NATURALLY PAINKILLER FREE
Emma H. 25/06/2016
An experiment I've tried out for you
I’ve always had painful periods. I mean, pass-out level of intensity. But I’ve found out that the pain is possible to manage naturally, without painkillers. Even if you’ve been hit with a debilitating condition, like hormonal imbalance or endometriosis. Let me lead you through my little experiment and share some tips.
Endometriosis is a very painful condition which affects about 1 in 10 women. It is a systemic, inflammatory disease (possibly of an autoimmune nature) where the lining of the uterus (endometrium) appears elsewhere in the abdominal cavity, causing internal bleeding and inflammation. And A LOT of pain. Find more information on the disease through the first documentary on endo, or read more about my journey in my Endo post or my Spoon Theory post.
Bold experiment
Recently, I’ve come across many articles and books pointing out that drug side effects may actually cause more harm than good. This convinced me to pluck up the courage and go for this bold experiment: try and manage one period with no painkillers whatsoever. I’ll tell you all about it; but first, let me expand on how harmful painkillers, like NSAIDs, can be.
I’ve read a wonderful book by Kelly Brogan MD called A Mind of Your Own [1], in which the author talks about natural treatment of depression. Among other interesting information, she mentions the following categories of drugs: antidepressants, hormonal contraceptives, statins (drugs used to decrease blood cholesterol), NSAIDs (painkillers that aim to reduce inflammation), and antacids (proton pump inhibitors). She speaks about how practice shows that, more often than not, these drugs have so many negative effects that patients do better without them (if they follow certain healthy lifestyle principles).
Ibuprofen is an NSAID
Ibuprofen has always been a life-saver during my period. (Advil would be Ibuprofen’s counterpart in North America.) Without my painkiller I would literally barely survive those painful days. But it’s been over a year since I’ve started looking for a more natural approach to my health and body, and I’ve paid much more attention to information on non-steroidal anti-inflammatory drugs (NSAIDs).
NSAIDs are available without prescription and are used worldwide every day by up to 30 million people. [2]
They lower the amount of prostaglandins in the body. Prostaglandins are substances that trigger inflammation (with the aim of healing the affected tissue), as well as support blood clotting and protect the stomach lining from being damaged by its acids. Because we lower the amount of prostaglandins in the body, the stomach environment gets out of balance and, no surprise, their main side effect is stomach ulcers or bleeding. (No surprise either that I used to have huge troubles with stomach pains, and even these days I get terrible cramps once I take more than one ibuprofen a day.)
One study [3] has shown that the small intestine was damaged in 71% of NSAID users (compared to mere 10% of people who didn’t take these drugs). Good gut health is vital for good functioning of our immune system. There has been proof [4] that negative changes in the gut microflora appear within three to six months of NSAID use.
Moreover, if women of reproductive age take NSAIDs for ten days in a row, these drugs can prevent ovulation even after such a short period of time [5]. Still wondering why all the effort to find natural remedies?
Some women experience painless periods, some women have pain on the first or the second day. The pain is triggered by the fact that the uterus lining (endometrium) starts to disintegrate and is shed if no fertilized egg has implanted in it. Cramping helps the lining to break up and be flushed out of the body.
However, if you struggle with estrogen dominance or endometriosis, you are very likely to suffer much more pain (way more). The pain is also likely to last longer than mere two days. Now, if there is a strategy that helps naturally manage these levels of pain without painkillers, there’s a very good chance it will work for you, too! Let’s have a look at individual steps that led to my success (though I must tell you upfront, even though my pain level has been dramatically reduced, I have never been able to make the pain go away altogether).
ONE MONTH AHEAD
Strictly follow the AIP
The Autoimmune Paleo Protocol (AIP) is a special diet (and lifestyle) designed specifically to combat autoimmune diseases (and the underlying leaky gut and inflammation). It omits pro-inflammatory foods (e.g. gluten or dairy), highly industrially processed plant oils (like rapeseed, sunflower, or soy, which are very reactive and lead to high oxidative stress and inflammation), nuts and seeds (because of phytic acid which is an anti-nutrient that prevents nutrients from being absorbed), and common allergens which overburden the immune system (e.g. eggs, nightshades, or chocolate). I also need to stress that it is designed to be followed short term, with a rigorous process of food reintroduction in the end, to help you figure out what foods make you thrive and what undermines your optimal health.
