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Protocols

Relieving Painful Periods Naturally with Essential Oils protocol

Overview

Relieving Painful Periods Naturally with Essential Oils

Author: Kristen Horner Warren, L.Ac., M.S., M.A., Dipl.OM

 

Dysmenorrhea, or painful periods, is a common condition that affects up to 90% of women at some point during their reproductive years, with more than 50% of women experiencing pain monthly.

This debilitating condition occurs frequently, with sufferers experiencing symptoms for years. Because painful periods are difficult to treat, because it is the most common menstrual condition, and because patients are often unsatisfied with standard medical treatment, there is a strong need for complementary and alternative medicine approaches for this condition.

 

Overview:

In this protocol, peppermint and Pain Relieving Essential Oil Blend* are used topically, and lavender is inhaled to help reduce intensity of pain and associated symptoms of painful periods. Additionally, the protocol recommends adding lemon oil to water daily to help reduce toxic load and stimulate the liver, reducing painful period symptoms. Chronic painful period sufferers make want to take additional steps, using a Monthly Painful Period Focus and use other suggested products monthly to help decrease painful period frequency and severity. This includes using the Women’s Monthly Essential Oil Blend,** and taking Digestive Enzyme Complex,*** Probiotic Defense,**** and thyme oil internal, plus increasing water intake, getting at least 20 minutes of physical activity a day, and reducing consumption of sugar.

 

*Deep Blue Essential Oil Blend (contains Wintergreen Leaf, Camphor Bark, Peppermint Plant, Blue Tansy Flower, Blue Chamomile Flower, Helichrysum Flower, and Osmanthus Flower essential oils)

**ClaryCalm Monthly Blend for Women (contains Clary Sage Flower, Lavender Flower, Bergamot Peel, Roman Chamomile Flower, Cedarwood Wood, Ylang Ylang Flower, Geranium Plant, Fennel Seed, Carrot Seed, Palmarosa Herb, and Vitex Plant essential oils)

***TerraZyme Digestive Enzyme Complex

****GX Assist GI Cleansing Formula

*****PB Assist+ Probiotic Defense Formula

Author's Preliminary Clinical Observations

 

“A large proportion of my patient population are women of childbearing age and, although it may not be the main complaint that brings them to my office, a sizeable number of these women suffer from discomfort with their periods. This discomfort ranges from being a minor annoyance for a few hours a month to being a major disability that confines women to bed (away from work, school, and household responsibilities) for several days each month despite narcotic pain medication.

 

Acupuncture and Chinese herbal medicine are generally quite effective in relieving the symptoms of painful periods, but my goal is always to help women find ways of dealing with their health challenges in the most cost effective way and in a way that does not require them to make time to come to my office for acupuncture on an ongoing basis.

 

When it comes to dysmenorrhea, I am focused on providing treatment that will prevent the condition from becoming worse over time. The tendency is for painful periods, especially when they are caused by an underlying condition like endometriosis (see the article “About Painful Periods” for more information), to get more severe as a woman ages. This is why my protocol includes nutritional supplements intended to regulate the hormones that are involved in the formation and growth of endometriosis.

 

Another subset of my patient population is women who are actively trying to conceive. Obviously these patients cannot resort to using oral contraceptive pills to prevent dysmenorrhea. Recent research suggests that non-steroidal anti-inflammatories (the most commonly used prescription and over the counter pain medication used to manage dysmenorrhea) use may increase the risk of early miscarriage, so many women trying to conceive avoid those medications as well. This leaves them, in some cases, with severe period pain that they have to live with until they are able to get pregnant. I have found that use of essential oils and nutritional supplements is particularly appealing for this population of patients, especially given that this protocol will have a fertility-enhancing effect.”

 

Read About Painful Periods by Kristen Horner Warren, L.Ac., M.S., M.A.

Discussion, Article Summaries, and Research

 

Essential oils such as peppermint, lavender, frankincense and helichrysum are widely used in alternative medicine for chronic pain conditions due to their chemical compounds that help decrease inflammation and pain and improve blood flow to the area. Various in vitro and in vivo studies have found that these plant compounds such as terpenes, acetophenones, phloroglucinols, 1,8 cineole, linalyl acetate, and limonene which help to inhibit inflammatory pathways, produce analgesic effects and relax the nervous and muscular systems. Studies have found that the use of essential oils during painful period episodes can also help to reduce associated symptoms including nausea, fatigue, and stomach upset. Essential oils have also been found to help decrease severity of painful periods, making them a viable treatment option for many migraine sufferers who have otherwise found no relief or do not wish to medicate.

