We have a narrative that periods should be difficult in some ways, but while period pain is very common, it’s never normal. It’s always a sign of an imbalance.
Most women can feel mild cramps on the first day of their period – which should not interfere with your day. This is caused by prostaglandins, inflammatory compounds that help the uterus contract to release its lining and blood. But even this mild level of can be reduced with the strategies outlined below.
Debilitating period pain is different. It seriously affects your days – you can’t go to school or work, and it doesn’t fully respond to conventional painkillers like ibuprofen. If this is your experience, I recommend getting it investigated. Severe period pain could be the result of a condition like endometriosis, which can run in families.
Growing up hearing from your female relatives that periods are painful does not mean you have to accept it as your reality.
In this article:
- What causes period pain and what you can do about it
- Nutrition for period health
- How mineral depletion causes pain, and the role of stress
- How smoking and vaping ruin your period
- The connection between vaginal microbiome and period pain
- Toxic menstrual products and what to use instead
- Ancient Chinese teachings about “warm” uterus
- Severe pain and when to seek diagnosis
- Common masking strategies – the pill and ibuprofen
- A summary with simple and effective strategies
What drives period pain – start with nutrition
The most important thing you can do nutritionally is to address the inflammatory picture.
Dairy from cows is more inflammatory than dairy from sheep or goat. Removing it tends to alleviate symptoms within a couple of cycles and it’s one of the most reliable nutritional interventions I use. Swap vegetable seed oils like sunflower oil for quality olive oil, and include oily fish like salmon and sardines twice to three times per week. Omega-3 from fish can counterbalance the inflammatory prostaglandins which cause pain.
Your kitchen also contains wonderful and very effective anti-inflammatory spices. Ginger and turmeric are natural anti-inflammatories – ginger is additionally a remarkable pain-reliever and helps alleviate nausea. You can easily make or buy turmeric-ginger shots, add both to soups and stews, or make a simple ginger tea by slicing fresh ginger root and brewing it with cinnamon and slices of lemon.
If you’re undereating animal protein and your periods are also heavy, it is likely that you are low in key minerals like magnesium, zinc, and iron all of which are needed for a healthy cycle.
Mineral depletion and period pain
Stress is not just emotional. Your body perceives poor sleep, skipping breakfast, overtraining, and blood sugar swings as stress. If this is chronic, it increases mineral turnover and pushes the body into survival state where key minerals are depleted faster than they are being replenished through food.
The first mineral affected is almost always magnesium. One of its functions is to relax muscles, including the uterus.
Magnesium depletion also shows up also as headaches, leg cramps, anxiety, and poor sleep. And then when your period arrives, the body does not have enough magnesium to regulate prostaglandins and relax the uterine muscle.
Magnesium glycinate is my number one supplement for period pain. It needs to be taken daily with meals throughout the month, not just during the period. The dose is very individual, but most women can benefit from taking 500mg per day. You can also benefit from Epsom salt baths so that magnesium is absorbed through the skin: 2 cups of salts stirred into hot bath water, soaking for a minimum 20 mins for full effect.
In my practice, I also assess mineral balance – not just through food diary, symptoms, and Hair Tissue Mineral Analysis, which shows the real state of minerals and toxic metals in the body. This is important because toxic metals like lead and arsenic actively displace essential minerals.
Smoking, vaping and your period
With smoking and vaping gaining resurgence in recent years, this is an important area to discuss.
Both lead to nutrient deficiencies and disrupt the vaginal microbiome.
Smoking and vaping reduce the body’s absorption of magnesium, calcium and also iron – precisely the minerals that you need to have a healthy cycle. B vitamins and vitamin C also become depleted. B vitamins are particularly important for many aspect of hormone health, including the breakdown and clearance of oestrogen…when this is affected, periods are likely to get heavier.
When I see a woman for severe period pain who also vapes, I am not surprised. She is depleting the exact nutrients her body needs to manage her cycle.
The vaginal microbiome and period pain
A healthy vaginal microbiome is a marker of vaginal health – it prevents infections like BV and HPV, and also keeps the vaginal environment well balanced. It is also a significant factor in the intensity of period pain.
