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I’ve reported before on another ginger study in menstrual cramps. This current study included 105 Iranian women who were at least 18 years old who had moderate-to-severe primary dysmenorrhea (menstrual cramps without an organic cause). Scoring was rated in a 4 grade system: grade 0 = pain free menses; grade 1 = painful menses but rare use of analgesics and able to maintain normal activity for the most part; grade 2 = moderately painful menses that influenced daily activity and analgesics use was needed; grade 3 = severely painful menses and significantly limited activities and analgesic use did not mitigate the pain and additional other symptoms such as headache, nausea, vomiting or diarrhea were present.

clip_image002Ginger capsules were given in one of two methods: 1) 500 mg ginger capsules or placebo 3x/daily starting 2 days before the beginning of menses and continued through day 3 of menses; 2) 500 mg ginger capsules or placebo 3x/daily on days 1, 2 and 3 of menses. The severity and duration of the pain were assessed on the first 3 days of menses. The severity of pain was significantly reduced in the ginger group compared to the placebo group for both dosing methods with a lower p value (better results) in the first dosing method. It is important to note that these results in both dosing regimens were better than the baseline cramp severity before the study began and again, more meaningful for the first dosing method where the ginger is started 2 days prior to the onset of menses. A 1.4 to 2.0 point reduction in severity was seen with ginger and with the first dosing method ginger significantly reduced the duration of pain compared with placebo. There was a 4.6 ± 10.6 hour decrease in the duration of pain versus a 2.3 ± 18.2 hour increase in duration in the placebo group. The second ginger dosing method was not significant in pain duration between ginger and placebo. Ginger can cause heartburn, and 3% of women in the study experienced this.

Commentary:

The cause of menstrual cramps is thought to be due to an increased production of prostaglandins in the endometrium (lining of the uterus). Menstrual blood of women with primary dysmenorrhea has greater amounts of the prospasmodic and proinflammatory prostaglandins, PGE2 and PGF2 alpha. It is thought that the anti-inflammatory properties of ginger are due to the gingerols, which can lead to a reduction in prostaglandins as well as some inflammatory substances. It would have been preferred if this study utilized a standardized ginger extract with the gingerol and shogaol content analyzed and reported. While it is not always possible to know the precise two days prior to the onset of menses, this technique of starting pain relief treatment with anti-inflammatories, whether herbal or pharmaceutical, a few days prior to the onset of menstrual pain is a very productive strategy that I recommend to my patients. Consider using ginger root either alone, or in combination with other important natural ingredients in the relief of menstrual cramps such as cramp bark, niacin, vitamin B6, valerian, wild yam and more.

Reference

Rahnama P, Montazeri A, Fallah Huseini H, Kianbakht S, Naseri M. Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial. BMC Complement Altern Med. July 10, 2012;12(1):92