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It's not unusual for women to experience pain of various kinds just before they have their periods. Some women get migraine headaches. Some women have flare-ups of eczema. Some women have knee pain or back pain. The pain usually last about three days, maybe five days, and then it goes away until the next period. But why does PMS cause painful symptoms?

The reason women experience pain with premenstrual syndrome, or as their premenstrual syndrome, seems to be that when women's estrogen levels are lower, their pain levels are higher. Estrogen levels bottom out and progesterone levels reach a peak just before menstruation. Women who are on oral contraceptives, however, don't  necessarily have lower estrogen levels just before their periods. (It depends on the composition of the Pill.)

This means that women don't develop joint problems or headaches or back pain or skin irritation just before their periods. They have these problems all the time, but they are more painful during the three to five days prior to menstruation.

What can be done to relieve the pain?

The obvious answer is, if it isn't really menstrual, then fixing a problem-that-isn't-quite-a-problem should reduce pain next time. There are, however, other things women can do to reduce this kind of monthly pain.

  • Most oral contraceptives are prescribed with a short hormone-free period each month. Premenstrual pain is minimized with a shorter hormone-free period. A 26/2 prescription (take the Pill for 26 days, skip the Pill for two days) minimizes premenstrual pain of all kinds.
  • For reasons that have not yet been elucidated, women who consume more dairy products tend to have more premenstrual pain. 
  • There haven't been studies with enough women to establish a statistically significant relationship between vitamin D deficiency and premenstrual pain, but at least one study has found that nearly all women who have problems with pain before their periods have vitamin D levels below 30 nanograms/ml. The lower the vitamin D level, the greater the pain.
  • Both smoking and passive tobacco exposure increase the severity of back pain and cramping. However, women who are in the process of quitting smoking also experience worse premenstrual pain.
  • Not surprisingly, women who drink more alcohol experience less premenstrual pain. We can't really suggest that you drink more right before you should have your period, especially since there is a possibility that you are pregnant and you won't have your period.
  • The essential oil of the herb Vitex agnus-castus reduces sensitivity to pain. Essential oils are inhaled rather than drunk. Never drink essential oil. When this herb is used as aromatherapy, there are few changes in hormone levels, but there as changes in pain sensitivity.
  • Curcumin, the antioxidant extracted from the curry spice herb turmeric, can reduce pain in PMS. This is a product most women can take all the time (assuming you aren't on chemotherapy for cancer).
  • A history of sexual abuse can be associated with heightened premenstrual pain. Support for the psychological issues surrounding the abuse can reduce sensitivity to pain.
  • Often there is a "trigger" for premenstrual pain. This can be physical or psychological. Some women have worse PMS pain when they eat certain foods. Salami, pastrami, red wine, chocolate, and soy sauce are common triggers for PMS pain. Some women have worse pain when they remember a painful experience. Avoiding triggers, to the extent that's possible, reduces pain.
  • It's really not clear whether obesity increases premenstrual pain or chronic premenstrual pain is one of the factors contributing to obesity. Either way, the efforts to control weight, even more than weight loss itself, often reduce pain symptoms. It's not that you have to lose a lot of weight. Losing just a little, 1-3 percent of your total body weight, can shift hormone levels into better balance.


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