Sarah, Jen, and Linda are among a majority of women who suffer from what is called primary dysmenorrhea, the most common form of menstrual cramping. This type of dysmenorrhea is not associated with any pelvic disease or inflammation; it's menstrual cramps, pure and simple. Secondary dysmenorrhea is menstrual pain caused by something else going on in the body: PID, endometriosis, or adenomyosis (growth of endometrium into the muscular layer of the uterus). Secondary dysmenorrhea can be quite serious and it's important to consult your health practitioner if your cramps are unusually severe, don't respond to dietary changes or stress management, or are accompanied by bleeding.
Western physicians believe that primary dysmenorrhea is caused by an overabundance of the hormone prostaglandin F2 alpha in the menstrual blood. When the prostaglandin hormone gets released into the bloodstream, according to Dr. Northrup, the smooth muscle of the uterus goes into spasm, and we get cramps. We can blame a diet high in animal protein and dairy products for too much prostaglandin F2 alpha in our systems, as well as a lifestyle filled with unrelenting stress.
Susan Lark, M.D., author of several self-help books for women, explains that primary dysmenorrhea manifests itself by either spasmodic or congestive cramps. Spasmodic cramps are most commonly found in teenagers like Sarah and women in their early 20s. Dr. Lark blames poor blood circulation and compromised oxygen delivery to the uterus, which aggravate the problem and result in an accumulation of lactic acid and carbon dioxide. Women sometimes find this type of cramping subsides after their first pregnancy. Congestive cramps, on the other hand, make life miserable for women in their 30s and 40s and seem to worsen after childbirth. These dull, achy cramps bring with them bloating, breast tenderness, weight gain, and headaches.
Gentle yoga can benefit women with primary dysmenorrhea. Some women like to bend forward and have something pressing against their bellies when they have cramps; other women feel better when they take pressure off the abdomen and create space in the pelvis. They find relief through mild backbends, like supported Supta Baddha Konasana (Reclining Bound Angle Pose), using belts, bolsters, blankets, and eye bags.
A catch-all phrase if there ever was one, premenstrual syndrome, or PMS, could be any one of more than 150 symptoms. Do you feel irritable, edgy, or "hot under the collar?" You have PMS. Anxious, moody, or ungrounded, and you can barely remember your own name? You have PMS, too. How about bloated, achy, and depressed—in fact you could cry if someone looked at you sideways? You guessed it, PMS. You could also have periodic bouts of acne, heart fibulations, insomnia, herpes, hives, migraines, salt or sugar cravings, or even asthma, and these would all be PMS symptoms. According to Dr. Northrup, the type of symptom doesn't much matter—it's the way it occurs. Generally speaking, she explains, women should see a pattern of flare-ups each month. Some feel anxious and flighty about a week before their periods and as soon as they begin to bleed, they feel better. Others may get angry and rage out of control two weeks before their periods only to fall into a depression the next week and feel appreciably better the first or second day of their periods. I get intense sugar cravings—particularly of the chocolate variety—about 10 days before I bleed. If I give in to my weakness, I end up not only with a horrific headache a few days later, but my joints ache and swell until I'm through the first or second day of my cycle.