Research shows that women with severe period pain have lower levels of Lactobacilli- the friendly bacteria – and higher abundance of Prevotella, Atopobium, and Gardnerella compared to those with only mild pain. These pathogenic bacteria promote the release of pro-inflammatory compounds that amplify pain. Atopobium specifically is the bacterium associated with BV and its presence disrupts vaginal pH and releases more cortisol which further intensifies pain. Optimising the vaginal microbiome is an important part of managing period pain. It is also something you can easily test at home with a lab kit provided by my practice.
The vaginal microbiome can be dysbiotic for a number of reasons – it can be inherited at birth, and disrupted further by antibiotics, over-the-counter treatments for vaginal infections, smoking and vaping, and everyday chemicals found in bath bombs and intimate soaps.
Supporting Lactobacillus through fermented foods, clearing any infections properly in ways that don’t kill the helpful bacteria, stopping smoking and vaping, and targeted probiotics all have direct relevance for period pain. [Read more about supporting your vaginal microbiome here – including why green tea can be helpful in intimate health]
Toxins in menstrual products
The vaginal mucosa is one of the most absorptive tissues in the body. This means that chemicals can be absorbed without undergoing first-pass metabolism; they go directly into the system.
Many conventional menstrual products contain phthalates, volatile organic compounds, parabens, environmental phenols, fragrance chemicals, dioxins and dioxin-like compounds. Dioxins are a by-product of the bleaching process used to whiten conventional cotton tampons and pads. They are also present in non-organic dairy and non-organic meat – one more reason to choose organic where possible. Research has shown dioxin exposure led to endometriosis, and endocrine-disrupting chemicals found in these products can interfere with hormones and cause gynaecological conditions including endometriosis and uterine fibroids.
I recommend all women switch to organic cotton tampons and liners. Menstrual cups need to be made from medical-grade organic silicone – though see my article here on how to clean them properly to protect the vaginal microbiome as, in my view, general cleaning instructions are not sufficient.
This is environmental medicine applied to menstrual health.
What TCM says about the warm uterus
In Traditional Chinese Medicine, a warm womb is essential for healthy menstruation. If you reach for hot water bottle to relieve your period pain, this is a classic sign of “cold” in the uterus.
Cold enters the uterus through cold lower abdomen (crop tops may not be the best outfit choice if you have period pain), cold food and drinks like smoothies and iced drinks, walking barefoot on cold floors, and spending long periods in air-conditioned spaces.
I always ask women about their habits around their period.
Simple practical steps: wear socks or slippers at home, cover your lower belly and lower back during your period. Eat hot meals; soups, stews, bone broth, at least during menstruation itself. A hot water bottle on the lower abdomen is also clinically validated by thousands of years of practice and has measurable effects on uterine blood flow.
When severe pain signals something deeper
Endometriosis is found in as many as 70% adolescents who undergo laparoscopy for period pain that doesn’t respond to pain relief. It’s incredibly underdiagnosed – many women wait over ten years to get proper diagnosis. Endometriosis is a multi-systemic disorder involving the immune system, and often also involving co-infections and a prior traumatic event. It is not simply a reproductive condition.
PCOS is another common underlying condition – though pain is not a symptom of PCOS alone. If pain is the main symptom, something else is going on.
Conditions like endometriosis and PCOS often have familial patterns. If your mother had the same symptoms, this should raise clinical suspicion rather than a reassurance that it simply runs in the family. There is also an epigenetic dimension, inflammatory patterns, how and what you eat, how you respond to stress – these can all be transmitted across generations. I already mentioned that women inherit their microbiome from their mothers at birth, so if your mother’s microbiome was dysbiotic when she gave birth to you, chances are yours is too. This is something that can be assessed and optimised.
There is also an emotional component, too. One of the first things I ask a woman with painful periods is: how did your mother feel about her periods? That conversation often unlocks something important that wants to be explored.
