Understanding and Managing Period Pain through Hormone Testing – A Naturopaths Perspective
Period pain is common, but not normal!
Period pain (or dysmenorrhoea) is something I see every single day I’m in the clinic. It breaks my heart when I hear stories of women who have been struggling for years with crippling pain because no one ever told them it wasn’t normal. You shouldn’t feel anything more than mild discomfort when menstruating, not even enough to warrant strong painkillers.
If you have lots of pain, firstly, it’s important to confirm it’s what we call primary or functional dysmenorrhea. This essentially means it’s not caused by anything else, like endometriosis, adenomyosis, Pelvic Inflammatory Disease, Pelvic Congestion Syndrome or fibroids. FYI, if you go to your GP and tell them you’re in pain and their only suggestion is to take the pill, especially without investigating any of the above, find a new GP.
What is Period Pain?
When you have period pain in the absence of these conditions it’s usually caused by a relative oestrogen excess. The problem with high oestrogen is it drives a prostaglandin imbalance. Prostaglandins are inflammatory signalling molecules that are released when implantation does not occur. They’re there to get your uterus contracting (needed for you to shed your lining) and to decrease the flow of blood to the endometrium so you don’t bleed to death when you do get a period. When you have too much oestrogen, the prostaglandins become too inflammatory, and this causes strong and frequent uterine contractions, leading to a reduction of blood flowing through uterine muscle and excessive cramping. The high oestrogen and prostaglandin load also lead to high histamine, which further contributes to inflammation occurring in ‘period pain’.
Sometimes, it’s not anything to do with the oestrogen per se, but rather, the baseline inflammatory load in your body is so high that when you get the natural monthly surge in oestrogen-driven inflammation, it tips you over the edge.
Testing your Hormones
Testing your hormones is a simple process, but it needs to be done right! While there’s nothing as important as a thorough, detailed case history, the body has an annoying habit of displaying the same symptoms for excess as it does for deficiency. An example would be something like premenstrual breast pain, which can be a symptom of either oestrogen OR progesterone deficiency.
A simple blood test from your GP can give you a PLETHORA of information about what’s going on with your cycle. The issue is that when doctors recommend these tests, they rarely tell you what day to get them.
When to test
Our sex hormones literally go from zero to over 1000 over the course of the month, and they’re supposed to be in certain ranges at different times – it’s not just a free-for-all. So, if you get a referral for a blood test for your hormones, there are 2 specific times you should get them done:
💫 Day 2 or 3 of your cycle: this is your baseline. We’re checking your oestrogen to make sure you’re both making enough and clearing it properly, and your follicle-stimulating hormone (FSH) and luteinising hormone (LH) to ensure you’re going to be able to develop and release your egg properly at ovulation.
💫 “Day 21”: this is when we check your oestradiol and progesterone. The level of progesterone tells us how well you’re ovulating, and the oestradiol tells us how well you’re metabolising your oestrogen. In reality, this could be a different day, the “day 21” refers to what day falls in the middle of the luteal phase (the second part) of an average 28-day cycle. Really, this test just needs to be done 7 days before you expect to get your period.
If your GP really doesn’t want to do any hormone testing, we can arrange this ourselves in our clinic. We also offer other testing options for hormones, including saliva and urine and would love to help you explore your hormone balance.
Thanks for reading!
For more information on your hormones, please book an appointment with Ali. You can book via the booking link above.
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