By Dr. Mercola
At least half of reproductive-age women suffer from painful menstrual cramps that begin shortly before the start of menstrual flow and continue for several days.
For some the pain is a mild annoyance, but for others it can be so severe that it interferes with daily activities.
Severe menstrual cramps are actually among the most common reasons for missed work and school days among young women.
For treatment, many women rely on over-the-counter NSAIDs like ibuprofen for pain relief, and conventional physicians may even prescribe birth control pills, which prevent ovulation and reduce the severity of cramps.
Both of these "solutions" carry significant risks of side effects while doing nothing to treat the underlying reasons why menstrual cramps occur.
Now researchers have uncovered another option that might ease menstrual cramp pain naturally via the "sunshine vitamin," or vitamin D.
Vitamin D Might Relieve Menstrual Cramp Pain
During menstruation, your uterus contracts to expel its lining, a process that's triggered by hormone-like substances called prostaglandins.
Prostaglandins are associated with both pain and inflammation, and higher levels of these substances are linked to more severe menstrual cramps.
Vitamin D not only helps to decrease the production of prostaglandins, it also helps decrease the production of cytokines, which promote inflammation in your body.
In fact, researchers recently revealed that women with relatively low vitamin D levels (less than 45 nanograms per milliliter (ng/mL)) who took a 300,000 IU mega-dose of vitamin D3 had a significant reduction in menstrual cramp pain. Two months after taking the vitamin D, the women rated their pain more than 2 points lower on a scale of 1-10, and all had stopped using painkillers. On the other hand, those who had taken a placebo reported no reduction in pain, and 40 percent were still taking pain medications.
These are impressive results, however I would caution you against taking this massive dose of vitamin D, especially without medical supervision, as it is possible to overdose on vitamin D when taken in supplement form especially when your vitamin A (not beta carotene) and vitamin K2 are not properly balanced. Very high doses of vitamin D3 supplements may lead to hypercalcemia (high blood calcium) over time. This can result in deposits of calcium in your heart, lungs or kidneys, and the damage can be permanent if your vitamin D levels remain elevated for too long.
The ideal way to optimize your vitamin D levels is through safe sun exposure, as this carries virtually no risk of overdosing on vitamin D.
Regular, Consistent Dosing is Best to Optimize Your Vitamin D
Vitamin D deficiency is currently at epidemic proportions in the United States and many other regions around the world, largely because people do not spend enough time in the sun to facilitate this important process of vitamin D production. This is linked to a number of serious health conditions including cancer and heart disease, not to mention that researchers in the above study found that the lower a woman's level of vitamin D, the more menstrual cramp pain she experienced.
So the first step to ensuring you are receiving all the benefits of vitamin D is to find out what your levels are using a 25(OH)D test, also called 25-hydroxyvitamin D.
There are two vitamin D tests -- 1,25(OH)D and 25(OH)D -- but 25(OH)D is the better marker of overall D status. It is this marker that is most strongly associated with overall health, and it is the one you should ask your physician for. The point of vitamin D testing is, of course, to be sure you are maintaining a therapeutic level of vitamin D in your blood. A few years back, the recommended level was between 40 to 60 nanograms per milliliter (ng/ml), but more recently the optimal vitamin D level has been raised to at least 50 ng/ml.
Sun exposure is the BEST way to optimize your vitamin D levels; exposing a large amount of your skin until it turns the lightest shade of pink, as near to solar noon as possible, is typically necessary to achieve adequate vitamin D production. If sun exposure is not an option, a safe tanning bed (with electronic ballasts rather than magnetic ballasts, to avoid unnecessary exposure to EMF fields) can be used.
As a last resort, a vitamin D3 supplement can be taken orally, but research suggests the average adult needs to take 8,000 IU's of vitamin D per day in order to elevate their levels above 40 ng/ml, which is the absolute minimum for disease prevention. The dosage that is right for you will be determined, ultimately, by how much is needed to keep your levels in the therapeutic range above.
For more details, be sure to read How to Get Your Vitamin D Within Healthy Ranges.
What's Wrong with Conventional Treatments for Menstrual Cramps?
If you visit a conventional physician complaining of menstrual cramps, you're likely to leave the office with a prescription for one of two medications: an NSAID or an oral contraceptive. Aside from the fact that these only cover up your symptoms, and do nothing to heal the problem, they carry significant risks. These are made even worse since most women with menstrual cramps seek long-term relief, and may take the drugs for many months or even years.
