By Dr Chelsea Cole, ND | Naturopath Victoria BC

Ginger: A Naturopath ‘s Alternative to Ibuprofen

Menstrual cramps are quite common, and can range from mildly bothersome to incapacitating. Many people rely on over the counter pain medication to treat cramping, but some of these medications are either not effective enough, or come with undesirable side effects and risks, which is why it is so important to know that there are other options available. One of those options is the herb, Zingiber officinalis, more commonly known as ginger. This spicy botanical is perhaps most well known for its ability to ease nausea, but there is research that demonstrates its ability to ease menstrual pain as well.

Primary Versus Secondary Dysmenorrhea (ie. Menstrual Cramping)

Dysmenorrhea is the medical term that describes menstrual cramping, and can be classified as either primary or secondary. Primary dysmenorrhea is pain without any identifiable disorder and usually begins around the time of a person’s first menstrual cycle, whereas secondary dysmenorrhea is pain caused by a pelvic disorder like endometriosis, ovarian cysts, or uterine fibroids, and begins sometime after the initial menstrual cycle. While many of the studies that will be mentioned in this article are specific to primary dysmenorrhea, ginger is still an option for pain management in those with secondary dysmenorrhea. In the case of secondary dysmenorrhea, treatment should also focus on the underlying disorder that is contributing to the pain.

What Causes Menstrual Cramping?

There is evidence to suggest that an increase in pro-inflammatory compounds, called prostaglandins (PG), cause menstrual cramps. During the time right before menstruation, if pregnancy hasn’t occurred, progesterone levels start to decline as the body gets ready to bleed, thereby causing an increase in PG production.[1] While this is true of all menstruating people, PG levels are higher in people who experience dysmenorrhea compared to those who do not experience dysmenorrhea.[2] Ibuprofen and other non-steroidal anti-inflammatory drugs (NSAID) block PG production, which is why they are often effective against menstrual cramps.

What the Evidence Says About Ginger & Menstrual Cramping

Most often, people will try NSAID’s and the birth control pill for pain management. These methods have their place, and can be effective and necessary; however, some people want other options for a variety of reasons. A fairly recent review paper found that ginger powder, given in a standardized dose, was effective in the treatment of primary dysmenorrhea.[3] Another study found that people who took 500mg of ginger three times daily for 5 days had less intensity and duration of pain compared to those taking placebo.[4] In addition, this study found that this effect was even better in those who took ginger 2 days before the onset of menstruation and continued for the first 3 days of menstruation, compared to those who started taking ginger on the first day of menstruation. It is also important to recognize that ginger is relatively safe, with the experience of side effects, like heartburn and headaches, being infrequent.[5] Interestingly, ginger has been found to be as effective for relieving menstrual cramps compared to common pain relief medication, like ibuprofen and mefanamic acid.[6] Based on this research, ginger should be considered in the treatment of dysmenorrhea.

What About Heavy Menstrual Bleeding?

Often, menstrual cramps and heavy bleeding co-exist, which is why a study demonstrating that ginger can be helpful for heavy menstrual flow is exciting for people concerned with both symptoms. Heavy bleeding is defined as more than 80 ml of blood in one menstrual cycle. In this study, the researchers compared the amount of blood lost after 1, 2, and 3 months of taking ginger, and found that lower amounts of blood loss were reported after the first month, and that effect was greater after 2 and 3 months of taking ginger.[7] While the results are promising, it is important to have heavy menstrual bleeding evaluated by a health care provider, as it could be a symptom of an underlying health issue, like uterine fibroids, and can lead to iron deficiency anemia.

A Naturopathic Approach to Treating Menstrual Cramps

If you have tried ginger to ease menstrual cramps, and have not noticed any benefit, it is a good time to see your naturopathic doctor to explore other pain management options. Ginger is just one of the treatments that can be used to help menstrual cramping, and in fact, naturopathic doctors will incorporate ginger into a treatment approach, instead of solely relying on ginger supplementation. Also, if cramps are a new symptom, or are getting much worse, further evaluation is warranted to determine whether there is an underlying health concern that is contributing. It is important to know that menstrual cramps don’t have to become part of your normal experience; there are many options for pain relief.

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References:

[1] Hudson T, “Women’s encyclopedia of natural medicine.” McGraw-Hill, 2008.

[2] Lacovides S. et al What we know about primary dysmenorrhea today: a critical review. Human Reproduction Update 21(6): 762-778, 2015.

[3] Daily J. et al. Efficacy of ginger for alleviating the symptoms of primary dysmenorrhea: a systematic review and meta-analysis of randomized clinical trials. Pain Medicine 16(12):2243-2255, 2015.

[4] Rahnama P. Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmnehorrhea: a placebo randomized trial. BMC Complement Altern Med 12(92), 2012. 

[5] Chen X. et al. Efficacy of oral ginger (Zingiber officinale) for dysmenorrhea: a systematic review and meta-analysis. Evid based Complement Alternat Med. 2016, 2016.

[6] Ozgoli, G. et al. Comparison of effects of ginger, mefanamic acid, and ibuprofen on pain in women with primary dysmenorrhea. J Altern Complement Med 15(2):129-132, 2009.

[7] Kashefi F. et al. Effect of ginger on heavy menstrual bleeding: a placebo-controlled randomized clinical trial. Phytotherapy Research 29:114-119, 2015.