What is dysmenorrhoea (period pain)?

Understanding your symptoms

Period pain, also known as dysmenorrhoea, is a type of cramping sensation experienced by some women during their menstrual cycle. The pain usually begins in the lower abdomen and may spread to the lower back or thighs. It can range from mild to severe period pain and may last anywhere from a few hours to several days. Irregular periods sometimes go hand in hand with painful periods.

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Functional medicine for painful periods

While period pain is common, it doesn’t need to be. Many women suffer severe or unbearable period pain without seeking help, even though it disrupts their lives, affects mood, jobs, exercise and relationships. 

The great news is that natural treatment is available to improve painful periods and balance your hormones. Using functional medicine, you can be free of pain and discomfort during your periods.


Period pain symptoms

Pain is the most common menstrual symptom, with reports in some countries of 91.5% of women experiencing period pain. The quality and severity of period pain can vary dramatically from woman to woman, and even from period to period. Often there is a dull, background ache or sense of heaviness over which can be superimposed an episodic, cramping pain. Usually the spasmodic, cramping pain is the most debilitating. It can be accompanied by vomiting, diarrhoea and/or headaches.

It is important to distinguish between primary and secondary dysmenorrhoea. Primary dysmenorrhoea is when there is period pain with no evidence of pathology. It is also sometimes called ‘functional dysmenorrhoea’. Secondary dysmenorrhoea is caused by an underlying complaint where there is pathology such as endometriosis, fibroids or pelvic inflammatory disease (PID).

Causes of painful periods

The cause of period pain depends on the type of dysmenorrhoea, outlined as follows:

Primary dysmenorrhoea 

The causes of primary dysmenorrhoea are not entirely understood, however the trigger is thought to be an alteration in prostaglandin levels. Prostaglandins are chemicals that can increase inflammation, which increases pain. Constriction of blood vessels and spasm of the uterine muscle also contribute to pain.

Secondary dysmenorrhoea

If you experience period pain that is debilitating and affecting your quality of life and ability to carry out normal daily activities, it is vital that you have the pain investigated to see if it is a symptom of an underlying condition. The most likely conditions are listed below. Each has different treatment options.


Endometriosis is caused by endometrial (the lining of the uterus) cells growing outside of the uterus on structures such as the ovaries, fallopian tubes, ligaments, bowel or bladder. These cells respond to hormone changes and therefore bleed during menstruation.


Adenomyosis is similar to endometriosis, except the displaced endometrial cells grow within the myometrial wall, which is the layer of muscle in the uterus. The bleeding into the muscle layer causes the pain.


Fibroids are non-cancerous growths in the uterus. They vary in size and can be diagnosed with an ultrasound. Fibroids can cause pain and pressure when they’re larger, as they may put pressure on the bladder or rectum.

Ovarian cysts and tumours

Although both benign and malignant ovarian cysts can cause pelvic pain, they are usually symptom free until quite large.

Note: Commonly women with period pain are concerned it is PCOS, however, pain is not a symptom of PCOS.  Pain and  PCOS can occur at the same time, however, pain is not caused by PCOS. 

Other possible contributing causes of painful periods (primary dysmenorrhoea)

Poor diet quality - a diet full of processed/refined grains, high sugar, processed vegetable oils and high alcohol consumption can contribute to inflammation and disrupt hormone production. Alcohol can interfere with the detoxification of oestrogen and toxins by the liver (even at 2 drinks per day) contributing to excess oestrogen in relation to progesterone, contributing to pain, heavy periods, sore breasts, moodiness and bloating.

Toxin exposure - we are all exposed to hundreds of chemicals every day, e.g. herbicides, pesticides, heavy metals, flame retardants, food additives, halogens, and solvents in personal care products, perfumes, make up, plastics, food, and water. Some act as endocrine disruptors, as they either mimic hormones or bind with hormone receptors in the body, thereby disrupting hormone function. Total avoidance isn’t possible, but we can limit our exposure easily by making better choices and filtering water, and if necessary, be guided through a detoxification program by an experienced practitioner. A heavy toxin load can disrupt hormonal production and metabolism, contributing to menstrual problems.

Poor gut health - dysbiosis of the microbiome (an imbalance in the gut flora), impacts every part of human health, including hormone regulation. The microbiome helps us to absorb nutrients, break down foods and compounds, detoxify oestrogen, and regulate inflammation. Some bacteria produce the enzyme beta-glucaronidase, causing oestrogen to build up and recirculate in the bloodstream, which can contribute to pain and inflammation. 

