How Prostaglandins Cause Painful Periods + What to Do About It

Dr. Jolene BrightenPublished: Last Reviewed: Menstrual Cycle Leave a Comment

Nearly every woman has experienced menstrual cramps at some point during her period. What most women don’t know is there are hormone-like substances known as prostaglandins that are behind these intense, and sometimes debilitating cramps.

What Are Prostaglandins?

According to Medicine Net, Prostaglandins are:

“One of a number of hormone-like substances that participate in a wide range of body functions such as the contraction and relaxation of smooth muscle, the dilation and constriction of blood vessels, control of blood pressure, and modulation of inflammation. Prostaglandins are derived from a chemical called arachidonic acid.”

Prostaglandin hormones are made by nearly every cell in the body. In the uterus, they're what causes the muscles to contract each month so that you can release the lining of your uterus (endometrium). Studies have shown the more prostaglandin inflammation you have, the worse your menstrual cramps can be, which is known as dysmenorrhea.

What Do Prostaglandins Do?

While all this menstrual cramp talk may make you think all prostaglandin functions are bad, they are actually very necessary and protective of your health. That is until there are too many of them.

When you have a blood vessel that's injured, prostaglandins are released at the site of injury to help with the formation of a clot, so that your body can heal the damaged tissue. They also stimulate the contraction of the blood vessels and the muscle tissue to prevent further blood from being lost.

Prostaglandins Function in Female Reproductive Health

Prostaglandins help with stimulating ovulation and making sure your uterus contracts appropriately so you can remove the endometrium efficiently during your period.

They also play a role in inducing labor. Prostaglandins in pregnancy elevate during labor to stimulate uterine contractions and the birth of baby.

Prostaglandins and Menstruation

Ever wonder why you poop so much before your period?

You may have noticed that you get loose stools or diarrhea the day before or the day of your period. It's kind of the worst to be having severe menstrual cramps and having diarrhea.

Diarrhea during your period is a sign that you have too many prostaglandins. While prostaglandins cause uterine muscle contraction (aka menstrual cramps), they also affect the bowels. Prostaglandins stimulate the contracting and relaxing of the muscles of the digestive tract, which is why your period can cause changes in your bowels.

The result of too many prostaglandins is loose stools and painful menstrual cramps.

What Causes High Prostaglandin Levels?

Prostaglandins, made from arachidonic acid, are elevated in response to inflammation. Now, this is not always a bad thing. Inflammation is the body’s response to infection and injury, and it usually resolves once the body heals. Inflammation is an important part of our survival.

However, inflammation can also be caused by other factors, which can increase prostaglandins and lead to painful periods. One such factor is a poor diet, rich in Omega 6s. Human beings need Omega 6 (it is an essential fatty acid); but we also need it to be in a balanced ratio with Omega 3s. 

Unfortunately, the ‘traditional' western diet is high in Omegs 6s, and woefully low in Omega 3s. Once that ratio becomes distorted, excessive and chronic inflammation can occur. Chronic inflammation is where the problems like painful periods begin, in this case because prostaglandins are elevated. 

Examples of foods high in Omega 6 fatty acids include:

  • Vegetable oils (like sunflower, corn, and soybean oil)
  • Fast food (often cooked in vegetable oil)
  • Commercially raised poultry

However, Omega 6s are also found in nuts and seeds, an important part of a healthy diet for many people. They are not all bad. It’s important to try to optimize that Omega 6 to 3 ratio to help reduce inflammation. 

How to reduce prostaglandins if they're too high and causing menstrual cramps?

Increase Magnesium

Magnesium has been shown to be more effective than placebo in positively helping lower prostaglandins and easing menstrual cramps.

If you're a woman who already has loose stools before your period, you're going to want to avoid taking magnesium citrate, which can stimulate the bowels further and cause even more diarrhea. Nobody wants that.

In my medical practice, I recommend Magnesium Bisglycinate Chelate to all my patients who experience menstrual cramps. This form is highly absorbable, meaning it is quickly absorbed and better retained by the body compared to other forms. The form of magnesium in my Magnesium Plus has been shown to reduce prostaglandins period pain.

Typical dosing is 300-450 mg nightly. Some women benefit from increasing the dose 5-7 days leading up to their period, depending on the severity of menstrual cramps.

Quit Smoking

Smoking is associated with an increase in menstrual cramps and in addition to that, it's inflammatory. Inflammation can lead to further disruption of hormones. Also, I think we all know it just isn’t good for your health.

Eat Ginger

In a small study, ginger was found to be as effective as ibuprofen in relieving menstrual cramps. Research suggests that 1,000 mg is the minimum dose to get relief during menstruation.

Ginger is an anti-inflammatory herb that can be incorporated into your diet. You can cook it in a stir-fry or soup, and you can brew yourself a cup of tea daily. If you're having severely painful periods, you’ll probably want to opt for ginger in capsule form.

