Dysmenorrhea or painful menstruation is a serious concern with estimates that 50-90% of women experience this.
In primary dysmenorrhea the pain can occur a couple of hours before or just after the onset of menstruation. The symptoms can last 48-72 hours.
Symptoms can include:
- Vomiting
- Diarrhea
- Headache
- On rare occasions even syncope (or fainting)
Secondary dysmenorrhea is different that primary dysmennorhea because the pain is caused by a disorder of reproductive organs including endometriosis, adenomysosis, uterine fibroids, or infection.
One common feature is that progesterone levels are decreased during the luteal phase of the menstrual cycle.
The luteal phase is the second half of the menstrual cycle; approximately days 14-28 of the cycle.
As progesterone levels go down various cytokines are released into the bloodstream including arachidonic acid and prostaglandins.
Peppermint contains antioxidants including menthol, rosmarinic acid, luteolin that have been shown to reduce muscle spasms and inflammatory cytokines which are common features of dysmenorrhea.
Here are the details of the clinical trial:
- 102 human subjects randomized to placebo or peppermint
- Peppermint extract was made from dried peppermint leaves with ethanol and dried
- Each capsule contained 330 mg of extract
- Capsules were taken every 8 hours during the menstrual cycle
- Human subjects took Peppermint extract for 3 cycles
- Pain was measured using the McGill Pain index, a test used in multiple clinical trials
Here are the results:
- *Patients did not know if they were taking peppermint or placebo during the study
- In the 2nd cycle, severity of pain reduced from 6.62 to 3.28; no change in the placebo group was observed
- Duration or length of pain (i.e. days) did not change with peppermint
- No side effects were noted during the study or during the followup after the study
Take away message: Peppermint extract capsules were able to reduce the severity of pain in primary dysmenorrhea. The mechanism appears to be through analgesic mechanisms (e.g. reducing muscle spasms). This clinical trial used 990 mg of Peppermint extract daily (i.e. 330 mg every 8 hours).
Given that low levels of progesterone are common during the second half of the menstrual cycle (e.g. Luteal phase) supplementation with bioidentical progesterone should be considered. A prescription from a doctor for bioidentical progesterone (e.g. 100 mg or 200 mg days 14-28) is an approach to help normalize the menstrual cycle and often reduces the symptoms of dysmenorrhea. Some physicians will recommend birth control to normalize the cycle which is a synthetic form of progesterone. Bioidentical progesterone is the same hormone your body makes and is a great place to start.
Volume 6, Issue 3, September 2016, Pages 137–141
His research on plant medicine has led to more than 45 publications and abstracts.This research has been presented at international meetings in the USA, France, Turkey, Peru, Israel, Austria, and Italy.
Categories: Clinical Trials, Menstrual Cycle, Pain, Plant Extracts, Women's Health