Normalizing bowel movements. Why it's important and how physical therapy can help.
Did you know your period should be pain free, easily managed, and regular?
It's true, your period should not be excessively heavy, thick, painful, or unpredictable. Physical therapy can help you experience #PeriodPeace.
Dysmenorrhea is a fancy term for painful periods. Read more about primary and secondary dysmenorrhea here.
I've shared my menstrual history below, which is a story many women relate to. In fact over 50% of women report experiencing painful periods.
I first experienced my womanly flow when I was in the 6th grade. As a young, introspective 11-year-old, I was learning how to wear a pad and to bring supplies everywhere I went. I hardly remembered to put deodorant on regularly! I was not ready to take on a menstrual cycle.
I first began birth control in 9th grade due to severe mood swings and cramping accompanying my monthly period. The cramps would come on suddenly and leave me sobbing, rolling on the floor in agony. Birth control managed my mood and my painful cramping, however, now I had the responsibility of taking a little pill everyday. I did not follow this well and often forgot to take 3 days in a row. During my period week, I would often take 6-10 capsules of Advil or non-steroidal anti-inflammatories (NSAIDs) to treat cramping, low back pain, and pelvic pain. This I believe contributed to chronic gastrointestinal complaints. Some side effects of oral contraceptives are listed here. Oral contraceptives may also contribute to pelvic pain. See this infographic about the harmful effects of NSAIDs.
I first went off of birth control in graduate school after a lapse in renewing my prescription due to the overwhelming demands of school. I remember my severe cramps began while in class reviewing anatomy. I excused myself in front of my classmates and instructor, vaguely saying I didn't feel well. I went into my car and cried on the phone with my sister, who also suffers from painful periods, and waited the three hours for them to pass.
I first decided to seek natural remedies and relief from my monthly pain one year post graduate school. As a physical therapist specializing in pelvic pain, I knew physical therapy combined with natural remedies could relieve my symptoms. It was time to put in the work and effort to reach my own #PeriodPeace.
5 Tips to Pain Free Periods
- Physical Therapy. Pelvic physical therapists will first assess your posture. Women with a history of pelvic pain often come into my office with legs crossed and bottom tucked in. This shortens and strains the muscles of pelvis that will contribute to pain. Some pelvic physical therapists are also trained in assessing the position and mobility of your pelvic organs including the uterus, ovaries, fallopian tubes, and bladder. If the ovary is rotated, this may interfere with any phase of the menstrual cycle that contributes to symptoms of pain. The illustration to the right demonstrates two suspensory ligaments that may be dysfunctional and contribute to pain referring to the pelvis and low back due to organ malposition. A pelvic PT will also assess your pelvic muscles for spasms, trigger points, dysfunction, strain, or fascial restrictions. These treatments will improve function of the female pelvic organs and improve fertility.
- Naturopathic Medicine. These doctors are the best at balancing hormones using remedies including supplements, herbs, and oils. For example, to naturally balance my estrogen to progesterone levels, my Naturopathic Doctor (ND) prescribed Chaste Tree or Vitex. She also instructed me to drink more water, include magnesium in my supplements, and use an ice pack rather than heat to treat menstrual cramping. These are examples of three easy, natural, non-invasive treatment approaches that you may be prescribed during your evaluation by an ND. If you live in the Los Angeles area, I highly recommend seeing one of these three amazing NDs. Dr. Jessica Marier Dr. Michelle Gerber Dr. Molly Jarchow
- Exercise. I am biased here as a physical therapist, but exercise helps everything. Exercise regulates our body's hormones and strengthens our body's ability to respond to stress. A combination of strength, endurance, and mobility training is ideal, but at the end of the day, do something you enjoy. I practice gentle therapeutic yoga, two to three days of strength training, 2 days of aerobic spin or jog, with the occasional hike and scenic stroll. **Look forward to an up-coming blog including my favorite yoga postures for period pain.
- Meditation. If you have not established a meditation practice in your life yet, now is the time. Do it. Your excuses won't cut it. Even if your mediation is 2 minutes of deep breathing before getting out of bed in the morning, you must begin and maintain a meditation lifestyle now. There is endless research showing the benefits of meditation. I believe meditation has taught me how to listen to my body. After meditation, I feel more gratitude for life, I am more aware of my posture, hunger, thirst, bowel and bladder movements, and I am less reactive to stressors in life. The reduction in stress and improved awareness of my body has directly affected my menstrual pain. Check out Insight Timer, my favorite FREE meditation app!
- Menstrual Cup and Thinx. This is the best combination of period protection. Ever. Never buy a tampon or pad ever again. Never risk toxic shock syndrome ever again. This allows me to feel free to maintain my activity level during my period without risk of leaking. No more running discreetly to the bathroom every hour during the day to change a pad or tampon. I put the cup in before I leave for my day, and take in out in the shower at night. I wear my Thinx panties as an added level of reassurance that there will be #NoLeaks. My favorite cup on the market right now is the Lena cup. There are so many different style of cups, so try a few until you find the right fit! My only word of caution is for women with pelvic pain-- inserting anything foreign into the vaginal canal increases risk of infection and may disrupt internal homeopathy. Tips for inserting and removing a menstrual cup: Use lubricant, find a good fold to insert, unhook the suction seal around your cervix with your finger before removing, relax pelvic floor or descend pelvic floor by exhaling and gently pushing the cup out.
See your pelvic physical therapist if you have pelvic pain to learn more about decreasing/eliminating period pain. It's your turn to find #PeriodPeace... period. xo
Contributed by Dr. Grace Abruzzo PT, DPT