It sounds pretty restrictive, doesn’t it? Well, it is. It’s not a protocol easy to follow. But trust me, it’s way easier than having to put up with pain whose intensity has been recently compared to that of a heart attack. [6] And as a short-term (though strict) intervention, it will help jumpstart your healing.
What CAN we eat? Tons of fresh and nutritious foods – quality meats, fish and seafood, healthy oils that are not processed using high temperatures (olive, coconut, avocado), a myriad of fruits and vegetables. (Did you know that vegetables contain at least as much, but often up to ten times more, vitamins and minerals as cereals? [7]). The AIP also puts emphasis on using unprocessed fresh food, so we automatically avoid eating pro-inflammatory addictive sugar. (Contrary to common belief, it is not fat but sugar that leads to a higher risk of cardiovascular disease. [8])
This strict diet ensures a stress and hunger-free monthly detox, so when it’s time for my period, my body doesn’t have to struggle with any other issues and can focus solely on combating the related inflammation.
Dietary supplements
If you’re a fan of dietary supplements, they fall within this category. When you follow the Paleo diet, few supplements are needed because the body gets enough nutrients from the diet (together with quality sleep, exercise and minimum stress). However, if you have an autoimmune condition, your body struggles with impaired immunity and poor digestion. The gut lining is damaged and doesn’t manage to absorb all the nutrients coming from food, and to send them via the blood stream towards the organs. Therefore, people need to resort to dietary supplements more often. There is a lot of information on endometriosis-friendly supplements, so I will only mention probiotics (to help restore healthy gut flora), chelated magnesium (to prevent cramping), or fermented cod liver oil (a natural source of omega-3 and vitamin D). If you're suffering from endometriosis, you can also consider the supplements mentioned below.
Serrapeptase
Serrapeptase is a natural enzyme that breaks down blood clots (and other dead tissue), which helps immensely during endometriosis and the internal bleeding the disease causes. Melissa M. Turner wrote an article on her EndoEmpowered blog recommending serrapeptase use but cautioning about the dosage – start slowly at first (with half the recommended dose) as your body may have trouble dealing with the enzyme and express flu-like symptoms. [9]
ONE WEEK AHEAD
One week before my period I made sure my body got all the nutrients it needed to get ready for (and better handle) all the inflammation that occurs during women’s period (especially if they have medical conditions).
Omega-3
Consider increasing your omega-3 intake two or threefold. Omega-3 is an anti-inflammatory substance. You can find it in wild salmon, sardines, albacore tuna, trout, or mackerel. If you prefer taking a supplement, make sure it is one that uses DHA and EPA (omega-3 coming from fish) rather than ALA (omega-3 coming from plant sources like flax, chia or walnuts). The first two types are much more easily absorbed by the body and, therefore, have much better effect.
Turmeric
Source: Health Aid
Curcumin
Curcumin is the active substance of turmeric, a spice made from the pod of a plant from the ginger family, which is the main ingredient in curry. Curcumin is strongly anti-inflammatory [10] and reduces oxidative stress in the body [11]. It is especially beneficial for women with endometriosis because it reduces estrogen (more precisely estradiol) [12] levels in the body and inhibits the activity of metalloproteinase (MMP) [13], an enzyme which is over-active with endometriosis.
TWO DAYS AHEAD
My health issues have taught me to make use of those moments when I feel well and am full of energy. I usually prepare for when I’ll have trouble to function normally. It’s the best strategy ever.
Never underestimate good preparation
Two (or so) days before your period it helps to make things ready for when you’re too tired to run around doing household chores. It makes life much easier to go do your grocery shopping, batch-cook a few meals and freeze them (and make some healthy muffins while you’re at it), do your laundry, or anything else that comes to mind. Trust me on this one, even if you don’t really feel like doing extra work, you’ll be grateful you did it!
