It’s Not Normal To Have Period Pain. Here’s What You Should Know.

More than half of the population deals with having a period. I say “deal” because for a lot of us that time of the month comes with a lot of not-so-awesome experiences.

For me, it’s the moodiness, the backaches, and the cramps. I know enough about my symptoms that I can tell roughly when my period should be making its appearance.

When I was told by Dr. Saru that there was a way to live a period pain-free life she was definitely met with a skeptical look. Really?

Turns out that as a women’s integrative doctor specializing in women’s hormonal health she may be on to something! I got to sit down and do a whole podcast interview with her, which you can find at the bottom of the article, where she tells me what is required to live a period pain free life and just where all the pain comes from, to begin with.

Below are just some highlights of our conversation.

There is a root cause behind each period pain symptom.

There's something that's causing those headaches, migraines, mood swings, fatigue, or cramping. In periods there are levels of estrogen and progesterone. For some people estrogen just gets out of control, it's a little bit too high. It's not where we want it to be, or that progesterone in your luteal phase isn't as adequate as we want it to be to kind of oppose that estrogen. A lot of times I see a combination of both your estrogen is really high and your progesterone is not high enough to meet that demand of how high your estrogen levels are. So that's when you start to see those symptoms. If you notice that you have those PMS symptoms, particularly the few days or the week before you start your period that's that estrogen being a little bit too high. If you notice that right before you start your period or right before you ovulate that triggers headaches and migraines for you again, that’s the estrogen. Because right before you ovulate, your estrogen drops, and right before you start your period, your estrogen drops again. So that big drop in your estrogen when you have to go from really high to really low. That's usually what triggers those symptoms in a lot of people and it can also trigger recurrent vaginal infections, like yeast infections, VB, that kind of stuff, even UTIs for some people, it can trigger a lot of different things. It really comes down to what's going on with your hormones.

What about cramps and period poops?

Other factors especially for pain are going to be prostaglandins. So prostaglandins are the chemical like hormones in our body that are responsible for inflammation. We need them in a small degree because they do help to contract your uterus to expel that lining when we have a period when we have too much of those prostaglandins, that is what's causing that pain. Because prostaglandins are responsible for causing that smooth muscle contraction. So the more you have, the more of that contraction you're gonna get. This is also why you get period poops. When you have too much of this prostaglandin, you might notice that you're pooping a lot right before your period or right as soon as your period starts or you might get diarrhea., All of that is telling me prostaglandin levels are high, especially if it's combined with that pain. So a few different factors estrogen and progesterone levels and those prostaglandins are typically what are responsible for pain and PMS.

What about mood swings and feelings of being depressed?

So mood swings can definitely be related to progesterone levels. It's that fluctuation, usually, people don't have enough progesterone to help them feel a little more stable. The role that progesterone plays in the second half of our cycle is a calming effect, we have a progesterone metabolite called allopregnanolone. And what that does is it binds to the GABA receptors in your brain to help keep you calm, and stable, help with anxiety, and help with sleep. If your progesterone levels are low, you're not getting that inhibitory response. You're not getting that calming effect. And estrogen is one of your more like upper-ish hormones. So that's where you're going to feel really antsy, more anxious, you're going to feel like you're having mood swings and maybe hot flashes or night sweats or just feeling really hot in general. All of that is because of that estrogen and not having enough progesterone to kind of balance that out.

So how do I go about trying to balance all these hormones?

What I like to say is, we start with the gut. We start with the gut and we start with liver metabolism. We start with your sleep, your stress levels, your diet, and your nutrition. All of those pieces are things we work on. For the most part, most people don't have trouble if they can be pretty consistent with you know, they're eating better, they're sleeping better. They're pooping regularly. We've worked on all these pieces. So now their body is able to metabolize all their hormones, and it's able to excrete those hormones. They don't have other sources of inflammation coming from their gut coming from their stress levels coming from their cortisol being all over the place coming from their insulin being all over the place.

Gut health is important but what does pooping have to do with managing your period pains?

Make sure you're pooping every day. So fiber is going to be huge because fiber is what feeds the bacteria in our gut. If you have dysbiosis and there's, you know, some issues with bloating or gas or constipation or loose stools. Your estrogen isn't going to clear it effectively. So we want to make sure that we're feeding that good bacteria that's in there which is through fiber. So it's gonna be really important to make sure you're getting a variety of fiber from legumes from vegetables, from fruits from grains, wherever you can get because that's what the bacteria in your gut thrive off of.

I typically like to say a cup of fiber and a couple of veggies with every single meal is a great place to start. That in and of itself can change so much for people especially if you have gut issues. Water intake is another really underrated one. I can't tell you how many people have come to me saying my PMS symptoms went away and my headaches went away because I drink more water. Don't underestimate how much water can do for you because even 1% dehydration in your body can lead to brain fog headaches, inability to concentrate, mood swings, irritability, and all of those PMS types of symptoms that might just be you're dehydrated.

I like to shoot for about 100 ounces a day. I know a lot of people don't quite get that. So that's going to be your goal. When drinking water obviously check with your doctor first, if you're on certain medications that might be too much but on average about 100 ounces a day, a cup of veggies with each meal.

How does sleep factor into all of this?

Sleep is going to affect your gut health surprisingly. A lot of people I know have trouble falling asleep or staying asleep or they feel really wired when they're trying to fall asleep and then they're really exhausted when they wake up in the morning. They just repeat that cycle over and over, feeling tired all day and wired all night and not getting quality sleep. So if you're not getting sleep, you're not getting that rest and digest parasympathetic activation, and that is where all the blood flow comes to your gut. You get to recover all of that. So if you're not getting good sleep, you're not recovering that's gonna affect your gut health too. So addressing your sleep habits and making sure that you are consistent with your bedtimes, consistent with your wake times, getting restorative sleep, and feeling refreshed when you wake up in the morning. That's going to be even more helpful for your gut health. I don't know if you've ever noticed when you have like, a few nights of bad sleep, and your stomach just hurts and you don’t want to eat. You feel just gross. Again, you're not getting that good. restorative sleep, that parasympathetic activation, that blood flow to your gut is decreased that's going to cause more dysbiosis. So believe it or not, sleep is affecting your gut and your gut is affecting your hormones.

These are just some of the insights Dr. Saru was able to share during our podcast. If you want to listen to the full interview check out! Gain even more knowledge regarding periods, PMS, your hormones, and a lot more by following Dr. Saru on Instagram.