Whenever one of my patients is in pain, I always create a short-term approach and a long-term approach to address their problem. In the short-term I want to help them alleviate their pain as quickly as possible and in the long-term, I want to resolve the hormonal problem associated with the pain on a more permanent basis.
Pain from cramps is often due to cramping in the muscles of the uterus as it is shedding the inner lining called endometrium. The muscles in the uterus are used to shed the endometrium each month that there is no fertilized egg and this is what produces a period.
To naturally relieve and reduce muscle contractions and pain associated with PMS I recommend nutritional magnesium. As a short-term plan, I suggest supplements and foods that are high in magnesium and I have patients start on these a couple of weeks before their period.
Foods that are high in magnesium include Swiss chard, spinach, summer squash, pumpkin seeds, broccoli and other green, leafy vegetables. Although organically grown vegetables are best, due to the depletion of nutrients in our soils over the last 50 years, I also recommend magnesium supplementation in divided doses during the day. Not all forms of supplements are bio-available. For example, magnesium citrate in a powder form that dissolves in water is extremely absorbable whereas magnesium oxide is
only about 4% absorbable.
After I focus on the short-term goal of reducing the menstrual pain during the first menstrual cycle the patient has under my care, I then focus on the long-term goal of treating any hormonal imbalances that are occurring during her menstrual cycle.
Treating Hormonal Imbalances and Stress
As I work with patients that have come in with a complaint of menstrual distress I look at solutions that include eating foods rich in essential fatty acids and fiber. Essential fatty acids omega 3, 6, and 9 are required for a women’s body to create our estrogens and progesterone. These hormones are also the precursor to our cortisol hormone known as one of our stress hormones.
When women do not have an adequate supply of essential fatty acids our stress management system and our menstrual system compete for the essential fatty acids that are available. Our stress management system will win every time leaving our menstrual system off balance which can cause pain and cramping among other PMS symptoms. If we eat foods high in essential fatty acids then we have an adequate supply for both our stress management system and our female hormonal system. Foods that are high in essential fatty acids are salmon, scallops, sardines, avocados, legumes (phytoestrogens act like weak estrogens) flax seeds, walnuts, cauliflower and cabbage.
One last note with regards to stress. According to Dr. Carolyn Dean, author of "The Magnesium Miracle", "Stress can cause magnesium depletion and lack of magnesium magnifies stress. Magnesium is necessary to support our adrenals, which are overworked by stress It is very significant if a woman has a magnesium deficiency because of the many vital enzyme systems that require this mineral. They include carbohydrate metabolism, blood sugar control and energy production. A strain on the adrenal glands puts a strain on the magnesium dependent energy system of the body, which further promotes energy depletion and leads to a vicious circle of decreased ability to manage stress. Magnesium is the anti-stress mineral and is known to alleviate stress, cramping from PMS, muscle tension, depression, anxiety and insomnia."
Fiber and Hormonal Imbalances
The next part of my long-term strategy for treating menstrual cramps (and most menstrual irregularities) is to look at how fiber foods impact your hormonal balance.
Why is fiber important in the hormonal balance process? Fiber foods act as a natural broom for our digestive system and help us to eliminate waste products from our body. Once our estrogen and progesterone have been used by the reproductive system, they are processed by the liver and deposited in our bowels to be removed when we have a bowel movement. If we are not having daily bowel movements, then those hormones can and do get reabsorbed into the body and begin to recirculate and act on our ovaries, uterus and hypothalamus (in the brain). This throws off the ratio or balance that our body is trying to maintain, causing menstrual imbalance.
This is where the fiber comes into play. Eating high-fiber foods, fruits, vegetables, whole grains, legumes, beans, nuts and seeds allows the body to eliminate the estrogen and progesterone before it has time to be reabsorbed. You can only get fiber from foods that come from plants. Foods that come from animals do not contain any fiber.
