Dysmenorrhea: the most effective dietary supplements

Dysmenorrhea refers to often intense menstrual pain affecting a significant proportion of women of reproductive age, with a prevalence of 60% to 90% according to international studies. In France, around 7 out of 10 women report moderate to severe pain during their periods. There are two main types of dysmenorrhea: • Primary: Occurs in the absence of associated pelvic pathology. It is mainly caused by an overproduction of prostaglandins such as PGE2 and PGF2α, which are responsible for painful uterine contractions. • Secondary: Results from an underlying condition (e.g., endometriosis, adenomyosis, uterine fibroids). It is often associated with persistent chronic pain throughout the cycle. Hormonal imbalance, notably the drop in progesterone during the menstrual phase, amplifies prostaglandin production, leading to vasoconstriction and myometrial hypoxia, which are sources of the observed pain.

Symptoms

The pain is typically located in the hypogastric region, sometimes radiating to the back and lower limbs, often accompanied by digestive disturbances (diarrhea, nausea), headaches, and sometimes dizziness. Dysmenorrhea also affects quality of life, leading to decreased school and work productivity, as well as repeated absences. Diagnosis is based on a detailed symptom history. Additional tests, such as a pelvic ultrasound, may be necessary if secondary dysmenorrhea is suspected to identify an underlying condition.

Risk Factors for Dysmenorrhea

Dysmenorrhea, particularly in its primary form, is influenced by several risk factors that can increase the intensity and frequency of menstrual pain. • Early menarche (<12 years): Girls who have their first period at an early age have more ovulatory cycles over a longer reproductive lifespan. This prolonged exposure to hormonal fluctuations, notably elevated prostaglandins during the menstrual phase, increases the prevalence of pain. • Long menstrual cycles: Women with prolonged (more than 30 days) or irregular cycles have a thicker endometrium, which leads to increased prostaglandin production during menstruation. These pro-inflammatory substances exacerbate uterine contractions and pain. • Absence of pregnancy is associated with an increased likelihood of primary dysmenorrhea. After childbirth, uterine contractions and endometrial thickness may decrease, which often reduces the intensity of painful symptoms. • Smoking: Nicotine stimulates uterine contractions through its vasoconstrictive effect, which worsens menstrual pain. Smokers also have increased production of pro-inflammatory prostaglandins, contributing to symptom severity. • Obesity: Excess adipose tissue influences estrogen levels and can disrupt hormonal balance, leading to increased prostaglandin production. Additionally, obesity is often associated with low-grade systemic inflammation, which can heighten pain perception.

Treatments

• NSAIDs (ibuprofen, naproxen) are first-line treatments to reduce prostaglandin production. • Hormonal contraceptives (the pill, hormonal IUD) decrease endometrial thickness and stabilize cycles. • Antispasmodics and adjunct analgesics relieve acute pain. • Application of heat (hot water bottles). • Relaxation techniques or meditation.