The Benefits Of Ginger For Menstrual Discomfort

Ginger has been considered a popular herbal medicine for thousands of years, harking back to traditional Chinese and Indian medicine. It is used to treat minor ailments such as cold and flu symptoms, nausea and pain. But just how effective could it be when it comes to treating menstrual discomfort?

What is Menstrual Discomfort?

It would be fair to say that the start of menstruation is not the highlight of the month for most women. And this is all the more true for those who experience menstrual discomfort. Menstrual discomfort, otherwise known as dysmenorrhoea, is defined as painful cramping, usually in the lower abdomen, which occurs shortly before or during menstruation or both.

Whilst the statistics vary, most likely due to the subjective nature of pain and what is deemed as ‘normal’, most studies are in agreement that up to 90-95% of women of reproductive age experience dysmenorrhoea at some stage,¹ with 2-29% experiencing severe pain.

Common Symptoms

You are most likely experiencing dysmenorrhoea if you have the following symptoms:

• The pain starts shortly before or at the time of menstruation
• You have cramping pain in the lower abdomen. Pain can also radiate to the back and inner thighs
• The pain lasts for approximately 3 days
• It improves as your period progresses
• You have associated physical and/or psychological symptoms such as: nausea and/or vomiting, diarrhoea, bloating, headaches, fatigue, lower back pain, feeling emotional

However, if you start to develop painful periods after years of painless menstruation, then it is important that you see a doctor as this could be a sign of secondary dysmenorrhoea, caused by an underlying pathology.

What causes dysmenorrhoea?

The menstrual cycle

In order to understand why menstrual discomfort occurs, we must first understand the menstrual cycle. It is a complex cyclical process encompassing two separate yet interlinked cycles: the ovarian and uterine. The ovarian cycle refers to the processes that lead to ovulation, whilst the uterine cycle refers to the shedding of the endometrium (uterine lining) in response to ovarian activity. Several hormones mediate this.

Menstruation is the first stage in the menstrual cycle and occurs in the absence of pregnancy. It involves the shedding of the old uterine lining, and it is mediated by the withdrawal of the hormone progesterone, which usually works to make the endometrium receptive to the implantation of a fertilised embryo. As progesterone levels fall, prostaglandin levels rise, stimulating uterine contractions and facilitating the removal of the old endometrium.

Prostaglandins

You can think of prostaglandins as ‘pseudo-hormones’. They are actually derivatives of fatty substances in the body called lipids and act to mediate various processes within the body. Their contribution towards the menstrual cycle has been documented extensively.²

Several studies have shown a positive correlation between prostaglandin levels and the occurrence of dysmenorrheic symptoms. A comparison of blood samples and endometrial biopsies have demonstrated much higher levels of prostaglandins in women who experience dysmenorrhoea compared to their pain-free counterparts.³ Whilst not fully understood, the belief is that through their actions on the uterus, prostaglandins cause vasoconstriction (narrowing of blood vessels), which leads to impaired uterine blood supply; ultimately, resulting in ischaemia and pain. They are also pro-inflammatory molecules that encourage the infiltration of other inflammatory substances, further increasing the sensitivity of pain receptors.⁴

Therefore, it is understandable that the mainstay of treatment is treatments that reduce prostaglandins' production. Whilst it is thought that the majority of women do not seek medical attention for menstrual discomfort, those that do are usually offered non-steroidal anti-inflammatory drugs (NSAIDs), e.g. ibuprofen, naproxen and mefenamic acid or hormonal contraceptives, based on their medical history and whether they wish to conceive.

However, these medications are not without their disadvantages. This is particularly true for NSAIDs, which contribute to a failure rate of 20-25% due to their intolerable side effects. This has led some women to turn to alternative treatments, such as natural remedies. One such possible remedy is ginger.

Ginger vs. Conventional Treatment

Ginger contains several constituents, including gingerol, gingerdiol, shogaol, beta-carotene, capsaicin and curcumin. These constituents work together similarly to NSAIDs and hormonal contraceptives to inhibit prostaglandin synthesis.⁵ However, unlike NSAIDs, ginger has an excellent safety profile. Its dosing has not been formalised and varies depending on why it is being used; however, the general recommendation is a maximum dose of 4 g/day. 

Although rare, side effects of ginger include heartburn and gastrointestinal upset; although the latter is not more than what has been observed with NSAIDs.

A recent analysis of eight independent trials looking at the efficacy of ginger for dysmenorrhoea showed that ginger was found to be more effective in relieving discomfort when compared to no treatment and equally as effective as NSAIDs. It also revealed that ginger may also reduce pain duration, with one study showing that the length of pain in patients who received ginger was significantly shorter than in those who did not.⁶

Ginger and systemic symptoms

What is even better is that ginger can be used to relieve not only pain but also a few of the systemic symptoms of dysmenorrhoea. Some of its bioactive components, notably gingerol and shogaol, have been implicated in inhibiting the pathways involved in causing nausea and vomiting.⁷ Whilst not entirely clear, one school of thought is that the anti-emetic effect of ginger is through its ability to inhibit serotonin receptors.⁸ This may be why ginger can also relieve migraines, as serotonin has also been associated with headaches.⁹

So, if you decide to try ginger, how should you take it?

There is no overall consensus, but typically, 2 g in divided doses is advocated from the start of your period for 3 to 5 days.⁶

Summary

Menstrual discomfort is painful cramping that occurs on or just before periods and is often associated with other physical and psychological symptoms.  Some women may accept this discomfort as a normal part of their monthly cycle, but for those women who do wish to seek relief, there could be an alternative option to the standard medical treatments. 

Ginger may be just as effective in treating menstrual discomfort as NSAIDs. Given its exceptional safety profile, it is a viable option for women looking for non-pharmacological remedies.