Q: I have a friend who is 15 years old, and she says that her periods are so painful that she needs stronger medications for them. I suggested NSAIDs and told her how to take them, but she said they didn't work. I worry about her taking "strong" medicines -- such as narcotics -- for cramps, and setting up a possible future dependency on drugs. Are there any natural products that can offer her relief?

A:

Having personally had menstrual cramps since I was thirteen, I sympathize with your 15 year old friend. Mine were very severe as a teen, and the gynecologist's only attempt to help was to tell me at age 16, that they would go away after I had a baby. Fortunately I didn't have my first child until I was 21, since three children later I still have cramps the first day of my period. I have however, though the years found a number of things to help me manage the discomfort including dietary changes, nutritional supplements, herbs, NSAIDS and even codeine.

It helps to identify the likely cause of the cramping. Most often it is due to increased levels of prostaglandins which increase uterine contractions. In some cases in young women it can be due to cervical spasm and/or hormonal imbalance (this is the type that may be better after childbirth). Often, with elevated prostaglandins, the periods will be heavy, while the spasmodic type will have light periods.

An excellent diet, with lots of fresh foods, the avoidance of sugar, hydrogenated fats and hormone containing meat and dairy products will help to normalize both prostaglandin and hormone levels. I always have less cramping when I have been attentive to good diet and drinking plenty of water, especially in the week to 10 days before my period.

A multiple vitamin mineral supplement along with extra calcium and magnesium will help with prostaglandins and hormones and also balance uterine contractions. It will also help with premenstrual symptoms and helps to build strong bones to prevent future osteoporosis. GLA and/or fish oil supplements can be helpful in promoting good prostaglandins and inhibiting the bad ones.

I have used herbs for my menstrual cramps for the last 15 years. They always help decrease my discomfort and sometimes are all that is needed. Two herbs that work as muscle relaxants and gentle sedatives are Valerian and Kava. Valerian tends to be more sleep promoting and may be better for use at night, with Kava during the day. For women with heavy menstrual flow and prostaglandin problems, both Black Haw and Cramp Bark (Viburnum prunifolium and Viburnum opulus) are very helpful. For women with light periods either Blue Cohosh (Caulophyllum thalactroides) or Dong quai (Angelica sinensis) help to normalize hormone levels. Women with heavy periods or an IUD should not use either Blue Cohosh or Dong quai as they can increase menstrual flow to hemorrhage levels.

NSAIDS are helpful for cramps due to excess prostaglandins, since they block the production of the bad prostaglandins. They usually work best if started the day before the period starts and continued through the day cramping usually stops. NSAIDS have the side effect of gastrointestinal upset. I have recently had to discontinue using ibuprofen for my cramps because it was resulting in severe abdominal distress for several days after stopping it. Another side effect with NSAIDS is heavier periods, since these medications also decrease blood clotting.

My last resort for menstrual cramp relief is acetominophen with 15-30 mg of codeine which my doctor prescribes. I reserve this for the most severe cramping, especially at night when I need to sleep. It has also been helpful when cramping was very severe and I was not able to just hang out at home for the day and take it easy. I think there is almost no risk of narcotic dependency when using one to three doses of this medication once a month. My experience and that of other physicians and patients is that it significantly decreases or totally eliminates cramping for up to 6 hours. Codeine does cause constipation, so its should be limited.

It is also helpful to me to be able to take the first day of my period off and relax without the demands of the outside world. While this is not always possible, I try to make it happen as much as I can. I discontinued the use of tampons 20 years ago because I found they increased the severity of the cramps. Homeopathic remedies can be helpful to both relieve discomfort and balance hormone levels. A good one to try is Mag Phos.

I certainly would not hesitate to utilize a combination of treatments including non-prescription and prescription pain medications for my own clients, especially as I remember the times as a teen when I was doubled over with pain.

* The information presented in this web site is intended to inform and educate. It is not intended replace a qualified medical practitioner to diagnose or treat medical conditions.