If you have PCOS, you can have regular menstrual cycles (ranging from 26-34 days), or really long cycles (35 days or longer). Or, you may never know when you are going to get a period, and when you do get it, it may be horrific!
What causes painful periods?
Your uterine lining builds each cycle in anticipation of a pregnancy, and when you ovulate (release an egg) and it’s not fertilized, then your lining sheds – this is your period. Note that you do NOT have a normal period if you are taking synthetic birth control pills as we explain here.
It turns out that during your period your uterine lining releases signaling molecules called prostaglandins. These are normal, and cause your uterus to contract, which you need to control bleeding. However, when there is too much prostaglandin around, it can signal pain.
It’s very common for women with PCOS to make too much uterine prostaglandin, and then experience heavy and painful menstrual periods.
The reason you make prostaglandins (PG) during your menstrual cycle is because shedding the inner lining is the same as an injury. You need a certain amount of “controlled” inflammation to heal that injury. The problem is that anything that leads to too much inflammation in your body will spike the release of too much PG.
Why does PG spike?
A big cause is estrogen dominance (too much estrogen relative to progesterone). Estrogen thickens your uterine lining which means more PG is needed to shed and repair the lining.
Estrogen dominance can be due to MANY things:
- Exposure to endocrine disruptors.
- Sugar and insulin issues.
- Toxin overload.
- Unhealthy gut bacteria that prevents the elimination of estrogen from your intestinal tract.
- Gastrointestinal infections — a direct cause of high PG in your body and specifically your uterus. Any intestinal or pelvic infections will cause period problems.
- Stress hormones — anything that messes with your cortisol (anti-inflammatory hormone) will bring on heavier periods.
- Poor progesterone production. This is often related to stress hormone imbalance, poor egg quality, or most commonly — lack of normal periods and ovulation.
Don’t accept painful periods as normal!
Did you know that it’s not normal to have menstrual periods that cause severe cramping, back pain, heavy flow (as in soaking a pad or tampon every hour), or a need for pain medication? Sure, it’s nice to take time away for the proverbial “menstrual hut,” BUT you should not HAVE to stay in bed, fight off a migraine, or miss work!
These are not symptoms you have to live with. Synthetic birth control hormones are not a fix either, as we explain here.
What is the fix for painful periods?
Well, as functional medicine providers we highly encourage you to take charge of your hormone health and reverse your PCOS and painful periods with lifestyle changes that you can do on your own. Yes, this is possible. We see it with every woman we work with who is willing to do the work. In our PCOS SOLUTION program we walk you through everything you need to know to change the underlying causes of your PCOS and painful periods. One of the main results of this program is to reduce the inflammatory prostaglandins that build in your uterine lining.
The program teaches you:
- How to eat to balance your hormones.
- The right type of exercise for hormone balance.
- How to regulate your adrenal hormones which are a big player in the reproductive hormone imbalance of PCOS.
- Ways to fix your gut microbes in order to balance your hormones.
- How to reduce inflammatory prostaglandins and other inflammatory molecules, always a part of PCOS.
- And much more!
Before taking the program, what can you do to alleviate period pain now?
First, check with your gynecologist, to rule out medical conditions that may cause a heavy painful period, such as coagulation disorders, hypothyroidism, endometriosis, uterine fibroids, or uterine polyps.
Our favorite research-based and clinic-tested interventions for painful periods:
- During your period, take 1000 mg ginger twice daily, 400 iu vitamin E daily, and 500 mg twice daily of an absorbable curcumin.
- Omega-3 fats, which make anti-inflammatory prostaglandins to combat the inflammatory ones. 3000 – 4000 mg of total omega-3 fats during your period, and 2000 mg the rest of the month. A reputable source is very important!
- Magnesium, magnesium and more magnesium! 400 mg per day of magnesium glycinate. If you don’t poop completely every single day, increase up to 800 mg. Apply topical magnesium on your belly, or take baths with epsom salts and soak up magnesium that way. Magnesium is the “great relaxer” mineral and most women are deficient.
- Increase progesterone levels with vitex or with bioidentical progesterone. Often low progesterone relative to estrogen is the cause of heavy painful periods.
- Calcium-d-glucarate to help “bad” inflammatory estrogens metabolize out of your body – 1-3 grams daily is helpful got excess estrogen relief.
- Optimize your vitamin D. It balances all things hormone. Aim for serum levels around 50-60. Start with 5,000iu a day with similar amounts of vitamin A if you are D deficient.
- Phyto (plant-based) estrogens help block “bad” inflammatory estrogen. Fresh ground flax seeds and soy (tofu, tempeh, miso) are good sources. One tablespoon of ground flax a day can do the trick.
- Cramp bark! Take 1 dropper of the tincture 3 times daily. It soothes smooth muscle cramps.
- Chinese Medicine: Get Acupuncture. Take a high quality Chinese herbal formulas such as Augmented Four Substances (tao hong si wu tong), or Warm the Uterus (wen jing tang).
- Reduce inflammation by avoiding wheat, dairy, and sugar, including too much alcohol. Dairy especially increases inflammation in cases of painful periods.
- Improve your gut microbes with a high quality prebiotic foods and fibers, and probiotics – see this post.