EP.250/ REPLAY: What I Do on My Period to Avoid a Pain Flare
Hi, everyone. So this week I've decided to do a replay because I'm still recovering from my broken ribs and lung puncture, and I just still feel like it's going to take a bit too much out of me to record a whole episode. So we're doing a replay today, and this replay is from May 2022.
Today I want to share what I do on my period to avoid a pain flare. Essentially, what I do on my period that allows me to experience either low pain levels or no pain at all, and if for some reason my levels do start to creep up, how I get them back down quickly and prevent them from getting worse.
Go back to last week’s episode if you haven’t listened to it already, but for context, before I started managing my endometriosis, my periods were excruciating. I would take pain killers upon pain killers with little to no relief at all. I couldn’t stand, sleep, walk, eat – pretty much anything.
Over the years, as I’ve come to train and to experiment, I have been able to pull together essentially a toolbox of strategies that I always go to on my period. To be clear, for me, managing endometriosis is something I do all cycle long, because if I don’t, the tools I am going to share today just aren’t as effective and my pain is worse, but a combination of month-long strategies like anti-inflammatory eating and physiotherapy for example, plus these tools on Day 1 of my cycle, really guarantee me the best results.
For years and years, I suffered with period pain that on a pain scale of 1-10, were a 12, now they’re 0-3, and a bad period would be seeing them creep to say a 5, which usually only happens very temporarily and using the strategies listed, my levels return back to normal.
Now, I want to be clear that we’re all different. You may have to play around for a few cycles to work out what you respond to, it may take you a couple of months to lower your inflammation overall, you may need different tools and strategies. So, please don’t give up if you don’t have the relief, you want straight away!
This episode is here to inspire and motivate you, but ultimately, it’s my personal protocol, and you’ll need to work out what yours looks like too.
So, now you have a bit of background and context, let’s get started…
So once I actually see fresh blood (as opposed to spotting or light pink or brown discharge), that’s when I bring in my main go-tos. As you all may know, I usually take a handful of anti-inflammatory supplements each month, and normally I will stagger these throughout the day. When I am due on however, I wait until my period starts, and then take them all at once – at the moment, I’m taking quercetin, glutathione which is a potent antioxidant and omega 3 fish oil. But I vary them up depending on what I need and if I’m on a specific healing protocol for say SIBO and histamine.
Taking them, all together gives me a dose of anti-inflammatory antioxidants that can start lowering any inflammation which comes with menstruation, and in turn, can help lower pain.
Sometimes I don’t take the whole dose in one go but instead split them into two. So, at the moment I take two glutathione a day and two omega 3 caps, and 6 quercetin, and so when I see the blood, I may take half of that, then a few hours later if I feel pain creeping in, I take them again.
The reason why I do this is because I’ve noticed a pattern in my bleeding. If I’m going to get any pain, it’s going to be when I first see fresh red blood, because that’s when the inflammation and inflammatory chemicals are doing their job to cramp the uterus up and shed the uterine lining. Then things calm down and I would say about five hours later, I get another flow of fresh red blood and if I am going to get any pain, that would be when the second wave comes, and so I may save my other dose for then.
The other things I do when I start bleeding is that I immediately put on my BeYou patches, one on the front of my pelvis and one of the back. These release natural essential oils selected for their anti-spasmodic properties, essentially, they reduce cramps. Once that’s in place, I pretty much soak my pelvis and sometimes my lower back if I’m a little achy there, with magnesium spray. Magnesium helps to reduce period pain, but also relaxes muscles and reduces cramping and inhibits the inflammatory chemical prostaglandin E2.
Now, a very quick science lesson, I talk about this in more depth in other podcast episodes and in my courses, etc. but essentially, inflammatory chemicals like histamines and prostaglandin E2 cause the smooth muscle of the uterus to contract, helping to shift the lining. That’s normal. However, when we have too many of these chemicals, it causes too much inflammation and cramping, and therefore pain. Research has found that people with endo have high levels of histamines and high levels of prostaglandin E2 in their pelvic cavity and menstrual blood, research also shows that people with dysmenorrhea or painful periods have high levels of prostaglandin E2 in their menstrual blood as well. So, what I am doing here, is essentially trying to lower the levels of inflammation and cramping.
Now, I do this all month long by adopting an anti-inflammatory diet and lifestyle and by avoiding things that raise prostaglandin E2 levels like refined vegetables oils, processed foods and too much sugar, and adding in practices that lower their levels, like eating a diet rich in antioxidants and omega 3 fats and utilising supplements and tools like magnesium baths.
But back to what I do on my actual period, within minutes of using all of these tools, any cramping I may feel creeping in dissolves or reduces greatly, and if I have none at all, this usually keeps it that way.
