Menstrual pain (dysmenorrhea) is the most common gynecological complaint of women and the main cause of women missing work, school, and other activities. Statistics indicate that over 140 million working hours are lost annual as a result of dysmenorrhea. There is no way to begin to count all of those women who suffer through their workday with cramps while wishing they were home in bed.

Cramps have been associated with a number of conditions including endometriosis, ovarian cysts, and stress, however the precise cause of the imbalance is highly individual. The most common symptoms are mild to severe uterine or ovarian pain, sometimes along with leg or low back pain. The pain is often sharp, stabbing, and cramping. It generally begins with the onset of the menstrual flow and reaches its peak within 24 hours. There may also be nausea, and sometimes vomiting, bowel changes, and fatigue. Many women resort to anti-inflammatories, anti-prostaglandins (ibuprofen or naproxen), pain killers, or birth control pills. However, many effective natural therapies are available.

Ayurvedic Dietary Recommendations: I make dietary recommendations according to the woman's ayurvedic constitution, or body type. Women who experience cramps along with constipation, chilliness, gas, bloating, and anxiety are likely to have a Vata , or air, imbalance. They are likely to feel better from eliminating members of the Brassica (cabbage) family, such as cabbage, broccoli, and cauliflower, especially raw. For this group of women, it is best to minimize salads, dried fruits, sweets, and caffeine and to concentrate on whole grains, fruits, and cooked vegetables. These women need to drink lots of water and herb tea, either warm, hot, or room temperature. Oiling their bodies with warm sesame oil is also helpful.

Women who have an excess of fire, Pitta, will likely feel hot and have diarrhea with their menstrual pain. They may get flushed, feel a sensation of heat or congestion in the pelvis from the concentration of blood to the area, and may find themselves unusually irritable and impatient along with their menstrual pain. I advise these women to cut out garlic, ginger, onions, and cayenne as well as citrus and other acidic or sour foods. They should avoid hot tubs, very hot showers or baths, and getting overheated around their periods.

Women of the third body type, Kapha (earth and water), tends towards sluggishness and lethargy with their menstrual cramps. They may experience quite a bit of water retention and bloating and will generally want to do nothing but stay in bed. These women do best to eat very lightly, or even to fast, and, if they feel up to it, to take a walk. Hot, spicy food may help their cramps to pass more quickly as well as avoiding heavy foods such as fats, red meat, salt, and dairy. For all body types, I recommend eliminating or reducing caffeine, sugar, and alcohol.

Exercise: Many women find that engaging in regular aerobic exercise, running, swimming, jazzercise, or another form, help them to move through periods more comfortably.

Homeopathy: The correct constitutional homeopathic remedy can bring great relief to sufferers of dysmenorrhea. Some of the more common remedies are Belladonna , Chamomilla ,

Kali carbonicum , Pulsatilla , Sepia , however the prescription is highly individual and only the one correct remedy will be effective. The appropriate homeopathic remedy will only need to be taken once or several times a year, rather than monthly regimens such as those which follow.

You may still be wondering if Tamara got the help she needed. She did. Homeopathic Veratrum album , white hellebore, brought her great relief. She was free of cramps. Her gas was at least 70% better and she had no diarrhea. Her stools were much firmer. She was no longer as hot during her period. She felt less angry and depressed before her period. She was glad to be a woman again! She was spared up to thirty years of menstrual misery.

Herbs: One of the most useful herbs for painful periods is Viburnum opulus (cramp bark).

Also helpful are Caulophyllum (blue cohosh), Dong quai (Angelica sinensis), and herbal sedatives such as Valeriana officianalis . Castor oil packs, applied to the abdomen, are Edgar Cayce's answer to abdominal and pelvic pain such as that experienced in dysmenorrhea.

Nutritional Supplements: Calcium and magnesium, taken in a three to one ratio, are good muscle relaxants and provide pain relief in some cases. Some women take B-6 during the menses, in a dosage of no more than 100 mg. per day, for relief of menstrual cramping.

Yoga and Deep Breathing: Pranayama, or yogic breathing, can be extremely beneficial in helping a woman relax. A simple technique to begin with is alternate nostril breathing. Breath- ing in and out through the left nostril only is also known to be calming and soothing in general.

Emotional exploration: Menstrual cramps may have a psychological origin. The source may be sexual abuse, dysfunctional sexual relationships, or messages from one's mother that periods and childbirth are painful and a problem. I find hypnosis very useful in such cases.

You do not need to be sentenced to a life of dreading your periods.Tamara found a natural way to eliminate her incapacitating menstrual pain, hopefully once and for all. So can you!

Drs. Judyth Reichenberg-Ullman is a naturopathic and homeopathic physician and cofounder of the Northwest Center for Homeopathic Medicine in Edmonds, WA. She is coauthor of The Patient's Guide to Homeopathic Medicine and Beyond Ritalin: Homeopathic Treatment of ADD and Other Behavioral and Learning Problems. She can be reached at (206) 774-5599.