Food intolerances 

  • Gluten in people with gluten sensitivity (including coeliac disease and non-coeliac gluten sensitivity) can contribute to thyroid dysfunction, dysbiosis, compromised immune health, migraines, and adenomysosis / endometriosis symptoms
  • Dairy beta-A1 casein protein in some people can increase pain, heavy bleeding and mood symptoms due to the beta-A1 casein converting in the gut to an inflammatory peptide called beta-casomorphin-7 (BCM7), stimulating mast cell release of histamine, and inflammatory cytokines. Many women find eliminating A1 or all dairy can help reduce pain.

What causes eczema?


Research has found people with the ‘atopic triad’ have a defective barrier of the skin and upper and lower respiratory tracts.

These genetic alterations cause a loss of function of filaggrin (filament aggregating protein), which is a protein in the skin that normally breaks down to create natural moisturisation and protect the skin from penetration by pathogens and allergens.

Filaggrin mutations are found in approximately 30 percent of people with atopic dermatitis, and also predispose people to asthma, allergic rhinitis (hayfever), keratosis pilaris (dry rough patches and bumps on the skin), and ichthyosis vulgaris (a chronic condition which causes thick, dry, scaly skin.)If one parent carries this genetic alteration, there is a 50 percent chance their child will develop atopic symptoms. And that risk increases to 80 percent if both parents are affected. 

Food allergy and sensitivity

Food hypersensitivity has been found to cause or exacerbate atopic dermatitis in 10-30% of cases, and 90% of these are caused by eggs, milk, peanuts, soy and wheat.

Compromised gut health

The connection between the gut microbiome and skin health is complex, however, research has found the microbiota contributes to the development, persistence, and severity of atopic dermatitis through immunologic, metabolic and neuroendocrine pathways.

Nutritional deficiencies

Deficiency of Omega-6 essential fatty acids (EFA) has been linked with the increased incidence of atopic dermatitis, along with the inability for the body to efficiently metabolise EFA’s to gamma linoleic acids (GLA) and arachidonic acids (AA).

Weather and environment

Changing weather conditions can certainly aggravate eczema symptoms, but the triggers are subject to change among individuals.


Hormones also play a role in the course of atopic dermatitis, including the stress hormone cortisol which triggers an inflammatory immune response affecting all organs of the body, including the skin.

Mould exposure

Mould exposure and susceptibility to mould can cause Chronic Inflammatory Response Syndrome (CIRS), of which dermatitis is a manifestation.

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Other risk factors of menstrual pain

Other causes of menstrual or pelvic pain include:

  • Fibroids
  • Ovarian cysts
  • Pelvic inflammatory disease
  • Sexually transmitted diseases
  • Pelvic floor dysfunction
  • Endometriosis / adenomyosis
  • Interstitial cystitis
  • Digestive problems coinciding with menstruation
  • Congenital conditions of reproductive organs
  • Narrowing of the cervical canal, restricting blood flow
  • IUD use

Period pain treatment - the conventional approach

The conventional approach to painful periods may include tests and examinations such as a pelvic examination to rule out more serious medical conditions, or referrals may be provided for:

  • Gynaecologist 
  • Pelvic ultrasound scan/transvaginal ultrasound
  • Laparoscopy - (under anaesthetic) via a small hole below the navel, a telescopic instrument is used to examine pelvic organs
  • Hysteroscopy - (under anaesthetic) a small camera on the end of a tube, passed through the cervix to view inside the uterus.

It’s recommended to see your doctor if you experience:

  • Bleeding between periods
  • Unrelieved pain with over-the-counter pain medication
  • Pain medication required all day to manage study or work
  • Time off from study or work due to pain
  • Woken by pain during the night
  • Pain or bleeding after sex
  • Pain with fever, or abnormal discharge

If no underlying condition is found, you may have medications prescribed such as over the counter analgesics such as paracetamol or, aspirin, or non steroidal anti-inflammatory drugs (NSAIDs):

  • Ibuprofen e.g. Nurofen, Rafen
  • Naproxen e.g. Naprogesic, Naprosyn, Inza
  • Or, Mefenamic acid e.g. Ponstan

Other medications prescribed might include:

  • The oral contraceptive pill (OCP) or contraceptive devices such as implants, vaginal ring and intra-uterine devices (IUD) such as the Mirena

These measures do not address the underlying cause, and long term use of NSAIDs can cause damage to the stomach lining, acid reflux and disruption of the microbiome. This is why many women look for natural dysmenorrhoea treatments to relieve the pain, discomfort and worry of painful periods.

