Does coconut contain a secret component that can comfort women experiencing menstrual cramps? As complicated as it may sound, the short answer is maybe yes, but probably not much. There are indeed studies that support the claim that coconut water can alleviate the symptoms of menstrual cramps, the facts and limitations regarding these studies are summarised in the present article.

Introduction

Menstrual cramps are also referred to as Dysmenorrhea, a term that originates from the Greek language and literally translates to ‘difficulty in monthly flow’. The majority of women experience this kind of difficulty that manifests as pain in their lower abdomen. Pain intensity varies among women, as there are women who are merely bothered by cramps, women who experience severe pain, and women who are greatly affected by cramps in such a way that they may have an impact on their everyday life tasks. On top of that, menstrual cramps may last for more than one day, which amplifies the need to figure out ways to overcome the symptoms. While certain medications may be prescribed by doctors, these include pharmaceutical compounds, and so many women opt to alleviate menstrual cramps with natural components, such as ones derived from coconut. The efficacy of such components are explored in the following senctions.¹

Understanding menstrual cramps

Dysmenorrhea, the scientific term referring to menstrual cramps, is distinguished in two categories: primary dysmenorrhea and secondary dysmenorrhea. The difference between the two lies in the aetiology of the painful symptoms.²

Primary dysmenorrhea

In primary dysmenorrhea, menstrual cramps are caused by the normal process of the uterus shedding its lining, the endometrium. This event takes place only in the absence of pregnancy and causes inflammation of the endometrium and uterus contractions that are experienced as painful cramps.^1,3 Molecules that are associated with inflammation, namely prostaglandins and leukotrienes, have been found to be in a greater amount in the menstrual fluids of women experiencing painful cramps.²

Established treatments for primary dysmenorrhea

In order to relieve women from menstrual cramps, the most common treatment is the prescription of anti-inflammatory medications (e.g., ibuprofen). Another option is treatment with oral contraceptives, which regulate the levels of a hormone-like compound involved in the inflammation of the endometrium and consequently the manifestation of painful cramps.^1,4 However, apart from pharmacological compounds, there are a few other methods that are considered effective in the treatment of menstrual pain. Interestingly, regular physical exercise as well as self-acupressure are among these methods, constituting readily available and low-to-zero cost treatments.  Moreover, heat therapy is also considered effective.¹

Secondary dysmenorrhea

Secondary dysmenorrhea refers to the type of menstrual cramps that manifest as a result of a pathological condition. One of the leading causes of secondary dysmenorrhea is endometriosis, a condition that involves ectopic endometrium presence outside of the uterus.^2,5 This type of dysmenorrhea has a later onset than the primary form and usually involves additional symptoms, such as abnormal bleeding, either in regards to quantity or timing of the bleeding.⁶

Established treatments for secondary dysmenorrhea

In order to relieve people AFAB with secondary dysmenorrhea of menstrual pain symptoms, pharmacological compounds with anti-inflammatory or hormonal-regulatory action are usually used. However, that and a number of other treatments may be combined according to diagnosis and symptoms in each individual case.^1,2

Effect of diet on menstrual pain treatment

Many reports have associated dietary supplements with dysmenorrhea symptom relief. However, these reports are based on studies with certain limitations (e.g., sample size). In an effort to draw a safe conclusion regarding the matter of diet’s impact on menstrual pain relief, the results of all studies were collected and analyzed together. Sadly, none of the results yielded from this secondary analysis of findings indicated a significant impact of dietary substances on menstrual pain. The substances that have been reported to affect women with dysmenorrhea without strong evidence are dill seed, valerian, fennel, fenugreek, ginger, guava leaf, Zakaria, chamomile, rhubarb, damask rose, fish oil, melatonin, zinc sulfate, Vitamin B1, and Vitamin E.⁷ Despite a large number of the aforementioned compounds, and there are even more studies correlating diet with dysmenorrhea treatment and indicating certain foods as potential candidates to aid pain relief in menstruating women. Interestingly, a few studies claim that water derived from green (young) coconuts can help alleviate menstrual pain.^8,9,10

Coconut components and their potential benefits

There is a lot of talk about the beneficial properties of coconut components. Coconut oil has entered the scientific research scope for its antimicrobial, anti-inflammatory, and skin moisturizing properties. However, and even though coconut oil is widely used in cooking, studies on the effect of consumption of coconut oil are greatly limited and no safe conclusions can be drawn.¹¹ The same applies to other coconut derivatives, such as coconut water. Supposedly, water from green (young) coconuts is beneficial for people’s health, but again, scientific reports on that front are few. The idea that the consumption of green coconut water may be beneficial to the organism comes mostly from studies on cells or animal models.