Eliminate Dairy for 30 days

In my clinical experience, I find that many women who have dairy sensitivities also struggle with menstrual cramps. Part of this is likely due to the fact that eating foods you are sensitive to (immune system is responding) can increase inflammation.

Inflammation can lead to further imbalance in your hormones, including estrogen dominance.

When estrogen goes high it creates a condition known as estrogen dominance, which can also contribute to prostaglandins pain and other period problems.

I recommend charting your symptoms and then removing dairy for at least 30 days. Then, try reintroducing and seeing how it affects your menstrual cycle. This will allow you to understand your relationship with dairy and how it's affecting your body.

You can grab my hormone friendly meal plan and recipe guide here to get more support in shifting your diet to one that supports healthy hormones.

Some of my patients, get menstrual relief for the first time in years and so they're hesitant to reintroduce dairy. Can you blame them?

If you’re feeling afraid to reintroduce dairy, I recommend trying camel’s milk before cow’s milk as many of my patients have found great success with this.

Keep in mind, you're going to have to go through a full menstrual cycle and be tracking your symptoms to really understand how it's affecting you.

Try a TENS Unit

TENS stands for transcutaneous electrical nerve stimulation. A TENS unit delivers an electrical current that helps stimulate the nerves bringing almost instant relief when it comes to pain.

You can chat with your doctor about how to use this and they can be purchased online.

Eat Cold Water Fish

Fish like mackerel, sardines, and salmon contain omega-3 fatty acids, which are anti-inflammatory. Prostaglandins are synthesized from fatty acids and more prostaglandins are made from omega-6, think inflammatory fatty acids, than omega-3 fatty acids.

While you can make prostaglandins from omega-3 fatty acids, they tend to be much less effective, or in other words, they don't make you cramp as hard.

The other cool piece about omega-3 fatty acids is they compete with omega-6 for the same binding site on what's called the COX-1 enzyme. This is the enzyme that takes your omega-6s and converts them into prostaglandins. So, omega-3s can be highly beneficial for period cramps and for cramping of muscles.

In my practice, we use Omega Plus, which delivers 1500 mg of omega-3s.

What about the birth control pill for menstrual cramps?

Well, it's true that the birth control pill is associated with easier periods, less menstrual cramps, and less pain, but this isn’t true for every woman. I’ve had many women in my medical practice who have reported that their cramps did not improve after starting the pill and some even experience worse period cramps.

To me, it seems a bit extreme to suppress your period and to take a pill every single day when, on average, women are only having menstrual pain for about three to six days out of the month. Plus, there are all those side effects that come with it.

Now, I'm not dismissing your pain by any means, but what I am saying is that there is a root cause for why you're having period cramps and taking something like hormonal birth control is only going to mask that root cause and make it more difficult for you to heal in the future.

I want to be clear I’m not judging you if you’re using hormonal birth control to get symptom relief. Heck, when my painful periods disappeared and I could actually leave the house during my period I thought the pill was the best thing ever. What I want you to walk away with is that there is a root cause to your menstrual cramps and you can heal it. Elevated prostaglandins are just one part of the equation.

period cramps prostaglandins treatment

You do not need to be at the mercy of your period!

You can enjoy easy, pain-free periods…and I'd love to show you how in the Hormone Revolution Detox.

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In each phase of the detox protocol you will:

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  • Improve estrogen production and elimination
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  1. Abraham GE. Primary dysmenorrhea. Clin Obstet Gynecol. 1978. 21(1). 139-45.
  2. DeSantana JM, Walsh DM, Vance C, Rakel BA, Sluka KA. Effectiveness of Transcutaneous Electrical Nerve Stimulation for Treatment of Hyperalgesia and Pain. Current rheumatology reports. 2008. 10(6). 492-499.
  3. Giti Ozgoli, Marjan Goli, and Fariborz Moattar. Comparison of Effects of Ginger, Mefenamic Acid, and Ibuprofen on Pain in Women with Primary Dysmenorrhea. The Journal of Alternative and Complementary Medicine. 2009. 15:2. 129-132.
About The Author

Dr. Jolene Brighten

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Dr. Jolene Brighten, NMD, is a women’s hormone expert and prominent leader in women’s medicine. As a licensed naturopathic physician who is board certified in naturopathic endocrinology, she takes an integrative approach in her clinical practice. A fierce patient advocate and completely dedicated to uncovering the root cause of hormonal imbalances, Dr. Brighten empowers women worldwide to take control of their health and their hormones. She is the best selling author of Beyond the Pill and Healing Your Body Naturally After Childbirth. Dr. Brighten is an international speaker, clinical educator, medical advisor within the tech community, and considered a leading authority on women’s health. She is a member of the MindBodyGreen Collective and a faculty member for the American Academy of Anti Aging Medicine. Her work has been featured in the New York Post, Forbes, Cosmopolitan, Huffington Post, Bustle, The Guardian, Sports Illustrated, Elle, and ABC News. Read more about me here.