Once those bits have been done, I or my boyfriend make a ginger tea. Ginger root powder is naturally anti-inflammatory, is an effective pain reliever and has been shown to alleviate period pain when taken for the first three days of the cycle. The studies range between using 1000mg to 2000mg a day for period pain, and it’s safe to go to 2000mg generally. I divide this dose across several teas if I’m not taking it in supplement form. You shouldn’t take too much ginger in one go, as it can cause diarrhoea, so you’ll find most supplements and studies dose at 250mg to 400 or 500mg at any one time. I tend to go for 250mg of dried ginger root powder per tea. I used to do higher, but it was just too spicy for me! So, I now drink less of it, but drink it more frequently.
If I have them in the house, I will also add turmeric and cinnamon, which both have anti-inflammatory properties, and cinnamon helps to alleviate heavy menstrual bleeding. I have to be a bit cautious with cinnamon because of my histamine intolerance, but I tend to allow it on my period as I’m usually only having it for one day.
I’ll link in the show notes to a latte recipe which includes ginger, turmeric, and cinnamon.
So, I drink that, and at the same time as we’re already boiling the kettle, I may also get a hot water bottle, which I’ll use for about 30 minutes, as any longer can actually worsening cramping because the blood vessels begin to restrict. I don’t love using hot water bottles, so I only really use them if I feel I need the comfort or if I feel like I need an extra tool to keep the cramping from increasing.
As I mentioned earlier, usually I am pain free or very low pain, and there are numerous factors that allow me to live with endo in this way, and I know from experience, that if I didn’t use these strategies, my pain would usually increase or will last longer.
Next up is movement and posture. I have noticed that if I am in that point where I’m bleeding freely, that point I mentioned earlier when if I’m going to be pain, it’ll be then, if I’m lying down, then the cramps can sometimes worsen. I think this is very likely my body realising it has to work harder to move the blood out, and I start to cramp more. It could also be that by lying down, I don’t have much else to focus on except for the sensation, and so I pay more attention to it, I get scared that it might get worse, my brain feels unsafe and sends danger signals, and then of course, the brain responds by increasing pain. If you want to learn more about how pain signals work, I’ve linked to an episode in the show notes.
So, it could be either of those or both. Either way, I find if I want to relax in bed, that sitting up or at least propped up, helps to reduce the chances of this happening and if it has already happened, it tends to reduce those cramps down again fairly quickly, which is why I think it’s more to do with the body having to work harder to shift the blood out because lying down has slowed the flow.
If I still don’t feel very comfortable sitting up, say the cramping has continued, then I’ll move around. I find that when I’m moving out of choice, rather than force, so I have chosen to get out of bed and move around vs. I have to get up and catch a train to a meeting, then the movement is very helpful and tends to support my menstrual flow and eases the cramping. A walk around the house, yoga for endometriosis and period pain or a walk outside if I’m up to it, tend to ease the cramps. The exception being is if I’m stuck out for some reason, I’m tired and I don’t have any of my tools with me – that kind of scenario would increase my pain.
This leads me onto my next strategy. As much as I can, I love to rest on the first day of my period. If I can fit it into my schedule, Day 1 of my period will be the one day of the month that I allow myself to sit in bed all day and just watch romcoms and chick flicks. And I’m going to say something that might sound strange to you, and I hope it doesn’t anger or upset you because please remember, I once suffered with horrific pain too – but I actually look forward to my period now. I know my period will (hopefully) involve a bath and a day in bed watching light-hearted films and series, all guilt free. I usually watch some of my favourites like period dramas, or a classic romcom like Notting Hill. In short, it’s a very stereotypical ‘girly’ day – and I love it. I don’t often do these things, and it just feels very indulgent, comforting and like a returning to myself because I get to pause.
I have found that if I don’t do this, I end up dragging myself through my period and coming out the other end of it exhausted. Your period is when your hormones are at their lowest. Your hormones help with energy, neurotransmitter production and a heap of other functions in your body. You quite literally have less energy, less happy hormones and less of a drive to socialise on your period as a result. Not to mention, you’re using up energy and nutrients in the process of bleeding, including losing iron and magnesium, two essential nutrients for energy production, so you’re more likely to be tired.
When we push through the lowest hormone days, 1 to three being the lowest, we are stressing are body and forcing it to function off cortisol and adrenaline to get us through, because it knows it needs to meet demands it doesn’t have the physical resources to meet. It’s no wonder then, that if I don’t allow even a little bit of rest, that I feel burnt out that month, which is the inevitable result of getting by on cortisol and adrenaline.
