Your Period Shouldn't be Painful By Alexandra Gilmore, LAc, MAcOM I

talk about menstrual cycles all the time—every day, multiple times a day. I talk about menstrual cycles so often and in such detail that I forget it’s not “normal” to do so. When we do talk about menstruation in our culture, it’s typically to lament the PMS, the pain, or the messy inconvenience of it all. What we don’t talk about is what is actually happening in our body every month, or the way our cycles can provide a striking window into the status of our overall health.

As a practitioner of Chinese medicine, the details of a woman’s

menstrual cycle will of course inform my treatment plan for any issue related to her cycle, but it surprises people that it will also inform my approach in treating almost any other complaint. Every aspect of your menstrual cycle tells me something important about the state of your general health: the length of your cycle, the volume of blood, the color of blood, the timing of ovulation, your basal body temperature, any pre-menstrual symptoms, and the presence or absence of cramping are all quite revealing. Positive changes in your cycle as we move through treatment also serve as a useful barometer to track your body’s journey back toward balance; this is true even if your primary complaint had seemingly “nothing” to do with your menstruation.

Bottom line? Menstrual cycles matter. This article is the sec-

ond in a year-long series for ELM chronicling different aspects of women’s menstrual health. My hope is that by the end, you’re as comfortable and curious as I am about the monthly event common to half of our population.

Periods Should NOT Be Painful

This month we tackle dysmenorrhea, otherwise knows as CRAMPS!!! Ladies—they’re the worst, am I right?

What’s unfortunate is that at least HALF of you out there are nodding in agreement, suffering through painful periods yourselves, every month. Some studies suggest that between 5 and 20% of women experience periods so painful that they interfere with daily life—missing school, calling out from work, or skipping social activities. Painful periods, like the PMS we discussed in our previ- ous article, may be common but they are not normal! Like PMS, cramps—even severe ones—are both preventable and treatable in the vast majority of cases. Periods should not be painful. Period (pardon the pun)!

So, when you’re cramping, what exactly is happening in that

cranky uterus of yours? Your uterine lining builds up every month in anticipation of the fertilized egg that may come down the pike looking for a soft, cozy spot to snuggle up and implant. Once your body determines you are *not* pregnant this time around, it gets to work expelling that lining—out with the old, in with the new. Cramps are caused by contractions of your uterus—a muscle—in its effort to clean house. After your period, the cycle starts all over again with your body building up a fresh lining to welcome next month’s potential embryo.

Now, I’ve said that cramping isn’t normal and I stand by that statement, but the fact of the matter is that your uterus *is* a muscle and it *is* contracting. This is normal. You may experience a sensa- tion associated with those contractions during the fi rst few days of your cycle, but it should not be painful, per se, and it certainly shouldn’t interfere with your life.

If a woman comes to see me and reports mild cramping for a

day or so that responds well to conservative measures like a heat- ing pad or a few ibuprofen, do I worry? No. Could she be totally symptom-free? Most likely. Must she be totally symptom-free to consider herself healthy, balanced, and fully vital? Not necessarily. A practitioner of Chinese medicine will take mild cramping under consideration as they assess the rest of the woman’s physical, men- tal, and emotional make-up.

On the other hand, if a woman reports that her cramps are bad enough to regularly miss school or work, this is a problem that needs to be addressed. Even if you’ve had bad cramps since you fi rst started menstruating, even if this is “normal” for you, even if you’ve been evaluated and your Western doc says there is noth- ing medically wrong and/or there’s nothing they can do about it, cramps like this are not normal and always call for further scrutiny. If your moderate to severe period pain is new, or is worsening, or is changing over time, this defi nitely merits investigation. Pain- ful menstrual cramps are a sign of a system in distress. While the particular distress signal of dysmenorrhea only has the opportunity to show itself strongly once a month through the rhythm of your cycle, the underlying issue is in fact present all of the time—and it may be responsible for other symptoms that you’ve been ignoring, or thinking are no big deal or completely unrelated. 19

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