Have You Tried Exercising to Reduce Your Menstrual Pain?

For a few years, I was in a state that can only be called alive. If I got more than six hours of sleep, it was considered a miracle. Additionally, I was mostly relying on a quick bite of fast food for most of my meals. Exercising was pretty much out of the question because when I did have some free time, I was too exhausted to move. The only form of exercise I had was running late.

During that time, I suffered from painful primary dysmenorrhea (menstrual cramps without other underlying diseases). It was especially bad on the first day of menstruation. Without a pain reliever and heating pad, I would have been rendered debilitated in a fetal position and unable to carry out most of the daily activities.

In recent years, I made an effort to live a healthier life. Besides sleeping more and eating more balanced meals, I also started exercising again. I started small, with short jogs a few times a week, and worked up to additional full-body exercise sessions accompanying longer runs most days of the week. Since I started exercising, within 1 month or two, I started noticing various improvements, such as improved energy level, better concentration, better mood. On top of all that, I also noticed that my dysmenorrhea symptom has become so minor that it was barely noticeable at all.

Pleasantly surprised and curious, I did some reading on published research in this space to see if exercising can really significantly alleviate menstrual cramps or I have simply ‘outlived’ my dysmenorrhea. Below, I will share my findings with you.

Menstrual Cramp is very common, and most who suffer from it suffer severe pain.

What struck me first was how common primary dysmenorrhea (menstrual cramp) is among women. Usually starting anywhere from 1–2 years to 6–12 months after the first period and remaining until around 40 years of age, this issue is affecting close to 80% of women worldwide, and about 60% of women have severely painful dysmenorrhea¹²-¹³.

This means, if you are currently suffering from a painful menstrual cramp, about 2.3 billion women worldwide are suffering along with you¹⁴.

There are treatments for it that are well studied.

NSAID (such as Asprin, Advil, ibuprofen, Pamprin, etc.) and oral contraception are two well-studied treatments that have shown significant pain reduction in most women¹². Most of the NSAIDs that were studied and are effective can be found over the counter. The downside of NSAID is that it does not have a preventative effect. Although it provides a significant pain reduction, NSAID does not always decrease the pain to an extent that normal daily activities can carry on uninterrupted. Additionally, the common side effects that come with the medication are applicable. Oral contraception on the other hand are prescription medications, so you will only be able to acquire them with your doctor’s prescription. Since it is hormonal-based contraception with side effects, not everyone sees it as the best option.

Neither are good options for you or looking for an alternative way to manage the menstrual cramps? Maybe give exercise a try!

Many studies currently have been published in this space. When there are a few studies that did not show a clear effect, the vast majority of the studies’ results showed significant positive effects of exercise on period pain reduction¹.

What else do you need to know about exercise as a treatment for menstrual cramps?

1. You don’t have to limit yourself to a single form of exercise. The methods of studied exercise are diverse, and the ones that have shown positive effects include stretching, isometric exercises, yoga, running, and other aerobic exercise¹-¹¹.
2. You may have to keep up the exercise for 8 weeks to see significant results. Several studies have shown that when it is possible to show a significant effect in 4 weeks, starting from 8 weeks and on is when additional improvements start to show²-³ ⁸ ¹¹. Therefore, if you are giving the exercise a try, try doing it consistently for 8 weeks.
3. You may not need to spend a lot of time exercising each time. When the duration of the exercise regime being studies varies from 10–40 minutes, most studies that have shown significant improvement have employed 30 minutes sessions with a frequency of 3 times a week⁷.
4. The lightest exercise regime studied and shown effect involves pelvic stretching for 10 minutes, 3 times a week⁹.
5. If it is not comfortable to exercise during the period, you can choose to only exercise during the luteal phase (the time before your period)⁴ ⁶.

Other things to consider or to rule out

Secondary dysmenorrhea can also manifest as painful periods, but the cause is different from that of primary dysmenorrhea. If you suspect that you may have secondary dysmenorrhea, it would be important to get it properly diagnosed and treated.

Some points to consider are the onset timing of the dysmenorrhea, pelvic abnormality, infertility, heavy or irregular cycles, or the pain has little to no response to NSAID or oral contraceptive medications¹². If you are in doubt, it would be important to consult with your physician.

Other methods have been studied and shown some effects as well, such as massage, aromatherapy, TENs units, herbal remedies, etc.