Now, clearly, I have the privilege of working for myself and I also don’t have children to look after. So, I appreciate that most of you have to go to work and some of you have people depending on you. And I get that, for many years I was an employee working with vulnerable homeless young people, who I couldn’t let down. I would drag myself to work in whatever state I was in. These days, it’s a bit different, but I still have commitments. I see clients every week, so if my period falls on a day when I have one or two clients, I will see them and rest afterwards or beforehand, and I’ll push everything else to the next day. If I know ahead that I have a really busy day of clients, I will move some around in advance – it’s worth stating here that the only way I am able to do this is by tracking my period and ensuring I know which day I’m due on, or as close to. Back when I wasn’t tracking my period, I’d be taken by surprise every single time. Anyway – back to the point, strangely, I don’t have to do rearrange my days too often as the universe seems to organise it that my clients ask to swap a day, or my period falls on an admin day or a day when I don’t have too many sessions.
Like I said, if I do have a day with a few clients and I haven’t moved them, I’ll rest up as much as possible between calls or afterwards, and I’ll also try to take some time out the next day, so I can squeeze in a full day’s rest. If that fails and for some reason, I’m unable to take any time out, say when I’m in a course launch, then I’ll take a weekend day out to rest.
For those of you who work for a company, perhaps you can talk to your managers about arranging it so you can work from home on Day 1 of your cycle, having endometriosis means you’re legally entitled to reasonable adjustments at work, even though it’s not classified as a disability. So, for example, when I worked at Centrepoint, I could work from home on Day 1 of my cycle and the other days of my period I could come in later and leave earlier, and I would make up the time at other points in my cycle – though honestly, they didn’t even expect me to do that. If you’re not sure what you’re legally entitled to, have a listen to my episode with Clare from See Her Thrive, which is all about this topic. It’s episode number xxx.
Now of course, if you have children, I understand this may be totally unrealistic and I’m not sharing this info about what I do for you guys to replicate it all. Instead, I hope it inspires you to carve out some kind of rest or time out that works for you and your lifestyle on Day 1. It could be having five minutes to yourself before the children wake up, or it could be that your partner takes the baby for half an hour whilst you lie down, or if you’re a single parent, maybe this is a day when your friend or your own parent might be able to give you a helping hand, so you don’t have to juggle everything alone.
I don’t know what will work for you, but I’m sharing what works for me, and I hope that perhaps it’ll help you discover what works for you!
So, my next strategy is an Epsom salt bath! Yes, I rave about these and with good reason. Research shows that having a bath two to three times a week with 500 g to 600 g of Epsom salts, for 10 to 30 minutes, reverses magnesium deficiency. Now here’s the thing, most of us are deficient in magnesium, especially people who menstruate or who experience frequent stress (which let’s be honest, living with chronic illness can be stressful) as these both deplete magnesium. And as I mentioned earlier, Magnesium is not only anti-inflammatory, but reduces muscle cramping, has been shown to reduce period pain and PMS, is essential for healthy hormone balance, energy production and helps to stabilise blood sugar. All important for managing endo and for aiding in energy and pain relief on our period.
So, on my period, I try my best to make time for a bath, even if it’s just 10 minutes, to soak up that magnesium, and help to relieve the tension from my muscles and uterus and restore my energy levels.
I also always have a couple of baths in the lead up to my period to help prevent my cramps being bad on my actual period.
If you don’t have a bath, you can do this with a foot soak or you can actually get inflatable baths, fold out baths and plastic bathtubs online, that you can just store away! So, you could always try that. The benefit of soaking in bath on your period as well, is that the heat actually works as a pain therapy too.
Next is how I eat on my period. As you learned last week, once upon a time I used to fast on Day 1 of my period. I would now never do that, given how much energy we need for Day 1 of our cycle! Then when I started being able to eat on my period, I moved to more keto based meals on Day 1, to avoid a blood sugar spike, which would lead to a pain flare on my period. Now I seem to have better stability with my blood sugar, I can eat meals with a normal amount of carbs, but I ensure that meal is blood sugar balancing as much as possible – so fat, fibre, protein, and complex carbs. I do actually still ease up a bit of the fibre, so I tend to have more low FODMAP veggies on day 1, just because we are already prone to having loose stools or diarrhoea on our periods because the prostaglandins also cause the colon to cramp and contract, and as I have SIBO, if I also aggravate that, the situation just gets worse and I can get intestinal inflammation and further cramping, causing me more pain and more IBS trouble.
I also add in a few extra blood sugar hacks now that I’m eating more carbs on my period, just to avoid any spikes. I have a tablespoon of vinegar in water before I eat, which has been shown to reduce blood sugar spikes and I eat my veggies first or try to have a side salad first, and eat my starches last in a meal, which again, has been shown to reduce blood sugar spikes because the fibre from the veggies delays the glucose release. And just to credit her, this info is from the incredible biochemist Glucose Goddess. I also walk around the house for 10 minutes after a meal, or just move gently on the spot, which helps to use up any excess glucose, preventing a spike. I have found that using these hacks on Day 1 of my period, really allow me to eat more comfort food like a pasta or something carby, without having a pain flare.