PERIOD TIME
Periods are different for every woman. However, a healthy period should take three to five days, the bleeding should be moderate, and it should NOT be accompanied by pain or mood swings. If this is the case, it means that your body is healthy. If not, there are issues to be dealt with. (Lara Briden's Period Repair Manual contains a lot of useful information on what periods should be like, and what to do if they're not.)
Ever since I started having my period, everyone kept telling me that pain during period is normal. Now I know that not only the excruciating mind-blowing pain related to endometriosis is not normal but you should hardly be experiencing any pain at all (if your body is in good health). Both Traditional Chinese Medicine and Ayurveda consider painful periods as a sign of an imbalance in the body (excess or deficiency). I personally believe that if we search for balance, our body will reward us.
Become your Priority no. 1
The longer I have had to deal with health issues, the more I’ve begun to take care of myself. I put myself first. (I believe that having children is the only reason to make an exception from this rule.) We usually tend to put others first, or to think that “this can’t wait” or “that is too important to be left aside”. Unfortunately, this approach may slap us back in the face.
If it is usually you who does the cooking (or laundry, or cleaning, or taking kids to school), delegate these tasks to your (understanding and helpful) partner. If he’s too busy to deal with these tasks, too, just agree on letting them be for a week. The laundry and the vacuuming will have to wait.
If there are no kids in the house, just skip all your (non-vital and non-job-related) tasks this week. Just make sure you give yourself enough time and space to rest and to regenerate. Your body is fighting a pretty demanding internal battle and there’s no reason for you to make it harder for it.
And let me add one more advice: Lower the bar and do not reproach yourself for that!
Sleep
My experience shows that I get much better when I allow myself to go take a nap whenever I need during my period week.
Are you tired after lunch and it happens to be the weekend? Snuggle in bed, draw the curtains and get the much needed sleep. Do you feel sleepy at 8 p.m.? Even though you never do it, now is the time to forget your chores and go have a good night’s sleep. There is little chance that you would wake up five hours later fresh as a daisy this week.
It is during sleep when your body regenerates most. Even though you usually skip this luxury (you shouldn’t!), do yourself a favour and take more rest at least during the time when there is a real chance the pain will make you want to pass out when queuing for eggs in the supermarket. (Well, there isn’t, really, because a) you’ve already done all your shopping beforehand, and b) we don’t eat eggs on AIP, anyway.)
Use organic, non-bleached feminine hygiene products
This has been a real eye-opener for me, once I changed my pads and tampons for organic ones, the pain intensity immediately went down (and my period headaches got less intense). Tampons can cause really big problems – and I’m not speaking about the toxic shock syndrome (which is related to the decomposition of the blood in the tampon and can be deadly). I am talking about toxic dioxins, chemicals which stay in the tampons after they have been chlorine-bleached. The vaginal walls are extremely absorbent and these toxins are quickly taken up by the bloodstream. Another issue is caused by the fact that tampons are mostly made of rayon (viscose) that continuously loses microfibers when in a moist environment. That means that even after taking your tampon out, it will have left behind tiny fibres (full of toxic chemicals) that stay in your body and wreak havoc. Not only does the body absorb more toxins for a longer period of time, but the blood that is still in these fibres is the ideal breeding ground for bacteria, and can lead to infections.
You can switch to 100% cotton organic products. These use gentler bleaching methods and do not lose any fibres at all. (The toxic shock syndrome, however, still can occur.) Or try using a menstrual cup! The majority of brands are made of medical grade silicone, plus it’s cheaper and more environmentally friendly! There have been speculations about the menstrual cup and the toxic shock syndrome saying that the probability is almost zero because the air doesn’t get to the blood stored in the cup when still inside your body and, therefore, the blood does not oxidize. However, there’s also been the first case study disproving this theory. [14] (A note on cups: For some endometriosis sufferers, menstrual cups can feel quite uncomfortable, as they may put pressure on your endometriosis lesions or scar tissue. You can try cups of different shapes and sizes, or simply stick to other non-toxic menstrual products, including natural menstrual sponges.)
