Conditions:
Dysmenorrhea

Principal Proposed Treatments
  • Fish Oil, Magnesium, Vitamin E
Other Proposed Treatments
  • Calcium, Manganese, Cramp Bark, Bromelain, Turmeric, White Willow, Black Cohosh, Coleus forskohlii, Dong Quai, Manganese

We do not know why menstruation is uncomfortable at all, or why it is much more painful for some women than for others and varies so much from month to month.

Occasionally, severe menstrual pain indicates the presence of endometriosis (a condition in which uterine tissue is growing in places other than the uterus) or uterine fibroids (benign tumors in the uterus), but in most cases no such identifiable abnormality can be found. Natural substances known as prostaglandins seem to play a central role in menstrual pain, but the details of the many interactions are scarcely understood, and the available treatments are not specific in their action.

Anti-inflammatory drugs such as ibuprofen usually relieve menstrual pain substantially. However, their blood-thinning effects can increase menstrual flow. Oral contraceptive treatment can also help over the long term, although its success is not guaranteed.

Principal Proposed Treatments for Dysmenorrhea

There is some evidence that the supplements fish oil, magnesium, and vitamin E may help reduce menstrual pain.

Fish Oil: Appears to Relieve Cramps

It is believed that the omega-3 fatty acids in fish oil may help relieve dysmenorrhea by affecting the metabolism of prostaglandins and other factors involved in pain and inflammation.¹

In a 4-month study of 42 young women aged 15 to 18, half the participants received a daily dose of 6 g of fish oil, providing 1,080 mg of EPA (eicosapentaenoic acid) and 720 mg of DHA (docosahexaenoic acid) daily.² After 2 months, they were switched to placebo for another 2 months. The other group received the same treatments in reverse order. The results showed that these young women experienced significantly less menstrual pain while they were taking fish oil.

Another double-blind study followed 78 women, who received either fish oil, seal oil, fish oil with vitamin B₁₂ (7.5 mcg daily), or placebo for three full menstrual periods.³ Significant improvements were seen in all treatment groups, but the fish oil plus B₁₂ proved most effective, and its benefits continued for the longest time after treatment was stopped (3 months). The researchers offered no explanation why B₁₂ should be helpful.

For more information, including dosage and safety issues, see the full fish oil article.

Vitamin E

One study suggests that vitamin E may be helpful for the treatment of dysmenorrhea. In this double-blind, placebo-controlled trial, 100 young women complaining of significant menstrual pain were given either 500 IU vitamin E or placebo for five days. ¹² Treatment began two days before and continued for three days after the expected onset of menstruation While both groups showed significant improvement in pain over the two months of the study, (presumably due to the power of placebo), pain reduction was greater in the treatment group as compared to the placebo group.

Magnesium

Preliminary studies suggest that magnesium supplementation may be helpful for dysmenorrhea. A 6-month double-blind placebo-controlled study of 50 women with menstrual pain found that treatment with magnesium significantly improved symptoms.⁹ The researchers reported evidence of reduced levels of prostaglandin F₂ alpha, a hormone-like substance involved in pain and inflammation.

Similarly positive results were seen in a double-blind placebo-controlled study of 21 women.¹⁰

For more information, including dosage and safety issues, see the full magnesium article.

Other Proposed Treatments for Dysmenorrhea

One small but carefully conducted double-blind trial suggests that making sure to get enough calcium and manganese may help control symptoms of menstrual pain.¹¹

The herb cramp bark has traditionally been used to relieve menstrual pain. Unfortunately, it has not received any significant scientific attention.

Herbs with possible anti-inflammatory properties may be helpful as well, including bromelain, turmeric, and white willow. Other potentially helpful treatments include black cohosh, Coleus forskohlii, dong quai, and manganese.

Last reviewed April 2002 by Medical Review Board

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