Dysmenorrhea: Most Effective Dietary Supplements

Dysmenorrhea refers to often intense menstrual pain affecting a significant proportion of women of reproductive age, with a prevalence of 60% to 90% according to international studies. In France, about 7 out of 10 women report moderate to severe pain during their periods. There are two main types of dysmenorrhea: • Primary: Occurs in the absence of an associated pelvic pathology. It is mainly caused by an overproduction of prostaglandins such as PGE2 and PGF2α, responsible for painful uterine contractions. • Secondary: Results from an underlying pathology (e.g., endometriosis, adenomyosis, uterine fibroids). It is often associated with persistent chronic pain throughout the cycle. Hormonal imbalance, particularly the drop in progesterone in the menstrual phase, amplifies the production of prostaglandins, leading to vasoconstriction and hypoxia of the myometrium, sources of the observed pain.

Symptoms

The pain is typically located in the hypogastric region, sometimes radiating to the back and lower limbs, often accompanied by digestive disorders (diarrhea, nausea), headaches, and sometimes dizziness. Dysmenorrhea also affects quality of life, leading to decreased academic and professional productivity, as well as repeated absences. Diagnosis is based on a detailed history of symptoms. Additional examinations, such as a pelvic ultrasound, may be necessary in cases of suspected secondary dysmenorrhea to identify an underlying pathology.

Risk Factors for Dysmenorrhea

Dysmenorrhea, particularly in its primary form, is influenced by several risk factors, which can increase the intensity and frequency of menstrual pain. • Early menarche (<12 years): Young girls having their first period at an early age have more ovulatory cycles over a longer reproductive lifespan. This prolonged exposure to hormonal fluctuations, notably the increase in prostaglandins during the menstrual phase, boosts the prevalence of pain. • Long menstrual cycles: Women with prolonged cycles (over 30 days) or irregular cycles have a thicker endometrium, leading to increased production of prostaglandins during menstruation. These pro-inflammatory substances exacerbate uterine contractions and pain. • The absence of pregnancy is linked to a higher likelihood of primary dysmenorrhea. After childbirth, uterine contractions and endometrial thickness may decrease, which often reduces the intensity of painful symptoms. • Smoking: Nicotine stimulates uterine contractions through its vasoconstrictor effect, worsening menstrual pain. Smokers also have increased production of pro-inflammatory prostaglandins, contributing to the severity of symptoms. • Obesity: Excess adipose tissue influences estrogen levels and can disrupt hormonal balance, leading to increased prostaglandin production. Moreover, obesity is often linked to low-grade systemic inflammation, which can heighten the perception of pain.

Treatments

• NSAIDs (ibuprofen, naproxen) are the first-line treatments to reduce prostaglandin production. • Hormonal contraceptives (pill, hormonal IUD) decrease endometrial thickness and stabilize cycles. • Antispasmodics and adjunctive analgesics relieve acute pain. • Application of heat (hot water bottles). • Relaxation techniques or meditation.