Source: Diva Cup
Walking
For me personally, walking during my period is probably the second best activity (after lying in bed with hot water bottle pressed against my stomach). I’m fortunate to be able to walk some 20 minutes to get to work, and countless times it has proved a life saver (even when I used to take painkillers – let’s face it, they don’t always provide relief anyway). A brisk walk always turns down the pain.
Brisk movement promotes blood circulation, which in turn relieves cramps. Set your pace so that you find it pleasant and unexhausting but, at the same time, you have to breathe in and out deeply and regularly. When we experience pain our breath usually gets shorter and quicker. Slower deep breathing brings more oxygen to the lungs and blood vessels and makes muscles relax.
Yoga / Other gentle movement
Let’s admit it: Many times when facing period pain (especially if we deal with endometriosis) the only thing we want to do is curl up in a ball and pass out. It is very difficult to make ourselves pursue any kind of physical activity. But it is well-documented that gentle exercise is very effective in relieving pain. It triggers the same mechanisms I’ve described above. Why don’t you try cycling, swimming or dancing (or any other activity you enjoy). Not only will it loosen up your muscles, it will also help redirect your attention away from the pain. Plus as a bonus, such movement also helps gently reposition your endometrium lesions and adhesions and prevent their further development.
If there’s no chance you could manage any kind of exercise, don’t worry. Try a technique a colleague of mine has successfully been implementing for years. A modification of the Reclining Hero pose (Supta Virasana). As you can see in the picture below, it beautifully stretches your lower belly (which relieves cramps again!). You can modify this pose in any way that keeps your lower belly stretched. You don’t need to lie on your heels, just use a support for your back, let your butt drop down and feel free to stretch your legs, or keep your feet together and knees apart. Whatever works and is comfortable! Cover yourself with a blanked and don’t forget to breathe deeply.
Source: Yoga Journal
Maya massage
The Arvigo Maya Abdominal Therapy was devised by Dr. Rosita Arvigo who perfected this technique after she spent some time with a famous shaman in Belize. This technique can help with many ailments, apart from period pain it can be beneficial in the case of tilted uterus (tilted back instead of forward), painful ovulation or bladder issues.
You can perform the massage yourself, ideally three to four times a day (it is very simple and you can basically do it whenever you feel like it). Watch this video by Melissa M. Turner to learn the technique.
Tune in to your body’s needs
Sounds like a cliché, right? Well, it works. Are you so sick that you couldn’t eat a bite? Don’t force yourself to eat. It’s been shown that stress and any other burden hinder good digestion. (The body gets ready to flee or fight, or simply deals with more important issues, and digestion loses priority.) Do you feel uncomfortable wearing certain types of clothes? No one will even notice if you don’t put on your favourite tight jeans for a week. There’s no point causing even more pain to your already super sensitive belly.
A word on herbs
When natural treatment (of anything) is mentioned, herbs usually come along with it (think teas or tinctures). I, also, have tried various herbs but apart from the above mentioned curcumin I have not yet made a definitive opinion on what to go for and what to avoid.
Especially when endometriosis is concerned there may be a glitch: herbs that are usually recommended for balancing female hormones can work well with healthy women, but can worsen the symptoms in women with estrogen dominance or endometriosis. Dong Quai (Angelica sinensis) is one such example. It increases estrogen levels and I personally have negative experience with it. Another herb to be warry of is St. John’s wort (Hypericum perforatum). Even though it promotes relaxation and good sleep, it can also help intensify menstrual bleeding. As far as this herbal tea is concerned, for me it was a guarantee of a sure knock-out effect (i.e. deep sleep) when taken together with Ibuprofen. So if you decide to try it, make sure you don’t need to get up in the morning and go to work (or drive!). Though drinking two St. John’s wort teas WITHOUT the Ibuprofen never gave me any issues.
