Is there anything I can do to relieve severe cramps that cut my running short?

Hi,

The HMO doctors you are referring to...is one of them a Gynecologist?

You mentioned that when you are running, you have painful periods that you would describe as "severe, stabbing pain". When you are not running, your periods are painful but not severe or stabbing.

As you know, painful menstruation is common for many women. "Some pain is normal, but excessive pain is not. The medical pain term for 'excessively painful periods is called dysmenorrhea'."

Since you are worried that your dysmenorrhea may have an underlying cause, I wanted to provide you with the two categories of what you could be experiencing:
* "Primary dysmenorrhea refers to menstrual pain that occurs in otherwise healthy women. This type of pain is not related to any specific problems with the uterus or other pelvic organs."
* "Secondary dysmenorrhea is menstrual pain that is attributed to some underlying disease or structural abnormality, either within or outside of the uterus."

You would want to talk with your Gynecologist about ruling out secondary dysmenorrhea, so that can take away some of the anxiety, stress...and possibly even reduce some of the pain...that you may have related to being concerned that there is something else wrong. Hopefully you find out that you "only" have primary dysmenorrhea, and here is what is recommended for this condition:

Medications
* Nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen or naproxen, to reduce levels of prostaglandins in the uterus and decrease pain
* Oral contraceptives, which prevent ovulation and reduce menstrual blood flow—This is particularly useful in women interested in contraception.

Lifestyle Changes
* Using a heating pad on your abdomen or taking a warm bath can reduce the discomfort of dysmenorrhea.
* Talk with your doctor about taking herbs and supplements. Fish oil, magnesium, and vitamin E may help reduce menstrual pain. Other natural treatments, such as the herb boswellia, have been suggested to be helpful for this condition, but there is less evidence for their effectiveness.

Prevention
To help reduce your chance of getting dysmenorrhea, take the following steps:
* Exercise regularly.
* Don’t smoke. If you smoke, quit.
* Drink caffeine and alcohol moderately.

The reason that hormonal contraception (birth control pills) are offered as the first-line-of-defense by the medical community to help women with dysmenorrhea is due to the belief that hormones are causing the pain in the first place. Couple this with the fact that BCP work well at managing pain, and have many benefits (regulating cycle to 28 days or more, pregnancy prevention), and they are inexpensive and accessible for most women. The hormone-like substances that are naturally produced in our body, are thought to be the culprits in causing dysmenorrhea are called "prostaglandins".

However, since you asked about specific non-drug treatments to control for pain (again, after having any underlying medical conditions ruled out), there are some options that fall under the category of "alternative and complementary":
- "Acupuncture: Two literature reviews have suggested that acupuncture may help with pain from menstrual cramps, but the research is limited."
- Fish oil/Omega-3s: "At least eight studies involving a total of 1,097 women have investigated the relationship between diet and menstrual cramps and have found that fish oil intake seemed to have a positive effect on menstrual cramps."
- Dietary Changes: Eating foods that are low in fat, sugar, salt, consuming low amounts of alcohol (if any), along with complex carbohydrates and foods with good sources of calcium and magnesium may also help alleviate PMS.

The last piece of the puzzle: your running.
I am a runner too, and I am wondering about your exercise routine: what are you training for, and what distances are you running weekly? Are you interested in tailoring your running and conditioning to allow for menstrual cramps? I'm assuming you do not have any "side cramps" from running; the cramps you experience are exclusively "menstrual cramps" or "pre-menstrual cramps (PMS)", correct? I would be frustrated, also, if I had to "start over" every few weeks to get back to my previous training regimen.
Have you tried any of these techniques:
- Non-cramping days: work on distance and endurance
- Cramping days: work on hills, speed/sprints, strength training or cross-conditioning. I'm sure you know this, but a runner does not need to specifically run to become a better runner; you become a better runner through cross conditioning with other fitness activities. Have you tried pool running? This is HARD and a great workout, and may lessen the impact of your menstrual cramps, but is still providing you with the specific running techniques. Other forms of exercise to help with running on your "off-running days" could include strength training (pilates or weight lifting), stretching and balance training (pilates or yoga). Swimming is a great all-around fitness activity that could meet all of these goals, too.

I hope I provided you with a few more ideas to keep up with your training and not sacrifice your overall running efforts. By having different goals each week through listening to your body, and your cycle, you may help your body achieve even better results!

And, just so you don't become discouraged, you will likely have to work harder to find a successful non-drug remedy for pain management, including a combination of herbs, supplements, acupuncture, acupressure, massage, yoga, relaxation techniques, heat therapy, etc. Remember to talk with your doctor before starting any type of herb or supplement, as if they are strong enough to help, they are also strong enough to cause harm.

I highly recommend reading more about dysmenorrhea at these sources:
- Dysmenorrhea at EmpowHer
- Dysmenorrhea at MedlinePlus
- Pain management at National Center for Complementary and Alternative Medicine (NCCAM)