Additionally, according to Dr. Dean, "PMS is considered to worsen with constipation and toxicity. If the bowel doesn't empty once a day, toxins can be reabsorbed back into the blood stream from the colon. The longer debris sits in the colon, the more fluid is reabsorbed, making stools more solid and difficult to pass. Magnesium is a natural detoxifier and muscle relaxer and helps alleviate constipation and painful cramps."
The message I want to convey is there is a process to naturally treat menstrual irregularities that will take some time, but will completely be worth the effort. What you eat and how you live can affect the level of pain and suffering of your menstrual cycles and can even potentially make them painless.
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Medica Forums -
5/17/13
Had a case the other day with the above finding on a pap. She was age 36 and had a Mirena in place. How do people feel about the idea of trying to do an EMB with an IUD in place? If not, how do we proceed?
Medica Forums -
5/16/13
Hello,
Has anyone tried FetalGrowth app (App Store for iPhone/iPad) ? I'm interested in using a simple and handy tool to calculate fetal percentiles, and I came across this app, which seems it does the job (plots growth charts, as well). I haven't seen anything else, besides this app, so I was wondering if there are people who have already tried it. Thanks !
Medica Forums -
5/12/13
Welcome to the new ObGyn.net Forum!
To all the members of OB-GYN-L… Thank you for coming! I’m thrilled that you’ve decided to check out the new Forum site, and look forward to reading about what’s on your mind. If you’re new to the ObGyn.net community... welcome aboard! You’ve just joined an outstanding group of physicians and health care professionals who have been sharing information, answering questions, and building professional relationships via the site’s listserv for nearly 20 years. Feel free to poke around on the site to get a feel for things, or take a look at the Help Topics page for instructions on how to use the different features of the site. A few quick tips: For those of you who like getting new Forum messages delivered directly to your inbox, the first thing you’ll want to do is click on the ‘Follow this forum’ button on the main page. You’ll have the option of getting notifications immediately, as a daily digest, a weekly digest, or only when you’re not online (which is to say, if you’re on the site when someone posts a message, you won’t be notified of it). You won’t be able to post on the site just by replying to the email, but the message will contain a link that takes you directly to the message you’d like to reply to. You can also follow individual conversations without following the whole list by going into the topic and clicking the ‘Follow this topic’ button next to the title. Also, in ‘My Profile’ you can:
Happy posting!
Medica Forums -
5/11/13
I helped another physician with removal of a retained placenta last night, we were unsuccessful in removing it vaginally, her cervix was too closed to allow manual removal and we could only get a few pieces out with ring forceps and a large curette, so we did a laparotomy/hysterotomy and were able to preserve the uterus. The placenta turned out not to be an accreta and it was easily removed via that route through a low vertical incision on the uterus. Any thoughts on the appropriate CPT code would be appreciated. The patient came in through the ER five days after home delivery by her husband. She was severely anemic, rcvd 7 units of blood and is still quite ill and in the ICU but improving.
Ronald E. Ainsworth, MD, FACOG
Medica Forums -
4/15/13
Recently, I had the occasion to review a case of a term primigravida with PROM in a private hospital (no housestaff or in house obstetricians). She was seen by an obstetrician soon after arrival, evaluated, and pitocin induction begun.
She did not deliver for around 29 hours after admission, and the delivering obstetrician (a different physician) was physically present during the last 2 hours of labor prior to delivery. Simply put, while the two involved obstetricians were in communication by phone with the nursing staff throughout labor (separately as their "shifts" did not overlap), no one actually came to the bedside and wrote a note) from admission until around 2 hours before delivery. Medical staff bylaws call for a daily progress note; this bylaw was easily met. In reviewing the case, it did not "feel good" that no one came to the bedside. My questions: 1. Does anyone have or know of any guidelines to mandate such bedside attendance? Of course, we all hope that the involved physicians would not need said guidelines. 2. Does anyone have a suggestion of hospital/nursing protocols? Simply, in this case I would like to have had a charge nurse or bedside nurse simply say, "Hey, no one has been by for a while. What's up?" Garry EducationalTutorialsEducational Tutorial: Complications of Laparoscopy
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