Managing painful periods and/or heavy bleeding is a common issue for women – especially during periods of additional stress and in the pre- and peri-menopausal years.

In fact, some studies suggest that many as 93% of women experience menstrual cramps, and up to 26% experience severe pain.

Conventional medicine has provided an array of pain medications to help temporarily alleviate pain – but some of these also come adverse effects ranging from stomach upset to liver damage.

In this small trial published in the journal Evidence Based Complementary and Alternative Medicine, Egyptian researchers studied 95 female nursing students between the ages of 17 and 20 years old. Before the treatments began, the students were randomised and their levels of pain and bleeding assessed over one complete menstrual cycle.

Abdominal massage

After the initial assessment, for seven days prior to each woman’s period, the researchers gave each woman a 10-minute abdominal massage once per day. On one group the researchers used a blend of essential oils in an almond oil base; on the other they used the neat almond oil.

The essential oil blend was made up of one-and-a-half parts cinnamon oil, one-and-a-half parts clove oil, one part lavender oil and one part rose oil diluted in sweet almond oil at a 5% dilution.

Each woman was assessed on the first, second and third day of menstruation bleeding and after one cycle of massage treatment, the two groups switched treatments.

At the end of the study, the researchers found that those given the essential oil massages had significantly less pain and bleeding than the control group.

During the first treatment phase, the essential oil-treated group had 17% less pain than the untreated group on the first day, 20% less pain on the 2nd day, and 28% less pain on the third day tested compared to the group massaged only with almond oil.

 After switching treatments pain reduction in the second group of women was similar, except that the third day’s pain was 57% less than those in the control group.

In both phases of the trial period pains were shorter in duration for the women in the massage group. Among those who had excessive bleeding the essential oil massage helped restore normal blood flow by the third day of menstruation.

Not an isolated finding

A previous 2006 study in Korea, involving 67 students also found that menstrual pain and severity of bleeding were reduced significantly among women massaged with the essential oils compared to massage with just almond oil or no treatment.

In this study, the women were given a short abdominal massage with an essential oil blend of two drops lavender oil, one drop of essential clary sage oil, and one drop of essential rose oil in 5 ml  (about 1/6th oz) of almond oil.

Both of the above studies confirm that while massage may be useful, daily massage with carefully selected essential oils can significantly reduce a significant amount of pain and excessive bleeding in menstruation.

Painful periods or dysmenorrhoea is a common experience in women of reproductive age. It is caused by uterine muscle contractions and can occur before and during your period and result in an uncomfortable feeling of pressure in the abdomen, and pain in the hips, lower back and inner thighs. Nausea, vomiting and diarrhoea are also common symptoms and for some women the whole experience can be very debilitating.

There are two types of period pain: primary and secondary. Primary period pain is a very common condition. The pain often starts shortly before or at the start of the period and continues one to three days. Non-steroidal anti-inflammatory drugs (NSAID) known as pain killers are common used to relieve the pain.

Now two new studies have compared the effects of acupuncture to NSAID treatments for dysmenorrhoea.

One published in the European Journal of Obstetrics, Gynaecology and Reproductive Biology provided evidence that acupuncture is very effective to relieve primary period pains. The study involved in 35 young women with a diagnosis of primary dysmenorrhoea. They were divided into two groups: acupuncture group and medicine group. One month treatments were given to these women with dysmenorrhoea and then the pain scores were assessed. They found that acupuncture is as effective as NSAID to reduce period pain. While 52% of women in the medication group had decreased pain, nearly 70% of women in the acupuncture group had reduced pain.

A second study compared three treatments for dysmenorrhoea: ibuprofen, electro-acupuncture plus a placebo supplement and electro-acupuncture plus an herbal supplement called Tao Hong Si Wu Wan ( a traditional Chinese remedy for menstrual pain that is a combination of peach seed; safflower; Chinese angelica; Szechwan lovage; rhizome; white peony root; rehmannia root).

The women received the treatments for a total of three months and were asked to evaluate their symptoms at the beginning and end of the study.

Both acupuncture groups had significantly better outcomes however, the women who received a combined treatment of acupuncture and herbal supplements experienced the best pain relief. They also had better long-term relief of symptoms compared to the electro-acupuncture only and ibuprofen groups.

Many studies have shown that acupuncture can provide significant pain relief. These findings suggest that acupuncture is just as effective, and for some may be better, than common medications for menstrual pain.

Around 40% of menstruating women experience PMS. The most common symptoms are: irritability, anxiety, depression, headache, bloating, fatigue or excessive tiredness, feelings of hostility and anger, and food cravings, especially for chocolate or sweet and salty foods. These usually start one to two weeks before menstruation and go away after their periods start.

In the recent study in the American Journal of Epidemiology, researchers analysed data on women from the Nurses’ Health Study II – an ongoing research project that includes health data on 116,686 women.

At the beginning of the study, none of the participants reported having PMS symptoms. After 10 years, the researchers identified 1,057 women with PMS and 1,968 without. Data on iron intake and other minerals was collected through questionnaires throughout the study.

The researchers found, after taking into account other factors including calcium intake (which can interfere with iron absorption), that women with the highest nonheme iron intake had a 36% reduced risk of developing PMS when compared to those with the lowest intake.

Conversely, high potassium intake was linked to a 46% increased risk for PMS. Significant links with other nutrients such as magnesium, manganese and sodium consumption were lacking in this study.

The authors concluded that paying attention to mineral intake may be helpful in preventing PMS.

Boost dietary iron

Iron is an essential mineral and an important component of proteins involved in oxygen transport and metabolism. Iron is also essential in the synthesis of neurotransmitters such as dopamine, norepinephrine and serotonin. Approximately 15% of the body’s iron is stored for future needs and mobilized when dietary intake is inadequate. The body usually maintains normal iron status by controlling the amount of iron absorbed from food.

There are two forms of dietary iron: heme and nonheme. Sources of heme iron include meat, fish and poultry. Sources of nonheme iron, which is not absorbed as well as heme iron, include beans, lentils, flours, cereals and grain products. This latest study suggests that including more from this latter category can be part of a healthy eating plan to avoid PMS.

In addition to iron, supplements such as evening primrose oil and vitamin B6 have been reported to improve symptoms of PMS such as mastalgia (breast pain or tenderness) and PMS-related depression or anxiety in some women. Additionally, there is some evidence that ginkgo biloba may relieve PMS-associated symptoms, including emotional upset.