I’m frequently asked by patients—either for themselves or on behalf of family members—about natural treatments for menstrual cramps. Cramping, which is characterized by inflammation, is caused by high levels of certain prostaglandins that trigger uterine contractions. Often high prostaglandin levels are accompanied by estrogen dominance, where estrogen levels are too high relative to progesterone. Using specific nutrients, I am able to balance the ratio between these hormones in patients and greatly relieve cramping.

You can use just one of the remedies below or all of them, depending on what helps you. You need to take most of these remedies all month (as indicated), even though symptoms occur on only a few days, because these remedies don’t just treat symptoms. Instead, they work to enhance the release of progesterone…improve circulation…or relax muscles.

Vitex. This herb (also known as chasteberry) improves the production of progesterone and offsets estrogen dominance. Dose: 160 mg to 240 mg, or 40 drops of tincture daily. Try it for at least three months. If it helps you, you can keep taking it. Don’t use vitex if you are taking birth control pills.

Pycnogenol. This pine bark extract contains potent anti-inflammatories and antioxidants. It boosts production of endothelial nitric oxide, which improves circulation and helps to reduce the pain of cramps. A Japanese study found that pycnogenol significantly decreased the amount of time women had menstrual cramps. Dose: 100 mg to 150 mg daily.

Calcium and magnesium. These minerals reduce premenstrual syndrome symptoms. Magnesium acts as a muscle relaxant, relieving cramps. Dose: A daily calcium supplement of 500 mg to 1,000 mg that contains at least half as much magnesium. It may take one to two menstrual cycles to reduce symptoms.

Natural progesterone. For severe menstrual cramps, I recommend bioidentical progesterone cream to reduce estrogen dominance. A typical dose is 20 mg twice daily starting two weeks before menses. Work with a holistic physician who can monitor your hormone levels while you use it.