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Dysmenorrhea: Nutritional Considerations

Diet therapies have not been extensively studied. However, evidence supports a role for diet changes that alter estrogen concentrations or estrogen activity. These interventions may also involve the inhibition of prostaglandins (eg, PGE2) that cause the uterine muscle contraction and ischemia.8

A low–fat, vegetarian diet may reduce dysmenorrhea symptoms. High–fiber, plant–based diets are associated with reduced blood estrogen concentrations. In a placebo–controlled, crossover trial, a low–fat, vegan diet was shown to increase serum concentrations of sex–hormone binding globulin and reduce duration and severity of menstrual pain.9 Another hypothesized protective aspect of these diets is their content of phytoestrogens, which compete with other estrogens for receptor binding. Vegetarian diets also have a higher ratio of omega–3 to omega–6 fatty acids, which may decrease pro–inflammatory prostaglandin formation.10–12 Omega–6 fatty acids (eg, animal products and vegetable oils) are precursors of proinflammatory eicosanoids.

Certain dietary supplements may be helpful for dysmenorrhea. A Cochrane library review determined that some evidence supports the use of thiamine, magnesium, and vitamin E in treatment of dysmenorrhea.13 A recent controlled trial of vitamin E came to similar conclusions.14

Orders

Vegetarian diet, low–fat, nondairy. See Basic Diet Orders.

Exercise prescription.

Smoking Cessation.

What to Tell the Family

A patient making diet changes to improve symptoms of dysmenorrhea will benefit from the support of family members, who are likely to find that the same diet changes help them with weight control and other health issues.

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