Dysmenorrhea (menstrual cramps)


Anti-inflammatory diet has been found to be helpful with symptoms of dysmenorrhea: appropriate dietaty modifications might include adding several servings of fish per week and increasing consumption of plant-based foods. Calcium in dairy products has been shown in double-blind, randomized controlled trials to reduce severity of PMS symptoms. Numerous small studies have found that fish oil can improve dysmenorrhea. Given our understanding of the basic mechanism of omega-3 fatty acids on eicosanoid synthesis, increasing fish consumption and/or taking 1-2 grams/day of fish oil in supplement form is a reasoned approach. There is evidence that thiamine, vitamin E, magnesium, and zinc may have some beneficial effects as well.


Many women use self-massage and abdominal heat to relieve menstrual cramps. There is a small amount of research suggesting that both massage by a therapist and self-massage can be beneficial for relieving dysmenorrhea, particularly when aromatherapy oils are used.Women have been applying hot water bottles and hot herbal poultices/compresses to relieve menstrual pain for centuries. Modern evidence suggests that topical heat (about 39 °C) may be as effective as ibuprofen and more effective than acetaminophen for reducing menstrual pain. For many women who are active at work or school, a heated patch that can be applied to the lower abdomen may be very helpful. These are readily available at most pharmacies.

Black Haw

(Viburnum prunifolium) or Cramp Bark (Viburnum opulus)

Black Haw

Herbalists and naturopathic physicians extensively recommend black haw and cramp bark for the alleviation of menstrual cramping, especially those that are accompanied by pain in the lower back. There have not been any randomized, controlled human clinical trials to confirm any of the historical uses for these herbs. Research has been limited to animal studies, which have confirmed that both species have an antispasmodic effect on the uterus.

Dose is generally 1000 mg of the dried root/bark taken every 3-4 hours as needed. There are no significant safety concerns associated with either herb.


(Valeriana officinalis)


Valerian is a classic nervine relaxant with antispasmodic properties. Midwives have long used it to relieve menstrual cramping and cramping during pregnancy. In a double-blinded, randomized, placebo-controlled trial, 100 students with primary dysmenorrhea were randomly assigned to receive 255 mg valerian (n=49) or placebo (n=51) 3 times daily for 3 days beginning at the onset of menstruation, for 2 consecutive menstrual cycles (Mirabi, 2011). Pain severity was evaluated with a visual analog scale. After the intervention, the pain severity was significantly reduced in both groups (P<0.001), but the extent of the reduction was larger in the valerian group, with the difference between the 2 groups being statistically significant (P<0.05).


(Zingiber officinale)


Ginger has pronounced anti-inflammatory and antispasmodic activity. Ginger is a safe and inexpensive supplement at doses of 1000-1500 mg of ginger powder and may be beneficial for women with dysmenorrhea.


(Foeniculum vulgare)


The common spice fennel has both antispasmodic and anti-inflammatory activity, which may make it useful for treating dysmenorrhea. Researchers noted that volunteers did not like the taste. Fennel would probably be much tolerated in capsule form.

Adapted from Arizona Center for Integrative Medicine – IMR – Family Medicine 2018