Period pain treatment - the functional medicine approach

Natural functional medicine treatment of painful periods starts with an in-depth investigation to identify the root cause and contributing factors, to then address those factors.

A functional medicine women's health practitioner spends time investigating all aspects of your cycle in your first consultation, looking at the whole person. At Melbourne Functional Medicine, period pain specialists Vicki van der Meer and Rebecca Hughes are both passionate advocates for women’s health. In your initial consultation they will investigate your:

  • Menstrual / symptom history
  • Lifetime medical history
  • Medications / supplements
  • Surgeries / accidents
  • Family and genetic history, especially your female relatives
  • Environmental exposures
  • Nutrition, diet and absorption
  • Lifestyle factors and stress 

They may recommend functional testing to help determine the cause of painful periods, and to investigate baseline health, with tests such as:

  • Microbiome and stool testing - looking for gut flora dysbiosis 
  • Organic Acids Test (OAT) looking for specific markers for inflammation, digestive function & nutrient absorption
  • Food sensitivities and allergy testing
  • Heavy metal or environmental toxin exposure
  • Hormone levels

Depending on your results and symptoms, a personalised dysmenorrhoea natural treatment strategy may target the following:

  • Removing causative / contributing factors such as dairy, or gluten consumption, sugar, alcohol or poor diet that contributes to inflammation
  • Improve pain and discomfort with herbal medicines, lifestyle strategies and dietary changes
  • Improve stress resilience, depression and anxiety to reduce its impact on dysregulation of hormones, and increased pain and inflammation with herbal medicines, and lifestyle changes
  • Restoring a healthy microbiome - poor digestion and dysbiosis contribute to many health conditions including hormone imbalance and inflammation. Dysbiosis can cause intestinal hyperpermeability (leaky gut), allowing foreign particles / LPS to cross over from the intestines and into circulation, causing inflammation and triggering the immune system to overreact
  • Restoring thyroid function - the thyroid is the master regulator, when not functioning optimally it can affect ovulation and hormone production 
  • Regulating blood sugar and insulin levels - blood sugar dips can stimulate cortisol increase causing weight gain, hormone dysregulation, and inflammation
  • Nutrient absorption and vitamin deficiencies - poor diet or digestive dysfunction may mean insufficient levels of important vitamins and minerals necessary for making / regulating hormones
  • Reduce the impact of medications and other concurrent health conditions - with holistic functional medicine treatment strategies

Natural remedies including dietary, lifestyle, herbal and supplemental strategies may include (depending on your condition):

  • An anti-inflammatory diet, or a specific diet plan personalised to your body’s needs - eliminating any food intolerances, allergies or sensitivities
  • Dietary recommendations for improving hormone production - including reducing refined vegetable oils, refined and processed grains, sugar, and fast foods and increasing foods and oils high in essential fatty acids (EFAs) that are anti-inflammatory.
  • Lifestyle medicine such as gentle movement, yoga, meditation and Shinrin-yoku (Japanese forest bathing) to build stress resilience
  • Reducing or eliminating alcohol consumption, which can impair liver function and reduce elimination of oestrogen
  • Improve vitamin / mineral status with dietary changes and supplemental medicines which might include - B vitamin complex, precision probiotics, calcium-d-glucurate, inositol, Omega 3 fatty acids, zinc, iodine, magnesium, iron, vitamin D, zinc, and selenium.
  • Herbal medicines depending on your symptoms, a tailored strategy might include a range of different herbs e.g. turmeric (curcumin), chaste tree, shatavari, wild yam, black cohosh, peonie, licorice, tribulus, passionflower, california poppy, hops, kava, St John’s wort, schisandra, ashwaganda (withania), lemon balm, or maritime pine. There are several herbal medicines that are effective in helping to reduce period pain.

All herbs must be prescribed by a practitioner ensuring correct dosages, that there are no contraindications or interactions with medications, and that they are appropriate for you.

In our unique 6-month program, you’ll be supported by your period pain specialist guiding and directing your personalised natural period pain treatment strategy, and a health coach who will support you in achieving your health and wellness goals. Making healthy changes can be hard, however, having a coach by your side will keep you on track, giving you the best chance of achieving pain free periods, and staying that way for the rest of your menstruating life. 

