Menstrual Cramps Alter Brain Chemistry

Here's a study that any woman who's ever suffered from menstrual cramps can really sink her teeth into!  Guys, you should take a bite too; you might discover some valuable information to make that 'one-week-a-month' a little more pleasant.

The most common gynecological disorder in women of childbearing age is Primary Dysmenorrhea (PDM), or menstrual cramps. 

Menstrual pain affects up to 90% of healthy women and adolescent girls. Menstrual cramps, which can sometimes be severe, begin in the lower abdomen often spreading through the pelvic area and into the back.  Some women experience headache, upset stomach, vomiting and diarrhea. These cramps and accompanying symptoms can last three days.

Cramping begins with the onset of menstrual flow and may continue up to three days, causing alterations throughout the central nervous system.

Magnetic resonance imaging (MRI) scans of the brain were examined in 32 women with a history of menstrual pain and 32 women with no history of menstrual pain by researchers, led by Jen-Chuen Hsieh, MD, PhD, of the Institute of Brain Science at the National Yang-Ming University in Taipei, Taiwan.

The brain's gray matter comprises the bulk of nerve cells or neurons within the brain.
The initial scans were conducted when the women were pain-free.  These images helped researchers create maps of the gray matter. 

A decrease of gray matter in areas of the brain involved in pain transmission and mood regulation, in tandem with increases other areas of the brain that are involved in pain sensations and in regulating certain hormones, occurred among women who experience painful menstrual cramps the study showed.  Changes were noted in the hypothalamus which regulates the menstrual cycle.

"Our results demonstrated that abnormal gray matter changes were present in PDM patients even in absence of pain. This shows that not only sustained pain but also cyclic occurring menstrual pain can result in longer-lasting central changes. Although the functional consequences remain to be established, these results indicate that the adolescent brain is vulnerable to menstrual pain. Longitudinal studies are needed to probe hormonal interaction, fast-changing adaptation (intra-menstrual cycle) and whether such changes are reversible or not."

Researchers wrote that "these results indicate that the adolescent brain is vulnerable to menstrual pain.  The next step would be to conduct studies to see what role hormones play in these changes, and to determine whether or not the gray matter changes are reversible."

"Hormonal changes sensitize the neurons to pain so you are apt to feel more pain given a stimulus such as cramps," says Edna Ma, MD, an anesthesiologist at St. John’s Health Center in Santa Monica, Calif.  "If these brain changes are related to the pain, and we can find a receptor, it would make sense to target it and minimize the menstrual pain, but if it is hormone-related then those changes may be unrelated to the pain."

"There are certain brain structural changes that occur with menstrual cramps, which could be related to pain, but there could be other contributing factors in addition to pain that is causing these structural changes such as hormonal changes and stress," says Duke Han, PhD, assistant professor of neuropsychology at Rush University Medical Center in Chicago.  "Targeting treatments toward the brain axis where there are changes may help better focus therapies for menstrual pain, if these results are indeed, validated"

Earlier this year, Andrzej R. Batt of Vantia Ltd., the U.K.-based pharmaceutical company, presented new information about the molecular structure of the drug known as VA111913, at the annual meeting of the American Chemical Society in San Francisco.  The new drug works by blocking the hormone vasopressin, which is involved in contractions of the uterus, and is now in Phase II clinical trials in the US and UK.

"We hope that the drug will provide a more effective treatment option for millions of women worldwide with this painful condition," says Blatt.  "Dysmenorrhea not only diminishes the quality of life for millions of women, but also has a hidden, society-wide economic cost that involves an enormous number of days lost from work and school."

Whether the brain or hormones cause the annoying and painful cycle of menstrual cramps doesn't really matter when you are missing work or school; all that is truly pertinent in those moments is the fact that you are  lying in bed with a hot water bottle and have a clear path to the bathroom "just in case". 

WebMD offers some suggestions to relieve menstrual cramps:

    *As soon as cramping starts, take aspirin, acetaminophen, ibuprofen or naproxen.
    *Avoid caffeine, smoking and alcohol
    *Apply heat to the abdomen and/or lower back.
    *Rest as much as possible

If you have severe or unusual menstrual cramps, experience a noticeable change in severity or length of cramps, or cramping that lasts for more than two or three days, contact your medical professional.

Laura Lamp King