1.Carroquino-Garcia, P., Jiménez-Rejano, J. J., Medrano-Sanchez, E., De La Casa-Almeida, M., Diaz-Mohedo, E., & Suarez-Serrano, C. (2019). Therapeutic Exercise in the Treatment of Primary Dysmenorrhea: A Systematic Review and Meta-Analysis. Physical Therapy, 99(10), 1371–1380. https://doi.org/10.1093/ptj/pzz101

2. Samy A, Zaki SS, Metwally AA, Mahmoud DSE, Elzahaby IM, Amin AH, Eissa AI, Abbas AM, Hussein AH, Talaat B, Ali AS. The Effect of Zumba Exercise on Reducing Menstrual Pain in Young Women with Primary Dysmenorrhea: A Randomized Controlled Trial. J Pediatr Adolesc Gynecol. 2019 Oct;32(5):541–545. doi: 10.1016/j.jpag.2019.06.001. Epub 2019 Jun 11. PMID: 31195099.

3. Kannan P, Chapple CM, Miller D, Claydon-Mueller L, Baxter GD. Effectiveness of a treadmill-based aerobic exercise intervention on pain, daily functioning, and quality of life in women with primary dysmenorrhea: A randomized controlled trial. Contemp Clin Trials. 2019 Jun;81:80–86. doi: 10.1016/j.cct.2019.05.004. Epub 2019 May 7. PMID: 31071464.

4.Rakhshaee Z. Effect of three yoga poses (cobra, cat and fish poses) in women with primary dysmenorrhea: a randomized clinical trial. J Pediatr Adolesc Gynecol. 2011 Aug;24(4):192–6. doi: 10.1016/j.jpag.2011.01.059. Epub 2011 Apr 21. PMID: 21514190.

5. Kannan P, Claydon LS, Miller D, Chapple CM. Vigorous exercises in the management of primary dysmenorrhea: a feasibility study. Disabil Rehabil. 2015;37(15):1334–9. doi: 10.3109/09638288.2014.962108. Epub 2014 Sep 22. PMID: 25243766.

6. Yang NY, Kim SD. Effects of a Yoga Program on Menstrual Cramps and Menstrual Distress in Undergraduate Students with Primary Dysmenorrhea: A Single-Blind, Randomized Controlled Trial. J Altern Complement Med. 2016 Sep;22(9):732–8. doi: 10.1089/acm.2016.0058. Epub 2016 Jun 17. PMID: 27315239.

7. Dehnavi ZM, Jafarnejad F, Kamali Z. The Effect of aerobic exercise on primary dysmenorrhea: A clinical trial study. J Educ Health Promot. 2018 Jan 10;7:3. doi: 10.4103/jehp.jehp_79_17. PMID: 29417063; PMCID: PMC5791467.

8. Kirmizigil B, Demiralp C. Effectiveness of functional exercises on pain and sleep quality in patients with primary dysmenorrhea: a randomized clinical trial. Arch Gynecol Obstet. 2020 Jul;302(1):153–163. doi: 10.1007/s00404–020–05579–2. Epub 2020 May 15. PMID: 32415471.

9. Shirvani MA, Motahari-Tabari N, Alipour A. Use of ginger versus stretching exercises for the treatment of primary dysmenorrhea: a randomized controlled trial. J Integr Med. 2017 Jul;15(4):295–301. doi: 10.1016/S2095–4964(17)60348–0. PMID: 28659234.

10. Motahari-Tabari N, Shirvani MA, Alipour A. Comparison of the Effect of Stretching Exercises and Mefenamic Acid on the Reduction of Pain and Menstruation Characteristics in Primary Dysmenorrhea: A Randomized Clinical Trial. Oman Med J. 2017 Jan;32(1):47–53. doi: 10.5001/omj.2017.09. PMID: 28042403; PMCID: PMC5187401.

11. Mohebbi Dehnavi Z, Jafarnejad F, Sadeghi Goghary S. The effect of 8 weeks aerobic exercise on severity of physical symptoms of premenstrual syndrome: a clinical trial study. BMC Womens Health. 2018 May 31;18(1):80. doi: 10.1186/s12905–018–0565–5. PMID: 29855308; PMCID: PMC5984430.

12. Duigan, C. V. (1999). Primary Dysmenorrhea. Australian Journal of Physiotherapy, 12(2), 55–56. https://doi.org/10.1016/S0004-9514(14)60961-2

13. Heidarimoghadam, R., Abdolmaleki, E., Kazemi, F., Zahra Masoumi, S., Khodakarami, B., Mohammadi, Y., & Moghadam, H. R. (2019). JRHS Journal of Research in Health Sciences journal homepage The Effect of Exercise Plan Based on FITT Protocol on Primary Dysmenorrhea in Medical Students: A Clinical Trial Study. J Res Health Sci, 19(3), 456.

14. https://countrymeters.info/en/World