Therefore, it is hard for me to say what herbs are recommended and safe for endometriosis. You can try yarrow tea (Achillea millefolium L.) to tone down heavy bleeding, or milk thistle (Silybum marianum) supplements to support liver function (which is important for detox) and to lower prostaglandin levels. A word of warning though: Make sure that you only use seed-based supplements, not other parts of the plant. Let me also add that I have no personal experience with these two herbs.
There's more on herbs and endo in Melissa Turner's post.
Experiment
Find your own path. I have read tons of books and articles and, therefore, I know that certain types of health issues can be alleviated by similar approaches. For example, there are several different diets recommended for endometriosis, or interstitial cystitis (bladder issues), or autoimmune diseases, or psychological disorders and depression. These diets have a lot in common (e.g. avoiding processed foods, emphasis on fresh produce with high amounts of fruit and vegetables, or avoiding sugar, gluten and dairy).
But our bodies are unique and what works for one individual may not necessarily work for another. The above mentioned recommendations are guidelines – a starting point for your own exploratory journey. They provide you with basic information that will lead you on during your own research. Each of us is responsible for our own health!
That’s why I’ve decided to take on the responsibility and look for answers myself. As you see, there are many things you can change yourself. It is very empowering. You can do it - create your own fate. Face your fears and start shaping your future by making everyday changes. Trust me, your body will reward you for it.
Was it all worth it?
Frankly, have no definitive answer for this question. Dealing with intense (and chronic!) pain is a hard nut to crack. Chronic pain can lead to changes in your brain (though they can be reversed, too [15]) and it is hard to tackle.
One thing is clear, though. I DO NOT regret conducting this experiment. It helped me learn a big deal about how my body works. I know exactly what type of pain to expect and when. I’ve also made several important discoveries. For example, I get the worst pain when I sit at a desk at work. I don’t get enough movement and my sensitive stomach is pressed and cramped all day. But I’ve also learned that I can make it better by taking short walks, applying the Maya massage and modifying the Reclining Hero Pose by lying on a table with feet on a chair (ideally in an empty room).
The most important revelation, however, was that when I felt I couldn’t take the pain any longer (in my case it’s nausea, blurred vision, and Ibuprofen ready in my hand) and I somehow made myself take it a few moments longer (by sheer will), it always took some five minutes more and then I started feeling better. Always!
So when I consider the above mentioned negative impact of painkillers, I guess I’ll give it another try next time.
[1] Brogan, Kelly. Loberg, Kristin. A Mind of Your Own. Harper Wave, 2016
[2] European League Agains Rheumatism. “Non-steroidal anti-inflammatory drugs inhibit ovulation after just 10 days.” ScienceDaily, June 11, 2015
[3] D. Y. Graham et al., “Visibal Small-Intestinal Mucosal Injury in Chronic NSAID Users”, Clin Gastroenterol Hepatol 3, no. 1 (January 2005): 55 - 59
[5] European League Agains Rheumatism. “Non-steroidal anti-inflammatory drugs inhibit ovulation after just 10 days.” ScienceDaily, June 11, 2015
[6]http://autoimmune-paleo.com/endometriosis-social-justice
[7] Sarah Ballantyne, The Paleo Approach, Victory Belt Publishing Inc., 2013
[8]https://www.framinghamheartstudy.org/about-fhs/index.php
[9]http://www.endoempowered.com/full-review-of-serrapeptase-including-dosage-recommendations/
[10]http://www.turmericforhealth.com/turmeric-cures/turmeric-for-inflammation-a-powerful-natural-remedy
[11]http://www.turmericforhealth.com/turmeric-benefits/why-is-turmeric-a-great-antioxidant
[12]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941414/
[13]http://www.ncbi.nlm.nih.gov/pubmed/19374255
[14]https://drjengunter.wordpress.com/2015/10/28/toxic-shock-syndrome-is-also-related-to-menstrual-cups/
[15]http://www.drjoetatta.com/how-chronic-pain-rewires-the-brain/
