Grandma's Formula: Alleviating Menstrual Pain

By: Kiran Ganga, Human Biology, Health, and Society '2024

In the journey of managing period cramps and primary dysmenorrhea (PD), many women have turned to the wisdom passed down through generations within their families. While modern medicine offers solutions, there's a timeless allure to the natural remedies cherished by our ancestors. Passed down through generations, these recipes carry not just ingredients but also stories and traditions. 

Primary dysmenorrhea (PD) refers to pelvic discomfort arising from the uterus during menstruation that lacks discernible cause. It stands as the most prevalent gynecologic issue among women of reproductive age [1]. Despite its widespread occurrence, PD often remains undertreated [2]. The cause of this discomfort lies in the overproduction of prostaglandins, leading to the heightened levels that result in intense uterine contractions. Moreover, the process of menstruation involves shedding the uterine lining, which can lead to a decrease in oxygen levels in the surrounding tissues. As a result, cells may switch to anaerobic metabolism, producing byproducts such as lactate and hydrogen ions [3]. These anaerobic metabolites can accumulate, contributing to tissue irritation and inflammation within the uterus. Additionally, the increased uterine contractions during menstruation can cause temporary reductions in blood flow, resulting in uterine ischemia—a condition where the uterine tissues experience insufficient oxygen supply. Both the presence of anaerobic metabolites and uterine ischemia can sensitize pain receptors, known as nociceptors, making them more responsive to stimuli [3]. Consequently, this heightened sensitivity of pain receptors exacerbates the perception of menstrual cramps, amplifying the discomfort experienced during menstruation. Various factors, such as high-stress levels, familial predisposition, age, parity, and oral contraceptive usage, can influence the risk of PD [4]. The connection between PD and other modifiable social factors like smoking, substance use, and dietary habits necessitates continued exploration. 

Management of PD primarily revolves around mitigating pain through pharmacological and lifestyle interventions. Non-steroidal anti-inflammatory drugs (NSAIDs) stand as the frontline treatment, functioning by inhibiting cyclooxygenase (COX) to diminish prostaglandin synthesis and inflammation [5]. However, NSAIDs may yield adverse effects such as nausea, vomiting, hepatotoxicity, ulcers, and fluid retention, which warrants consideration. Some individuals use hormonal contraceptives, which impede ovulation and endometrial thickening to halt prostaglandin production and menstrual pain [3,5].  However, this also presents concerns; one survey found that 40% of women turned down birth control due to side effects such as weight gain, irregular bleeding, mood swings, and cramping [6].  Non-pharmacological interventions, such as heating pads, topical creams, and massage therapies, offer alternative avenues for relief, but they often require menstruating to disrupt their daily lives. 

For many women, including myself, my grandmother and aunts’ recipe for cramp relief has been a comforting ritual during times of menstrual discomfort. The mixture of roasted flour, dates, dry fruits, nuts, and ghee embodies the holistic approach to wellness that resonates deeply with our cultural heritage. We would take one a day and our cramps would significantly decrease. This is similarly found in Iranian cuisine, and Aunt Flo’s Kitchen, a startup at Cornell, sells Iranian period snacks that aim to alleviate period pain. While the recipe is a traditional recipe from founder Armita Jamshidi’s grandmother, the ingredients –from tahini to cinnamon to cardamom to dates and much more –have been scientifically proven to have analgesic and antispasmodic impacts. The product comes in three flavors: rose, pistachio, and sesame, and is currently sold at multiple locations around Ithaca [7]. 

While my and Armita’s grandmothers’ recipes remain a beloved tradition, many women have also embraced modern adaptations of natural remedies for period cramps. Herbal teas infused with ingredients like ginger, chamomile, or raspberry leaf offer soothing relief; they have often been used in many cultures to treat chronic pain generally. One study finds that rose tea in female adolescents causes a perceived decrease in pain, distress, and anxiety [8]. This can likely be attributed to an increase in glycine, known for its ability to calm muscle spasms, as well as the general facilitation of fatigue relief and the promotion of increased energy levels [9]. Additionally, essential oils like lavender or peppermint can be applied topically for targeted comfort [10]. Many of these oils are abundant with terpenes shown to have analgesic effects [11]. Additionally, mind-body practices such as yoga and meditation continue to gain popularity for their ability to ease menstrual discomfort by promoting relaxation and reducing stress [8]. Positive affect, self-compassion, inhibition of the posterior hypothalamus, and reduced salivary cortisol levels were all demonstrated to act as mediators in the relationship between yoga and stress alleviation [12].