NSAIDs (non-steroidal anti-inflammatory drugs) are linked to serious gastrointestinal risks, like bleeding of the digestive tract, increased blood pressure and kidney problems. This applies not only to prescription medications like Celebrex but also over-the-counter drugs like aspirin, Advil and Motrin. NSAIDs are also notoriously bad for your heart; a study by researchers at The University of Bern in Switzerland revealed that NSAIDs lead to a two to fourfold increase in the risk of heart attacks, stroke or cardiovascular death, noting that it would only take 25-50 patients being treated with NSAIDs for one year to lead to an additional heart attack or stroke.1
Birth Control Pills
Hormonal birth control methods like "the pill" contain synthetic progesterone and synthetic estrogen -- something that is clearly not advantageous if you want to maintain optimal health. These contraceptives contain the same synthetic hormones as those used in hormone replacement therapy (HRT), which has well-documented risks, including an increased risk of blood clots, stroke, heart attack, and breast cancer.
In fact, studies have found that HRT increases post-menopausal women's breast cancer risk by at least one percent per year, and HRT with progestin increases your risk by eight percent per year, potentially going as high as 30 percent after just four years of use!
Furthermore, using birth control pills to relieve menstrual cramps is counterproductive, because you may end up simply exchanging them for another health condition. Birth control pills have been linked to an increased risk of:
✓ Cancer: Women who take birth control pills increase their risk of cervical and breast cancers, and possibly liver cancer as well.
✓ Thinner bones: Women who take birth control pills have lower bone mineral density (BMD) than women who have never used oral contraceptives.
✓ Heart disease: Long-term use of birth control pills may increase plaque artery buildups in your body that may raise your risk of heart disease.
✓ Fatal blood clots: All birth control pills increase your risk of blood clots and subsequent stroke. And if your prescription contains the synthetic hormone desogestrel, your risk of fatal blood clots nearly doubles!
✓ Impaired muscle gains: A recent study found that oral contraceptive use impairs muscle gains from resistance exercise training in women.
✓ Long-term sexual dysfunction: The Pill may interfere with a protein that keeps testosterone unavailable, leading to long-term sexual dysfunction including decreased desire and arousal.
✓ Weight gain and mood changes
✓ Yeast overgrowth and infection
More Natural Strategies to Ease Menstrual Cramps
If painful menstrual cramps are interfering with your quality of life, there are a number of safe, natural strategies to consider, in addition to optimizing your vitamin D levels.
• Evening Primrose Oil: This contains the essential fatty acid gamma linolenic acid (GLA), which is useful for treating pain. It is also helpful to restore abnormal hormone physiology, which can contribute to PMS symptoms.
• DIM (diindolylmethane): DIM is a natural phytochemical found in cruciferous vegetables like broccoli, cauliflower, cabbage and Brussels sprouts. It has unique properties that allow it to modify the metabolism of estrogen, promoting optimal estrogen balance and supporting healthy progesterone and testosterone production. The severity of PMS symptoms in women has been linked to elevated estrogen, with symptoms becoming more severe as estrogen rises.2 DIM exerts a balancing effect on hormones and may benefit conditions like PMS, which are associated with estrogen-progesterone imbalance.
• Chinese Herbs: Chinese herbal medicine has been used to treat menstrual pain for hundreds of years, and one study found certain Chinese herbs were more effective than NSAIDs, oral contraceptive pills, acupuncture, heat compressions, placebos, or no treatment at all in relieving menstrual cramp pain.3 Herbs in the study included:
◦ Chinese angelica root
◦ Szechuan lovage root
◦ Red peony root, white peony root
◦ Chinese motherwort
◦ Cinnamon bark
• Acupuncture: A review of 27 studies found that acupuncture may alleviate menstrual cramps better than drugs or herbal medicine by stimulating the production of endorphins and serotonin in your central nervous system.4
• Dietary changes: Dietary changes can be very useful to relieve cramping and other PMS symptoms. You can try:
◦ Avoiding caffeine, alcohol, and carbonated drinks
◦ Reducing your sugar intake
◦ Avoiding smoked cheeses, meats, and fish (as they can increase your fluid retention)
◦ Making sure you're getting enough nutrients in your diet, specifically vitamin B6, manganese, vitamins A and E, calcium, magnesium, animal-based omega-3 fats and tryptophan
• Exercise: This is another useful tool that helps to relieve menstrual cramps, perhaps because it raises your levels of endorphins, which are chemicals in your brain that are associated with pain relief.
• Heat: Using a hot water bottle on your lower abdomen or soaking in a warm bath may provide temporary relief of menstrual pain.