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Are you ready for a personalised, natural functional medicine treatment? Our unique model of care was designed with you in mind. Find out how, then book a call today


Why do I have cramps and period pain but no period?

Your period is like a regular monthly report card, and each month your body decides if it feels ‘safe’ and has the resources needed to make a baby, and therefore produce an egg. This is called ovulation, and it regulates the rest of your menstrual cycle. There are many reasons why you might be experiencing menstrual cramps outside of your period:

  • annovulatory cycle - where you have not ovulated and therefore do not produce enough of the hormones required to have a ‘proper’ menstrual bleed, this can result in light, heavy or no period.
  • ovulation occurs around Day 14 of your cycle and can feel (in some women) like a cramp or dull ache on one side of the abdomen
  • coming off contraception can affect ovulation and therefore pain
  • very mild cramping can sometimes be experienced during the first trimester of pregnancy
  • ectopic pregnancy - which happens when a fertilised egg implants outside the uterus
  • gastrointestinal disturbances, diarrhoea, constipation, IBS or IBD
  • pelvic inflammatory disease
  • endometriosis
  • food intolerances
  • uterine fibroids

What is dysmenorrhoea?

Dysmenorrhoea is the medical term for period pain. Some mild painful period cramping low in the pelvis, or lower back pain in the first couple of days of your period is considered ‘normal’.

However, if your pain is between cycles, or during sex or during the flow and so severe that it affects your daily activities like work, school, study or exercise, or it can be described as: stabbing, searing, throbbing or burning - then, this is not considered normal pain and should be investigated by a medical practitioner. Any underlying pathological or structural cause of the pain needs to be diagnosed.

How to stop period pain?

Once an underlying cause for the period pain has been ruled out, there are many dietary and lifestyle changes you can implement to help reduce the pain. 

Removing foods that are common intolerances such as dairy and gluten can help reduce inflammation and therefore decrease pain. Identifying if you have a problem with foods that are high in histamine and removing these can also help enormously. 

Improving gut health and having daily well-formed bowel motions is an essential first step to reducing pain. This will improve the metabolism of hormones and decrease the influence of gut symptoms increasing the experience of period pain.

Beyond these diet and lifestyle interventions, working with a period pain expert can help provide you the natural period pain relief you’re seeking.

Why are periods painful?

Your body releases inflammatory molecules called prostaglandins and leukotrienes which cause the uterus to contract and cause painful period cramps. The uterine muscle can also spasm, along with blood vessels to the uterus constricting which also causes pain. 

 If you have endometriosis, adenomyosis, fibroids, or a number of other reproductive issues, you may experience more pain, and this should be investigated.

Can naturopaths help with period pain?

Yes, naturopaths and functional medicine practitioners can make an enormous difference in how you experience your periods, from regulating cycles, to ensuring you ovulate and reducing pain. A naturopath period pain treatment will include a tailored healthcare plan that seeks to restore balance where it’s needed, through dietary and lifestyle interventions as well as naturopathic medicines like herbs or nutrient supplementation. 

If you’re looking for naturopath period pain treatment, there are functional medicine practitioners at Melbourne Functional Medicine ready to help you be pain-free. Vicki van der Meer and Rebecca Hughes are passionate about women’s health, and can help with painful periods, with natural remedies for natural period pain relief, and strategies to reduce prostaglandins naturally during painful periods. 

As naturopaths trained in functional medicine, both Vicki and Rebecca can help with period pain specialist treatment methods to restore hormonal balance and reduce pain using herbal, lifestyle and supplementary medicine. 

If you’re looking for a period pain treatment in Melbourne or elsewhere in Australia, find out more about our approach here, then book a call with us here.

What is the difference between dysmenorrhoea and endometriosis?

Dysmenorrhoea is the term used for painful periods, of which endometriosis may be a cause. Endometriosis is a separate condition, caused by endometrial cells growing outside of the uterus.

How to reduce prostaglandins during your period naturally

Reducing the inflammation that is associated with painful periods through the release of prostaglandins requires a holistic, multi-pronged approach.

There are many things that can contribute to inflammation, from poor diet and lifestyle to suboptimal gut health. Working with a functional medicine practitioner who is a period pain specialist will help to get inflammation and therefore pain under control.

Some interventions such as Omega 3 fatty acids have been shown to directly reduce prostaglandins as well as herbs such as curcumin, eating an anti-inflammatory diet, and reducing stress.

Can’t find what you’re looking for? Reach out to the team directly – we’ll be happy to assist.