What Do We Know About Herbal Remedies and Menstrual Cramps? (Spoiler Alert: Not Much.)

herbalWhen I was entering adulthood and suffering from severe menstrual cramps, I suffered without relief for far too long. And I am certainly not alone in this experience. The most common gynecological disorder is dysmenorrhea — painful menstrual cramps — which strikes an estimated 90 percent of reproductive-age females. Furthermore, around 40 percent of American women use some form of complementary and alternative medicine, or CAM. “CAM” is a catchall for approaches to health care that fall outside of the mainstream. Given the popularity of CAM and the ubiquity of dysmenorrhea, it was no surprise that I experienced painful cramps, nor was it shocking that I tried a few herbal remedies, which are a type of CAM.


“Natural” doesn’t necessarily mean safe or effective, so be critical.


During my second year of college, at the age of 19, a friend recommended a couple of herbal remedies to add to my cramp-fighting arsenal. I tried them, but it was difficult to know if they really worked. My pain varied so wildly cycle to cycle that I had no way of knowing if I was just having a “good month” when I initially tried these products. Although I thought they worked at first, after I had accumulated more menstrual cycles under my belt, I started to wonder if my cramps were really any less painful. On average, I still seemed to be missing just as much school and work as before — but I wasn’t sure.

The problem was that I never collected any before-and-after data — I didn’t spend years ranking the severity and duration of my cramps, or keeping track of the hours spent in bed away from school, work, or other obligations. Furthermore, my initial sense of optimism could have colored my perceptions. Since we can be tricked by our own expectations and biases, it is important to have access to quality evidence — gathered in large, methodologically powerful studies.

Raspberry leaf tea was the first herbal remedy I tried. It tasted OK, and the ritualistic nature of drinking a hot beverage from a steaming mug was soothing. But is there any actual evidence that raspberry leaf can help relieve the pain of dysmenorrhea? Although it’s been used therapeutically since at least the 1500s, the only human studies I can find for any gynecological condition examine its use during pregnancy or labor — not for treating menstrual cramps. The only claims for raspberry leaf’s efficacy in treating cramps come from biased sources, like the manufacturers themselves. It seems the tea I drank during my late teen years had word of mouth and marketing going for it, but not much else. Continue reading

Diagnosing Endometriosis

If you missed it, you can read the previous post explaining the basics of endometriosis here. In this post, we’ll look a little more at how endometriosis is diagnosed as well as some current barriers to diagnosis.


Wait. So you’re telling me that killer cramps of doom aren’t normal? If I did suspect I had endo, how would I go about getting diagnosed?

Endometriosis diagnosis is a tricky thing in that there’s no in-office procedure that can definitively determine whether someone has the condition or not. However, because the “gold standard” test is laparoscopy with biopsy — a surgical procedure — many health care providers prefer to do some in-office tests before recommending laparoscopy. The most common such procedures are pelvic exams and ultrasounds, which may allow a provider to see or feel if the endometrial lesions have formed cysts (known as “endometriomas”), but won’t pick up on smaller lesions.

Another complicating factor is that endometriosis isn’t the only cause of either dysmenorrhea or chronic pelvic pain. Other causes can include uterine fibroids, pelvic floor dysfunction, pelvic inflammatory disease, irritable bowel syndrome, and interstitial cystitis.

Even with laparoscopy, diagnosis isn’t necessarily straightforward. Not only is it a surgical procedure, which carries with it extra expense and risk, but even then, presence of the disease is often missed or underestimated. Seeking out a doctor who specializes in endometriosis can minimize this, but of course, due to geographic, cost, or other access issues, this isn’t always possible. Continue reading

March Is Endometriosis Awareness Month

As my ever-creative title suggests, March is Endometriosis Awareness Month. I have endometriosis (“endo” for short), and I like this month because I know plenty of people in my life who could definitely use some more awareness as to what endometriosis is and how it impacts the lives of those who have it.

So what is endometriosis, anyway?

Endometriosis is a condition where the endometrium, the lining of the uterus, grows outside the uterus — often on the ovaries, bladder, bowel, and/or lining of the pelvic area. This can be a problem for two reasons. One is that during menstruation, there’s nowhere for this “rogue endometrium” (not a technical term) to go, not having a way to the cervix and vagina and all. This can cause pain — most often pain during menstruation — as well as a buildup of tissue that remains throughout subsequent cycles, where even more “rogue endometrium” is added to it. The other is that the endometrial lesions can contribute to infertility, particularly if the endo obstructs the ovaries or fallopian tubes.

That doesn’t sound like fun. Is endometriosis rare?

Surprisingly, no. Exact numbers are hard to come by because a lot of cases are thought to go undiagnosed (which is part of the reason for this whole “awareness month” thing). But the estimate is that endo affects just over 10 percent of people with ovaries during their reproductive years — and about 30 to 50 percent of such people who have problems with infertility or pelvic pain. Odds are pretty good that you personally know someone with endometriosis, even if you don’t (or they don’t!) know they have it. Continue reading