20 . 12 . 2019

Case Report - Menstrual Pain

This is the case of a 17-year-old woman who sought help due to severe pain and other disabling symptoms during her menstrual period.

A.F. was a 17-year-old healthy teenager, except for the severe symptoms that recurred every month. In addition to severe abdominal pain, A.F. experienced nausea, vomiting, headaches, and diarrhea. The situation had been getting worse in recent months, and A.F.  even had to miss school on her period days. Symptoms were only partially relieved by the use of nonsteroidal anti-inflammatory drugs.

Due to her dysmenorrhea (medical designation for menstrual pain), A.F. and her parents consulted a Gynecology specialist who recommended starting oral contraceptives for symptom control. In fact, oral contraceptives are effective in treating dysmenorrhea because they block a woman’s hormonal cycle and prevent the normal fluctuation of sex hormones. However, estrogen and progesterone produced by women during their cycle have essential physiological functions and should not be artificially suppressed.

Aware of the dangers of oral contraceptives,  A.F.’s parents looked for a more natural approach to control symptoms rather than just starting a chronic medication with potential side effects. At the first visit, the anamnesis revealed a healthy teenager on a diet that included fruits and vegetables, good sources of protein, but also refined carbohydrates (including crackers) and dairy products. On examination, no abnormalities were detected, and body composition was appropriate for age and gender.

A treatment plan to decrease inflammation, which could be originating the patient’s menstrual symptoms, was then proposed. It specifically consisted of a diet free of gluten, dairy, and sugar, and supplementation with magnesium and turmeric. Gluten-containing grains and dairy products are the main allergens in our diet. Therefore, they can contribute to the activation of the inflammatory cascade. Dairy products, particularly derived from cow’s milk, have a protein called casein that is quite immunogenic. Magnesium has a relaxing effect on smooth muscle, which helps with menstrual pain, and turmeric is a potent anti-inflammatory agent.

After a month, the patient menstruated again and was amazed at the reduction in symptoms. There was only residual pain that resolved entirely with a single dose of a nonsteroidal anti-inflammatory drug. None of the accompanying symptoms were noted, and A.F. could continue her usual routine. In the meantime, the initial bloodwork came back and didn’t reveal any abnormal parameter.

It was possible to control A.F.’s dysmenorrhea by supporting the body, rather than blocking its natural rhythms. Menstrual pain is a fairly common problem in young women, and this type of functional approach can have significant benefits.