Coconut water and inflammation

A study in rats has indicated that green coconut water consumption has a beneficial role in inflammation. More specifically, rats with paw edemas were administered either green coconut water or mature coconut water, and the effect of treatment was calculated by measuring the progress of their oedema. Interestingly, the scientists who performed the study suggest that the consumption of green coconut is more beneficial than that of mature coconut.¹² More studies in rodents that use coconut water as a compound in anti-inflammatory and tissue damage treatment constitute coconut water as a promising candidate for further study in humans.^13,14 Since menstrual pain is a result of inflammation during the shedding process of the uterus lining, it stands to reason that coconut water may prove beneficial in cases of women suffering from dysmenorrhea.

Green Coconut Water as pain relief for menstrual cramps

A total of three studies address the effect of green coconut water on menstrual pain. The first study was published in 2020, and their hypothesis of the positive effect of coconut water on dysmenorrhea was based mainly on the composition of the water. Magnesium, sodium, and potassium constitute three of the main ingredients in coconut water. Out of the three, magnesium has been previously reported to affect uterus cramps, and if so, it seems possible that it may act the same way if administered through coconut water consumption. Indeed, the study showed that green coconut water led to decrease of pain intensity in women with dysmenorrhea.9 The second study that followed in 2021 also demonstrated a positive effect of green coconut water on menstrual cramp pain.⁸

The third and most recent study came out in 2023, and it aimed to compare green coconut water with two other treatments: a pharmacological one, ibuprofen; and a non-pharmacological treatment, dark chocolate. The study showed that even though coconut water consumption reduces the severity of pain in the women tested, it is far from being as effective as the other two treatments. Unfortunately, none of the women tested reported elimination of pain after coconut water treatment, contrary to women who had received ibuprofen or dark chocolate treatment.¹⁰

The latter study points out its limitations regarding a few key aspects that might affect the interpretation of results and, consequently, conclusions. For example, there was no monitoring of the commitment of women tested to follow treatment, meaning that they might have missed treatment doses while the researcher was unaware of it. Furthermore, it should be noted that all three studies were published by researchers working in Indonesia, and even though the origin and residence of the women tested were not always reported, it may be assumed that they all come from a nearby birthplace. This may have a significant impact on the results, as their genetic background and nurturing environment could both affect the aetiology, pathology, and treatment of dysmenorrhea. Consequently, investigating the role of coconut water in other populations (e.g., women in Western countries) is of great importance in order to reach a reliable conclusion. Nevertheless, it is essential that more studies are conducted so that the sample of participating women is increased. It is likely that more research has already been carried out, but findings have not been published in English, so they are not easily available.

Safety considerations

Even though there is not enough data to support the consumption of green coconut water as a treatment for menstrual cramps, one might think there is no harm in trying it as a self-remedy. However, there are many points that someone should take into consideration before following any treatment themselves. First of all, possible allergies to certain compounds may prove fatal if one is caught unaware of their own sensitivity. But even if no such danger exists, there is always the possibility of complications when more than one treatment is involved. In any case, when menstrual pain is severe or manifests in a non-periodic pattern, women should always seek advice from a doctor, as in some cases, the cause of the pain may be caused by other conditions and need medical care.

Summary

Menstrual cramp pain is considered a common problem, but it negatively affects everyday life and needs to be treated. Despite the existing pharmaceutical compounds that relieve pain, research is being conducted on non-pharmacological compounds that may effectively alleviate menstrual pain. One of these compounds is hypothesized to be found in coconuts and can be easily administered through coconut water consumption. Sadly, research on the effect of coconut water on menstrual pain intensity is limited, with only a few available studies in the English language. Even though there are many indicators that coconut water may relieve women from menstrual cramps, there is a lack of strong evidence to support the claim. However, most findings that provide little evidence come from recently published studies, which raises hope that the subject is far from closed and that more research will shed light on the matter soon.