 

One study used a quasi-experimental design with patients serving as their own control. Every participant applied both aromatherapy massage with lavender oil and placebo massage with odorless soft paraffin. Participants were evaluated prior to the intervention using a visual analog scale to indicate their level of pain. Higher scores indicated a greater severity of pain. When the lavender massage and the placebo massage were compared, the visual analog scale score among the lavender massage was found to decrease at a statistically significant rate whereas the placebo massage did not. (Apay, S.E., et al., Effect of aromatherapy massage on dysmenorrhea in Turkish students. Pain Manag Nurs, 2012. 13(4): p. 236-40. ABSTRACT)

 

A number of investigators have looked at aromatherapy massage for relief of dysmenorrhea. In one randomized, placebo controlled study with a crossover design, nursing students with primary dysmenorrhea received abdominal massage once daily for seven days prior to menstruation. The treatment group (aromatherapy group) received massage using a blend of cinnamon, clove, rose, and lavender oils in a base of almond oil and the control group received the same massage procedure using plain almond oil. In the second phase of the study the two groups switched to the alternate regimen. Level and duration of pain and amount of menstrual bleeding were evaluated at the baseline and after each treatment phase. During both treatment phases, the level and duration of pain and amount of menstrual bleeding were significantly lower in the aromatherapy group than in the placebo group. (Marzouk, T.M., A.M. El-Nemer, and H.N. Baraka, The effect of aromatherapy abdominal massage on alleviating menstrual pain in nursing students: a prospective randomized cross-over study. Evid Based Complement Alternat Med, 2013. 2013: p. 742421.ABSTRACT * PDF)

 

In another randomized, double blind clinical trial, patients with primary dysmenorrhea were assigned to either an essential oil group or a synthetic fragrance group. The treatment received by the essential oil group was a blend of lavender, clary sage, and marjoram essential oils diluted to 3% in an unscented cream. This blend contained four key analgesic components, including linalyl acetate, linalool, eucalyptol, and beta-caryophyllene. The synthetic fragrance group received the same cream with the addition of synthetic fragrance to mimic the odor of the essential oil cream. All patients used the cream daily to massage their lower abdomen from the end of the last menstruation to the beginning of the next menstruation. The numeric rating scale and verbal rating scale decreased significantly after one menstrual cycle of intervention in both groups. The duration of menstrual pain was significantly reduced in the essential oil group only. (Ou, M.C., et al., Pain relief assessment by aromatic essential oil massage on outpatients with primary dysmenorrhea: a randomized, double-blind clinical trial. J Obstet Gynaecol Res, 2012. 38(5): p. 817-22.ABSTRACT)

 

Raisi et al divided 96 college students with moderate to severe dysmenorrhea into treatment and placebo groups. The treatment group inhaled lavender oil in sesame carrier oil and the placebo group inhaled sesame oil only. The subjects were followed for four menstrual cycles. The severity of dysmenorrhea symptoms was measured through a questionnaire and amount of menstrual bleeding was assessed based on sanitary towel usage. Symptoms of dysmenorrhea were significantly lowered in the lavender group compared to placebo. The amount of menstrual bleeding was lowered in the lavender group but the difference was not statistically significant. (Raisi Dehkordi, Z., F.S. Hosseini Baharanchi, and R. Bekhradi, Effect of lavender inhalation on the symptoms of primary dysmenorrhea and the amount of menstrual bleeding: A randomized clinical trial. Complement Ther Med, 2014. 22(2): p. 212-9.ABSTRACT)

 

In the first, 84 college students with primary dysmenorrhea were randomly assigned to three groups: thyme essential oil, ibuprofen, and placebo. The first group was given 200 mg ibuprofen per dose plus 25 drops of a placebo essential oil. The second group was given 25 drops of 2% thyme oil plus a placebo capsule per dose. The third group was given 25 drops of placebo essential oil plus a placebo capsule per dose. Subjects were instructed to start treatment on the first day of menstruation and take a dose every 6 hours. Pain intensity was recorded before treatment was started, an hour after each dose, and 24 and 48 hours after treatment was started. Subjects were also asked to rate their blood flow. The thyme essential oil group’s pain score went from 6.57 prior to treatment to 1.21 during the first cycle of treatment and to 1.14 during the second cycle of treatment. In the ibuprofen group, the pain score decreased from 5.30 to 1.48 in the first cycle and to 1.68 in the second cycle. (Salmalian, et al. Comparative effect of thymus vulgaris and ibuprofen on primary dysmenorrhea: A triple-blind clinical study. Caspian J Intern Med. 2014 Spring; 5(2): 82–88. ABSTRACT * PDF)

 

Hotta et al demonstrated that carvacrol derived from thyme essential oil regulates COX-2 (a key enzyme for prostaglandin synthesis) expression through its antagonistic effect on PPARgamma (ligand-dependent transcription factors involved in the control of COX-2 expression). (Hotta, M., et al., Carvacrol, a component of thyme oil, activates PPARalpha and gamma and suppresses COX-2 expression. J Lipid Res, 2010. 51(1): p. 132-9).This same team of investigators followed up this study and examined the role of citral* derived from lemongrass essential oil also suppressed COX-2 expression. They speculate that these effects may play a role in understanding the anti-inflammatory and anti-lifestyle related disease properties of thyme and lemongrass essential oils. (Katsukawa, M., et al., Citral, a component of lemongrass oil, activates PPARα and γ and suppresses COX-2 expression. Biochim Biophys Acta, 2010. 1801(11): p. 1214-20.ABSTRACT)