Beyond their therapeutic benefits, natural remedies for period cramps foster a sense of connection—to our bodies, our heritage, and the natural world. By honoring the wisdom passed down through our families, we not only find relief from physical discomfort but also reaffirm our cultural identities and strengthen familial bonds. In sharing these remedies with future generations, we ensure that the legacy of healing endures, enriching our lives in ways that extend far beyond mere symptom relief.

References

1. S. Iacovides, I. Avidon, and F. C. Baker, “What we know about primary dysmenorrhea today: a critical review,” Human Reproduction Update, vol. 21, no. 6, pp. 762–778, Sep. 2015, doi: 10.1093/humupd/dmv039.

2. E. Ferries-Rowe, E. Corey, and J. S. Archer, “Primary Dysmenorrhea,” Obstetrics & Gynecology, vol. 136, no. 5, pp. 1047–1058, Oct. 2020, doi: 10.1097/aog.0000000000004096.

3. R. Itani, L. Soubra, S. Karout, D. Rahme, L. Karout, and H. M. J. Khojah, “Primary Dysmenorrhea: Pathophysiology, Diagnosis, and Treatment Updates,” Korean Journal of Family Medicine, vol. 43, no. 2, pp. 101–108, Mar. 2022, doi: 10.4082/kjfm.21.0103.

4. G. Grandi et al., “Prevalence of menstrual pain in young women: what is dysmenorrhea?,” Journal of Pain Research, p. 169, Jun. 2012, doi: 10.2147/jpr.s30602.

5. I. Guimarães and A. M. Póvoa, “Primary Dysmenorrhea: Assessment and Treatment,” Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, vol. 42, no. 08, pp. 501–507, Jun. 2020, doi: 10.1055/s-0040-1712131.

6. S. Kingsberg, J. Loving, H. Alex, B. Bernick, and S. Graham, “Women and Healthcare Professionals’ Understanding of their Concerns of Birth Control Side Effects,” The Journal of Sexual Medicine, vol. 19, no. Supplement_3, pp. S9–S9, Aug. 2022, doi: 10.1016/j.jsxm.2022.05.023.

7. Aunt Flo’s Kitchen | Natural Period Pain Relief. (2024). Aunt Flo’s Kitchen. Retrieved February 28, 2024, from https://auntfloskitchen.com/

8. Tseng, Y.-F., Chen, C.-H., & Yang, Y.-H. (2005). Rose Tea for Relief of Primary Dysmenorrhea in Adolescents: A Randomized Controlled Trial in Taiwan. Journal of Midwifery & Women’s Health, 50(5), e51–e57. https://doi.org/10.1016/j.jmwh.2005.06.003

9. Ravikumar, C. (2014). Review on Herbal Teas [Review of Review on Herbal Teas ]. Journal of Pharmaceutical Sciences and Research, 6(5), 236–238.

10. 13 ways to stop period cramps. (2019, October 10). HealthPartners Blog. https://www.healthpartners.com/blog/13-ways-to-stop-period-pain/

11. Del Prado-Audelo, M. L., Cortés, H., Caballero-Florán, I. H., González-Torres, M., Escutia-Guadarrama, L., Bernal-Chávez, S. A., Giraldo-Gomez, D. M., Magaña, J. J., & Leyva-Gómez, G. (2021). Therapeutic Applications of Terpenes on Inflammatory Diseases. Frontiers in Pharmacology, 12. https://doi.org/10.3389/fphar.2021.704197

12. Riley, K. E., & Park, C. L. (2015). How does yoga reduce stress? A systematic review of mechanisms of change and guide to future inquiry. Health Psychology Review, 9(3), 379–396. https://doi.org/10.1080/17437199.2014.981778