible causes of high histamine include:
  • High histamine intake in the diet
  • Excess oestrogen (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. 

A foundational change you can make to support high histamine levels:

Try a low histamine diet. This includes 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.

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

3. Are Hormone imbalances causing your period pain

Low progesterone

Progesterone is one of your most important sex hormones alongside oestrogen. 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. 

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

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

What are signs you may have low progesterone?

Signs you may have low progesterone include anxiety, spotting, heavy periods, irregular periods, poor sleep and bad PMS. 

How do we support 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, you can take our FUTURE WOMAN symptom checker to see which test is right for you. 

high or unopposed oestrogen 

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

Signs of high oestrogen:

Some common signs of high or unopposed oestrogen include period pain, PMS, tender breasts, weight gain, mood swings, histamine symptoms, and heavy periods. 

How can you support healthy oestrogen detoxification?

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

Foundational change to support healthy oestrogen levels:
  • Cutting out alcohol: try removing alcohol for at least 4 weeks. 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. 
A quick note on testing for oestrogen and progesterone:

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. There are several ways to do this including understanding your genetic tendencies for hormone balance, including oestrogen detoxification through our FUTURE WOMAN Hormone, Histamine & Methylation tests, or testing your actual hormone metabolism with our FUTURE WOMAN Advanced Hormone Test.

Advanced hormone test

Test your hormones easily at home.

So we’ve covered 3 common causes of period pain. But what are some easy changes you can do from home?

Four recommendations to help with period pain

1. Take a good quality magnesium glycinate supplement.

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

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. Try CBD oil.

 

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. Check out our FUTURE WOMAN hormone tests here

Top 3 takeaways:

  • The top causes of period pain are high prostaglandins, high histamine, low progesterone and high oestrogen. 
  • It is important to make the foundational changes first, such as removing alcohol, removing dairy, managing stress and supporting healthy oestrogen 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 genetic predispositions. 
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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