The first phase of menstruation is the follicular phase and begins on day 1 of your bleed, when the reproductive hormones oestrogen and progesterone are at their lowest. The most active hormone at this stage is estradiol, the most potent of the three types of oestrogen in the body. If fertilization doesn’t occur, the spiral arteries of the lining close off, stopping blood flow to the surface of the lining. The blood pools into “venous lakes” that burst once they are full and with the endometrial lining form your menstrual flow. Uterine cramping is one of the most common uncomfortable sensations women may have during menstruation.
There are two kinds of cramping:
- Spasmodic cramping: Resulting from the production of prostaglandins, the hormone-like substances that regulate pain and inflammation in the body by causing either relaxation or constriction of the smooth muscles.
- Congestive cramping: Resulting from possible food allergies (mainly wheat, dairy, or alcohol), which can increase oestrogen levels, creating pelvic congestion and causing the body to retain fluids and salt.
Menstrual cramping and vitamin D
Vitamin D is not actually a vitamin; it’s an essential fat-soluble hormone made through skin exposure to the sun, hence its nickname: the “sunshine vitamin.” Vitamin D is necessary for calcium absorption and deficiency can contribute to rickets and other bone problems, some cancers, and multiple sclerosis and would appear to influence the immune system. The body also makes less vitamin D as you age—typically someone in their 70s makes 75% less vitamin D than someone in their 20s, leading to chronic vitamin D deficiency in the elderly.
Upping your vitamin D intake has been shown to help relieve some of the distress associated with menstrual cramping. That’s because hormone-like substances called prostaglandins trigger the uterus to contract during menstruation as a means of expelling the uterine lining. These substances are associated with inflammation and pain, and high levels are linked to menstrual cramps. Vitamin D helps to decrease both the production of prostaglandins and cytokines, which promote inflammation in your body.
You cannot get adequate vitamin D through dietary sources alone, but upping your consumption of foods fortified with vitamin D, such as cereal flours and milk, and foods naturally containing vitamin D are very helpful. Alfalfa and mushrooms (shiitake and portabella) are good sources of vitamin D2. Free-range egg yolks, beef liver, and wild-caught fatty fishes such as eel, catfish, tuna, salmon, sardines, and mackerel are good sources of vitamin D3, the more important of the two D vitamins. The ideal way to increase vitamin D levels is through safe sun exposure. Take a “sun bath” for 15−20 minutes a day (depending on where you live and the strength of the sun), which should net you 10,000 IU (international units) of vitamin D, a recommended daily dosage to top up vitamin D stores naturally for health. It’s important to expose large areas of your skin to the sun as close to midday as possible in order to receive the correct UV rays for vitamin D production. Limit exposure to just the point when your skin starts to turn pink, then cover up and use your usual sunscreen for the rest of the day to protect the skin. Realistically, it can be very hard to get adequate therapeutic vitamin D from sun exposure in northern latitudes with inadequate sunshine, such as Britain, and modern lifestyles increasingly mean that we are indoors much of the time, so you may well need to take a daily over-the-counter oral vitamin D3 supplement for health. The suggested dosage will depend very much on where you live, your sun exposure, your age, your lifestyle, and the vitamin D levels in your body.
Adapted from Natural Wellness Strategies for the Menstrual Years by Laurel Alexander