The problem of masking
Many young women are prescribed the pill to minimise period pain. The pill works by stopping ovulation and ovulation is how women make hormones. It may offer a relief from monthly pain but does not address the root cause, and it unknowingly delays the diagnosis of a potential underlying condition like endometriosis and PCOS. It also exacerbates nutritional depletion and microbiome dysbiosis both in the gut and the vagina deepening the imbalance further.
Ibuprofen is generally considered safe but regular use has an impact on ovulation and fertility. As a COX inhibitor, ibuprofen blocks the prostaglandins that trigger ovulation – and regular use can delay and affect luteal phase progesterone production. This is why it is not recommended if you are trying to conceive.
Symptoms are signals from your body. One of the most important questions to ask is: what is my body trying to tell me? This will help you make the right choices about treatment.
What you can do
Track your symptoms and investigate. What kind of pain, when in the cycle, are there any other symptoms? If you can predict your symptoms you can manage them more effectively, and bring meaningful data for any practitioner. If pain is severe, investigate. This also helps you become more aware of your body.
Tracking also deepens your awareness of your body, and this in itself is an important part of your healing journey.
Address the minerals. Consider supplementing magnesium glycinate daily with food.
Consider herbs. Cramp bark, chaste tree, and black cohosh can be highly effective but would need to be taken for several weeks before the period is due to produce meaningful relief.
Address nutrition. Ginger, turmeric, reduce dairy, increase healthy omega-3 fats. A protein-rich breakfast stabilises blood sugar and reduces the cortisol that drives mineral depletion.
De-stress your life. Sleep, adequate food, not overtraining, no coffee on an empty stomach. Minerals can only be retained if the body is not in permanent survival mode.
Non-toxic menstrual products. Organic cotton pads and tampons. Menstrual cups that are certified plastic-free and made from medical grade silicone. Period underwear if PFAS (forever chemicals)-tested though I am cautious about these as bacteria can accumulate over cycles and more research into the full ingredients is needed.
Keep warm. Lower abdomen, lower back and feet. Hot water bottle. Warm meals and drinks.
Optimise the vaginal microbiome. Fermented foods like kimchi and sauerkraut. Avoid bath bombs and intimate washes. Stop smoking and vaping.
If you smoke or vape – address the accompanying nutrient deficiencies especially magnesium, zinc, B vitamins and vitamin C.
On the first day of your period. Peppermint oil mixed into a carrier oil, massaged into the lower abdomen, provides relief for many women. A hot water bottle. Warm herbal teas – peppermint, chamomile, ginger.
Symptoms are signals from the body. Your period is one of the clearest signals you have.
If my approach resonates with you, I would be happy to work with you and help you transform your menstrual health.
Read next: [What your period reveals about your health]
References
Briden, L. (2018) Period Repair Manual. Macmillan.
Hechtman, L. (2018) Clinical Naturopathic Medicine. Elsevier.
Marroquin, J. & Pollack, A. (2024) ‘Chemicals in menstrual products: a systematic review’, BJOG: An International Journal of Obstetrics and Gynaecology.
Nursing Research (2021) ‘Associations between dysmenorrhea symptom-based phenotypes and vaginal microbiome: a pilot study.’ PMC.
Robbins, M. (2025) Root Cause Protocol Newsletter. therootcauseprotocol.com [newsletter.]
Labban, L. et al. (2019) ‘The implications of e-cigarettes on nutritional status’, Journal of Medical Research and Health Sciences.
Armour, M. et al. (2020) ‘The prevalence and educational impact of pelvic and menstrual pain in Australia’, Journal of Pediatric and Adolescent Gynecology.
Burnett, M. & Lemyre, M. (2017) ‘Primary dysmenorrhea consensus guideline’, Journal of Obstetrics and Gynaecology Canada.
Zeng, M.Y. et al. (2017) ‘Mechanisms of inflammation-driven bacterial dysbiosis in the gut’, Mucosal Immunology.
Haldar, S. et al. (2016) ‘Female reproductive tract microbiome in gynaecological health and problems’, Journal of Reproductive Health and Medicine.
Arias-Carrasco, R. et al. (2024) ‘The relationship between female genital tract microbiome and dysmenorrhoea: a systematic review of current evidence’, ScienceDirect.
