In the blinding, searing, white-hot moment of the first major cramp of the month — when you're doubled over on the kitchen floor clutching the family-sized bottle of ibuprofen — at that moment you're probably not wondering if there might be an herb you could have taken to prevent this ugly scene.
That's okay. Think about it now, a good week before your period begins, says Dr. Woodson Merrell of Beth Israel Medical Center. Because whether you choose to explore herbal options or stick to an over-the-counter pain reliever, the key to preventing cramps is to start managing symptoms a week before they hit.
Menstrual cramps are caused by prostaglandins, molecular compounds released when your old uterine lining starts breaking down. Prostaglandins cause your uterus to contract. Researchers have found that in comparing women who experience cramps to those who don't, there is a direct correlation between elevated levels of prostaglandins and crippling pain.
Your anatomy is also something to consider. Women with an unusually narrow cervical canal seem to experience more severe cramps, as the uterus must work harder to squeeze larger clumps of blood and tissue out of the body.
There's not much you can do about the size of your cervix, but you can show your prostaglandins who wears the pantsuit.
Anecdotal evidence suggests that Borage Oil, Evening Primrose Oil, and Black Currant Seed Oil work in some women to reduce prostaglandins. Essential fatty acids promote the production of the prostaglandins that help the uterus contract without causing cramping, says Merrell.
"In my experience about 25 percent will respond to any of the natural remedies, while 30 to 40 percent will respond to something like Advil," he says.
"The medical literature on this is not very strong," he adds. "The science is very soft. But the risk is so minimal and the benefits so potentially significant that this is an area ripe for more research."
But as with any new regime, as a general precaution check with your doctor first.
Professor Gail Mahady, an expert in herbal medicine at the University of Illinois, says the alternatives makes good sense.
"All of these seed oils are anti-inflammatory," she says. Still, she echoes, there's a dearth of clinical trials.
To see if you could feel like a natural woman, Merrell suggests taking Evening Primrose Oil in a 500-1000 mg dose once a day in capsule form (available at vitamin shops and health food stores) along with 200-400 mg of magnesium and 100-200 mg of vitamin B6 for four to seven days before the onset of your period.
Says Mahady: "There is fair evidence to show that B6 reduces bloating. Calcium and magnesium have been shown to reduce spasms." Diet also plays a role, she says. Avoid foods that cause inflammation, like sugar.
In addition, she says, reducing the amount of meat and dairy consumed may help. "But it may be what we add to dairy — like antibiotics — that causes inflammation, rather than the meat and milk itself."
Exercise is another weapon against inflammation, she says. Further, the endorphins your body will produce can positively affect your perception of pain.
What if the natural route fails to provide relief? Don't wait until you want to chew off your own arm to start what doctors call non-steroidal anti-inflammatory drugs (ibuprofen, Advil, Motrin etc.). Starting a week before, take one painkiller a day to block prostaglandin production. When your period arrives, you might just feel okay.