Exercise: SOS for Menstrual Cramps

The best relief for period pain? Get off the couch and on the move.

By Gina Shaw
WebMD the Magazine - Feature

Reviewed by Michael W. Smith, MD

Pam Kelly (not her last name) was only in the third grade when she got her first period. From the beginning, her menstrual cycle was a source of monthly dread. "I was out of school a couple of days just about every month, the pain was so bad," says Kelly [real name withheld at her request], now a 46-year-old office worker living in Arlington, Va., and mother of twin 8-year-old daughters. "The school nurse would give me codeine for the pain, and I was finally put on high-dose birth control pills. Those helped some." (Since birth control pills maintain more consistent hormone levels, they can help alleviate period pain.)

But then, as she entered junior high, Kelly found something that worked even better: exercise. "I joined the basketball team and then the soccer team, and I found that the pain was becoming less and less," she says. "By ninth grade, I didn't even need the birth control pills anymore."

Dysmenorrhea -- which means menstrual pain -- affects many women. Some studies estimate as many as 90% of younger women have severe period pain, and it's the leading cause of school and work absences for this group.

Exercise relieves cramps because it helps release beta-endorphins, which are internal opioids -- your own "human morphine," according to Kelly's doctor, Gustavo Rossi, MD, an obstetrician-gynecologist at Virginia Hospital Center in Arlington. "It produces analgesia [pain relief] and helps to burn the prostaglandins -- chemicals released during menstruation that cause muscle contractions -- much faster."

The best form of exercise for relieving menstrual pain, experts agree, is aerobic exercise -- something that gets your heart rate up, such as brisk walking, biking, swimming, or, in these cooler months, ice-skating. "The important thing is that you do it at least three times a week, for 30 minutes at a time," says Paula Castano, MD, an assistant clinical professor of obstetrics and gynecology at Columbia University College of Physicians and Surgeons in New York.

Kelly recently noticed her severe menstrual pain is back, after dropping her exercise routine last November because of family illness. While Rossi wants to rule out other problems, both he and Kelly agree that her new sedentary ways have to go.

"My neighborhood is very hilly, and I love to go on long walks with my dog, so that's my plan for making time for it again," Kelly says.

Walking for Cramp Relief

The Exercise: Break a sweat by walking at a brisk pace. You should be able to talk to someone accompanying you, but not without a little effort. Need to push yourself? Try doing what Kelly does: Hit the hills, or bring an energetic pooch -- or both.

The Benefit: Real relief from period pain seems to come from vigorous exercise, the kind that gets you breathing hard and your heart pumping fast. When that happens, your body releases endorphins that help counteract the cramp-producing chemicals that are part of the menstrual cycle.

Prostaglandins, which are hormone-like chemicals made in our bodies from fatty acids, are one of the causes for menstrual cramps-they cause uterine muscles to contract. Therefore, women who have higher levels of prostaglandins may have more contractions which usually means more pains. As a matter of fact, artificial prostaglandins are used to induce labor. How's that for pain!

Exercise

Exercise that gets your heart pumping may help relieve cramps. The best relief comes from strenuous exercises such as aerobics, brisk walking,walking,etc. When you do these types of exercises endorphins are released and they help counteract prostaglandins. Plus exercise helps to relieve stress and tension in muscles. I have also found that strengthening my abdominals have lessened my menstrual pain.

Eat Well

Eating a low-fat diet with lots of fruits and vegetables will help ease pain. High fat diets ususally contain a lot of saturated trans- fats (butter,animal fats) which may metabolize into pro-inflammatory prostaglandins while good fats( oil oil,flaxseed oil, omega-3) metabolize into anti-inflammatory prostaglandins which may result in less pain.