My female patients often ask “Is period pain normal”? My answer is “No”. If it were, then every menstruating woman would experience it. As we know, not all women suffer from period pains. It is, however, a common complaint.

The medical jargon for period pain is dysmenorrhoea. There are two distinct types - Congestive dysmenorrhoea and Spasmodic dysmenorrhoea.
- Congestive dysmenorrhoea tends to be worse before the period. It is described as a dull, prolonged pain that produces a bearing down sensation on the pelvic area. The pelvic area is also visibly bloated due to congestion and poor circulation.
- In Spasmodic dysmenorrhoea, the pain is sharp and cramping. The pain begins just a short time before the period flow. This is often associated with hormonal, prostaglandin and nervous imbalances.

It is possible to suffer from both types dysmenorrhoea. If they are extremely painful with heavy blood loss, you should always consult your doctor for the presence of other serious conditions. Should there be an underlying condition such as endometriosis, ovarian cyst, uterine fibroid or pelvic inflammatory disease (PID), then the period pain is known as Secondary dysmenorrhoea. This type of pain will not improve until you have treated the underlying condition. Herbal approaches are available and can be successful for endometriosis, cysts, fibroids and PID, although it is best to consult your doctor first.

Helpful Herbs
The following herbs are very effective for treating painful periods:
- Dong Quai, Wild Yam, Cramp Bark – especially if pain is cramp-like on first day of flow.
- Black Cohosh – for is in lower cervix.
- Blue Cohosh, Peony – especially if pain is around ovaries and radiates to your back and down the legs.
- Ginkgo, Ginger, Yarrow – to improve blood circulation, reduce congestion / bloating and ease the release of blood.

As herbal remedies do not have instant and immediate action, they should be taken well before your period starts to allow them time to produce a positive response. Unless you do not mind swallowing a handful of tablets, the best way would be to use liquid herbs which allows you to mix all the herbs together. Another big advantage of using liquid herbs is that the body easily assimilates them.

Useful Supplements
Calcium & Magnesium - A deficiency in either will cause problems once the uterus starts to contract to dispel the blood.
Zinc - This is one of the most important minerals for fertility and hormonal health. Essential fatty acids - A good balance of omega-3 and omega-6 is required to alleviate the imbalance of prostaglandins commonly found in those who suffer severe cramping.
B Complex - The B vitamins are crucial to reduce premenstrual syndrome and period pain. They play an important role in the hormonal response to stress.
Vitamin E - the all-important vitamin to ensure healthy functioning of the ovaries and uterus.

Eating Right
A well balanced diet is extremely important. Ensure adequate complex carbohydrate, protein plus plenty of cooked vegetables. Fish and chicken (rather than red meat) should be your main source of protein. Trim all fat. Fiber can prevent constipation and this is an important factor to remember in cases of period pain. Drink 8 - 10 glasses of water daily. In Chinese medicine, period pain can be caused by energy (Qi) imbalance, particularly stagnation of energy in the liver and kidney systems. Managing stress is important as negative, unresolved emotions and overwork stagnate Qi, leading to menstrual pain. Raw vegetables, excessive fruits, oily food, sugar, caffeine, cold food/drinks and dairy products should be limited.

Dang Qui Congee
This sweet congee is easily digested, soothing and nourishing for women. Excellent for menstrual complaints like period pain, menopause, bloating, backache and all forms of premenstrual syndrome.

2 slices each of Dong Quai, Huang Qi and Huang Yao Zi (readily available from Chinese medicine shop)
¼ Chen Pi
1 cinnamon stick (2-inch long)
½ inch fresh ginger, sliced
3 cardamom pods
5 red dates, chopped
½ rice
1 cup soya milk
2 cups water

2 servings.

Put all ingredients in a stainless steel pot and bring to boil on high heat. Reduce heat to low and simmer for one hour, stirring occasionally. Serve warm.

Patricia Loh is an educator and writer on natural therapies. She is a qualified clinical herbalist and operates a herbal centre in Subang Jaya. Comments and inquiries: herbz@tm.net.my or 03-5631 7751.