Journal of Medicinal Plants

Herbal Medicine in the Treatment of Primary Dysmenorrhea

Kashani L (M.D.)1, Mohammadi M (M.D.)1, Heidari M (M.D.)2, Akhondzadeh S (Ph.D.)3*

1- Infertility ward, Arash Hospital, Tehran University of Medical Sciences, Tehran,

Iran
2- Iranian Academic Center for Education, Culture & Research (ACECR), Tehran,
Iran
3- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical
Sciences, Tehran, Iran
* Corresponding author: Psychiatric Research Center, Roozbeh Hospital, South
Kargar Street, Tehran 13337, Iran
Tel: +98-21-88281866, Fax: +98-21-55419113
Email: [email protected]

Received: 21 Jan. 2015 Accepted: 17 March 2015

Abstract
Dysmenorrhea is called "primary" when there is no specific abnormality and "secondary" when
the pain is caused by an underlying gynecological problem. It is believed that primary
dysmenorrhea occurs when hormone-like substances called "prostaglandins" produced by
uterine tissue trigger strong muscle contractions in the uterus during menstruation. However, the
level of prostaglandins does not seem to have anything to do with how strong a woman's cramps
are. Some women have high levels of prostaglandins and no cramps, whereas other women with
low levels have severe cramps. This is why experts assume that cramps must also be related to
other things (such as genetics, stress, and different body types) in addition to prostaglandins.
Secondary dysmenorrhea may be caused by endometriosis, fibroid tumors, or an infection in the
pelvis. In this article we focus on herbal medicine in the treatment of primary dysmenorrheal.

Keywords: Herbal Medicine, NSAIDs, Primary dysmenorrhea

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Introduction can begin later in a woman's life. The

Dysmenorrhea refers to the symptom of prevalence of dysmenorrhea is estimated to be
painful menstruation. It can be divided into 2 up to 90% in adolescents, and, in fact, is the
broad categories: primary (occurring in the most common reason for school absence.
absence of pelvic pathology) and secondary Dysmenorrhea can be crippling, both
(resulting from identifiable organic diseases) physically and psychologically [5, 6].
[1]. Primary dysmenorrhea is common Several drugs can lessen or completely
menstrual cramps that are recurrent (come eliminate the pain of primary dysmenorrhea.
back) and are not due to other diseases. Pain The most popular choice is the nonsteroidal
usually begins 1 or 2 days before, or when anti-inflammatory drugs (NSAIDs), which
menstrual bleeding starts, and is felt in the prevent or decrease the formation of
lower abdomen, back, or thighs. Pain can prostaglandins. These include aspirin,
range from mild to severe, can typically last 12 ibuprofen, and naproxen. These drugs are
to 72 hours, and can be accompanied by usually begun at the first sign of the period and
nausea, vomiting, fatigue, and even diarrhea taken for a day or two. There are many
[2-4]. Common menstrual cramps usually different types of NSAIDs, and women may
become less painful as a woman ages and may find that one works better for them than the
stop entirely if the woman has a baby. others [6-9].
Secondary dysmenorrhea is pain that is caused If an NSAID is not available,
by a disorder in the woman's reproductive acetaminophen may also help ease the pain.
organs, such as endometriosis, adenomyosis, Heat applied to the painful area may bring
uterine fibroids, or infection. Pain from relief, and a warm bath twice a day also may
secondary dysmenorrhea usually begins earlier help. While birth control medications will ease
in the menstrual cycle and lasts longer than the pain of dysmenorrhea because they lead to
common menstrual cramps. The pain is not lower hormone levels, they are not usually
typically accompanied by nausea, vomiting, prescribed just for pain management unless the
fatigue, or diarrhea. Some of the risk factors woman also wants to use them as a birth
for primary dysmenorrhea include an early control method. This is because these
onset of menstrual periods (before the age of medications may carry other more significant
12), heavy or prolonged menstrual flow, a side effects and risks [6-9].
prior family history of dysmenorrhea, obesity, Dietary recommendations to ease cramps
or a history of smoking [5, 6]. The risk factors include increasing fiber, calcium, and complex
for secondary dysmenorrhea include the carbohydrates, cutting fat, red meat, dairy
presence of fibroid tumors, pelvic products, caffeine, salt, and sugar. Smoking
inflammatory disease, tubo-ovarian abscesses, also has been found to worsen cramps. Recent
endometriosis, IUD, or ovarian torsion. research suggests that vitamin B supplements,
Primary dysmenorrhea can affect up to 50 primarily vitamin B6 in a complex,
percent of all women who have menstrual magnesium, and fish oil supplements (omega-
periods, and up to 15% of these women will 3 fatty acids) also may help relieve cramps.
have a level of pain that interferes with their Other women find relief through visualization,
daily lives. Typically, dysmenorrhea begins concentrating on the pain as a particular color
during adolescence, although occasionally it and gaining control of the sensations.