If you want to understand this process in more detail, have a listen to last week’s episode and episode xx, and it’s definitely worth checking out the Glucose Goddess!
So that’s it! That’s everything I do on my period to prevent a pain flare or to reduce pain if I have any.
Usually, these practices keep me pain free or at a low level of pain, but if for some reason it creeps up, I double down on these and repeat some of the processes, like spraying magnesium, drinking tea, applying a new patch, or taking some more supplements, and if I really need to, I take a paracetamol. Usually, I just need one and that’s enough to nip it in the bud.
Now of course, what works for me may not work for you because we’re all different. This period protocol has been created after years of experimenting and training as an endo health coach, and I’ve adapted it over the years as my endo has changed. If you’d like to create your own protocol, I really recommend going over some previous podcasts and articles for further research and information, and of course, I have the masterclasses and my course Live and Thrive with Endo.
Please do consult your doctor before taking any supplements or making any dietary changes!
Show Notes
Anti-inflammatory Living for Endometriosis (pain signals)
Christie Uipi episode (pain signals)
Curcumin
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533742/
https://www.karger.com/Article/FullText/491886
https://www.sciencedirect.com/science/article/abs/pii/S0753332217346838?via%3Dihub
https://www.sciencedirect.com/science/article/pii/S1756464615000092
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407015/
https://pubmed.ncbi.nlm.nih.gov/24672232/
https://pubmed.ncbi.nlm.nih.gov/25277322/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476912/
Quercetin
https://pubmed.ncbi.nlm.nih.gov/19462895/
https://www.hindawi.com/journals/ecam/2014/781684/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808895/
https://pubmed.ncbi.nlm.nih.gov/19297429/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6273625/
https://avivaromm.com/remedies-seasonal-allergies/
Omega 3 Fatty Acids
https://pubmed.ncbi.nlm.nih.gov/16531187/
https://pubmed.ncbi.nlm.nih.gov/2832216/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3614254/
https://pubmed.ncbi.nlm.nih.gov/11687013/
https://pubmed.ncbi.nlm.nih.gov/17434511/
https://pubmed.ncbi.nlm.nih.gov/22261128/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257651/
Magnesium
https://www.mdpi.com/2072-6643/5/10/3910
https://onlinelibrary.wiley.com/doi/full/10.1111/dme.12250
https://drbrighten.com/boost-low-progesterone/
https://www.composednutrition.com/blog/increase-progesterone-naturally
https://pubmed.ncbi.nlm.nih.gov/2675496/
https://pubmed.ncbi.nlm.nih.gov/25023192/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5112180/
https://pubmed.ncbi.nlm.nih.gov/30880352/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847116/
https://pubmed.ncbi.nlm.nih.gov/17229895/
Ginger
https://pubmed.ncbi.nlm.nih.gov/23865123/
https://pubmed.ncbi.nlm.nih.gov/26177393/
https://pubmed.ncbi.nlm.nih.gov/25912592/
https://onlinelibrary.wiley.com/doi/10.1002/ptr.6730
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171779/
https://pubmed.ncbi.nlm.nih.gov/23657930/
Cinnamon
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443385/
https://pubmed.ncbi.nlm.nih.gov/30396627/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5220230/
https://academic.oup.com/ajcn/article/89/3/815/4596714
https://pubmed.ncbi.nlm.nih.gov/30396627/
https://examine.com/supplements/cinnamon/
https://jandonline.org/article/S2212-2672(16)30899-1/fulltext
Essential oils
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4979258/
https://www.hindawi.com/journals/prt/2016/8158693/
https://www.sciencedirect.com/science/article/pii/S2221169115001033?via%3Dihub
Need more help?
Free resources:
This podcast!
Ways to work with me:
This EndoLife, It Starts with Breakfast digital cookbook
Masterclasses in endo nutrition, surgery prep and recovery and pain relief
Live and Thrive with Endo: The Foundations DIY course
One to one coaching info and application
This episode is sponsored by Semaine. Semaine is a plant-based supplement for reducing period pain and inflammation, that you take for 7 days of your cycle, during your period. Semaine is made up of 9 super-powered plant extracts and minerals that are all vegan and sourced for maximum quality and bioavailability and selected based on the latest clinical research. If you want to try Semaine, they are currently offering 15% off your first order and they deliver worldwide! Head to: www.semainehealth.com
This episode is sponsored by BeYou Cramp Relief Patches. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches. Click here to find out more and to shop: https://beyouonline.co.uk/pages/how-it-works
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