 

Three investigations have evaluated the effect of orally administered sweet fennel oil on dysmenorrhea compared to mefenamic acid (a non steroidal anti-inflammatory drug). In one study, patients with moderate to severe dysmenorrhea were evaluated for three cycles. During the first cycle no medication was given (control cycle), in the second cycle mefenamic acid was given at a dose of 250 mg every 6 hours, and in the third cycle a 2% concentration of sweet fennel was given at a dose of 25 drops orally every 4 hours. Both the mefenamic acid and the fennel oil effectively relieved pain compared with the control cycle. (Namavar Jahromi, B., A. Tartifizadeh, and S. Khabnadideh, Comparison of fennel and mefenamic acid for the treatment of primary dysmenorrhea. Int J Gynaecol Obstet, 2003. 80(2): p. 153-7.ABSTRACT)

 

In another study comparing the effect of fennel oil to mefenamic acid, 80% of patients in the mefenamic acid group and 73% of the patients in the fennel oil group showed complete pain relief or significant pain decrease, while 80% of patients in the fennel group and 62% in the mefenamic acid group no longer needed to rest during menstruation. There was no significant difference between the groups in level of pain relief. (Modaress Nejad, V. and M. Asadipour, Comparison of the effectiveness of fennel and mefenamic acid on pain intensity in dysmenorrhoea. East Mediterr Health J, 2006. 12(3-4): p. 423-7.ABSTRACT)

 

In another study a double-blinded quasi-experimental crossover design was used to compare the effectiveness of fennel extract combined with vitamin E to ibuprofen in patients with primary dysmenorrhea. A visual analog scale was used to rank the intensity of pain. The mean peak of pain intensity in the first, second, third, sixth, and forty-eighth hours was lower in the fennel/vitamin E group compared to the ibuprofen group. These differences were statistically significant in the first and second hours. (Nasehi, M., et al., Comparison of the effectiveness of combination of fennel extract/vitamin E with ibuprofen on the pain intensity in students with primary dysmenorrhea. Iran J Nurs Midwifery Res, 2013. 18(5): p. 355-9.ABSTRACT)

 

In a third study, the investigators compared 30 mg of fennel extract given in a capsule orally four times per day for three days from the start of menstruation to a placebo (wheat flour) given according to the same schedule. Both groups experienced pain relief but there was a statistically significant difference with the fennel group experiencing greater pain relief than the placebo. (Omidvar, S., et al., Effect of fennel on pain intensity in dysmenorrhoea: A placebo-controlled trial. Ayu, 2012. 33(2): p. 311-3.ABSTRACT)

 

In a fourth study, sixty college students suffering from dysmenorrhea were randomly assigned to two groups and followed for two cycles. One group received oral fennel essential oil and the other received mefenamic acid. Comparison of pain intensity in the groups showed no significant difference in pain relief between the two. (Bokaie, M., et al., Oral fennel (Foeniculum vulgare) drop effect on primary dysmenorrhea: Effectiveness of herbal drug. Iran J Nurs Midwifery Res, 2013. 18(2): p. 128-32.ABSTRACT)

 

Ostad et al evaluated the effect of fennel essential oil on uterine muscle contractility in a rat model. For assessment of pharmacological effects on the isolated rat uterus, oxytocin and prostaglandin E2 were used to induce muscle contraction. Administration of different doses of fennel essential oil reduced the intensity of oxytocin and prostaglandin E2 induced contraction significantly. Fennel essential oil also reduced the frequency of contractions induced by prostaglandin E2 but not with oxytocin. Lethal dose 50 of fennel essential oil was determined to be 1326 mg/kg in female rats. (Ostad, S.N., et al., The effect of fennel essential oil on uterine contraction as a model for dysmenorrhea, pharmacology and toxicology study. J Ethnopharmacol, 2001. 76(3): p. 299-304.ABSTRACT)

 

Note: Though the literature suggests that orally administered fennel oil is helpful in relieving dysmenorrhea and it appears to be widely used for this purpose in traditional Iranian medicine, we have elected to not to include it in this protocol. Many experts believe that fennel essential oil exerts an estrogenic effect and it is therefore contraindicated in patients with secondary dysmenorrhea caused by either endometriosis or fibroid tumors (exogenous estrogen will tend to feed the progression of both of these conditions). Because many women who suffer from painful periods are not aware that they have either endometriosis or fibroid tumors, we have elected to err on the safe side by excluding fennel oil from this protocol.

When to seek a medical professional for treatment:

 

If after 2 menstrual cycles while using the Self Treatment Protocol you are still having painful period symptoms, then contact your physician for instructions on additional treatment or interventions.  If you are already seeing a physician for painful periods, follow instructions as directed by your physician.  Continue to follow the above protocol while being treated by your physician.

 

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