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Aromatherapy and massage may ease pain for Cinnamon (Cinnamum camphora (L.)
some women. Others find that imagining a Nees & Eberm.): Cinnamon is one of the
white light hovering over the painful area can oldest spicies known to man. This spice also
actually lessen the pain for brief periods [6-9]. has medicinal properties which include pain
Herbal medicine has an important role in relieving during menstrual cramps, apart from
women health [10-14]. There are a number of other remedies such as the reduction of LDL
herbal remedies for treatment of depression cholesterol, blood sugar levels, heart disease,
and PMS in women and the most famous one and cancer fighting properties [22].
is saffron. In addition, there are a number of Cramp Bark & Black Haw (Viburnum
herbal remedies for treatment of primary opulus L. and Viburnum pranifolium L.):
dysmenorrheal [15-21]. These are probably the most effective herbs
Ginger (Zingiber officinale Rosc.): Ginger for reducing uterine spasm and cramping.
has been traditionally used to treat ailments These sister herbs bring relief of pain and
such as arthritis, colic, diarrhea, and heart muscle spasm in the uterus. Cramp bark and
conditions. Ginger can be consumed by Black haw have been shown safe for use for
boiling it in water and drinking the water at several days prior to onset on menses in
least 3 times a day to get relief from anticipation and prevention of painful cramps.
dysmenorrhea. Research and clinical trials I can attest to these plants wonderful pain
conducted by Ozgoli et al, from Iran, show relieving action. I personally feel these herbs
that ginger has the same effect on killing pain are one of the best herbs to have on hand at all
as mefenamic acid or ibuprofen, so it can be times for any sort of menstrual pain, I prefer it
used as one of the home remedies for over NSAID’s. There is also no risk of liver
dysmenorrheal [22]. damage from this herb like there are with
Parsley (Pteroselenium hortense Hoffm.): NSAID use [8, 10].
Parsley has menstrual cycle-regulating Black Cohosh (Actea racemosa L.): This
properties and pain relieving properties. plant is very anti-inflammatory and wonderful at
Parsley can be consumed as a juice mixed with reducing spasm in both the smooth muscles, but
various vegetables such as carrots, beetroots, also the skeletal muscles associated with pain
cucumbers, and tomatoes for good results [23]. that radiates to the lower back and down the
Mint (Mentha longifolia L.): Mint has thighs [8, 10].
been used to treat many ailments, including Chamomile (Matricaria chamomilla L.):
stomach disorders, indigestion, nausea, and This sweet little flower is both anti-
vomiting. Consumption of mint tea helps in inflammatory and antispasmodic. It is also
alleviating the associated pain of helpful for women with digestive constipation
dysmenorrheal [24]. contributing to pain. Because this herb is also
Coriander (Coriandrum sativum L.): The a nervine and mild sedative it may help to
use of coriander has been traditionally reduce stress, relax the nervous system and
mentioned by Ayurvedic practices in India as a induce a restful state in the body. This can be
remedy for dysmenorrhea. It can be consumed very useful when experiencing menstrual
by boiling a few stems of fresh coriander in cramping accompanied by anxiety and
water. This is known to reduce dysmenorrheal irritability. Chamomile is best sipped as a tea
[24]. during menstruation [8, 10].

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