Often when pain occurs during menstruation, the last thing we think of is inflammation; however, inflammation plays a stronger role in menstrual pain than you may think. In this week’s article Dr. Bristow explains what happens to the levels of CRP, a marker of inflammation, during menstruation, and how this marker can contribute to pain. Discomfort is often just bad news, but one of the benefits of inflammation is that it can often be eased with dietary changes. Find more about the Mediterranean diet (an approach to food that has been shown to decrease inflammation) below!
Where there is physical pain, there is inflammation: these two things go hand in hand. Menstruation is no different: when there is pain with menses, there is inflammation. But inflammation isn’t just located where you experience pain; there is actually an effect all throughout the body. It is important to start thinking of inflammation as systemic rather than isolated to one part. Our bodies are not separated in segments, all of the parts work and flow together as a whole. In order for immune messages to be delivered and resources to be allocated the whole body is impacted by the inflammatory response.
During menstruation, researchers have found that C-reactive protein (CRP) levels, measured in blood plasma, can increase by up to 50% compared with other phases of the menstrual cycle. CRP is one of the most commonly used markers of inflammation, created and released by your liver when your immune system signals that there is something wrong. It is a very general marker and can be increased through a number of mechanisms such as: infection, injuries, cancer, heart disease, menstruation etc. One of the really neat details about inflammation is that we have the ability to 
decrease it with our diet, physical activity and mood. Studies show that our CRP levels are impacted by our lifestyle, this is good news!
If you want to keep inflammation low and improve your monthly flow, a healthy diet is the way to go!
Mediterranean diets have shown to significantly reduce CRP (inflammation), immune and cardiovascular markers.
The basics of a Mediterranean diet:
- Low in saturated fat but high in monounsaturated fat (mainly from olive oil)
- High in complex carbohydrates from legumes; and high in fiber – mostly from vegetables and fruits.
- The total fat content is high (more than 40% of calories) but favoured by monounsaturated fats (ex: olives, extra virgin olive oil, avocados, almonds, cashews, eggs).
- Intake of milk is low, but consumption of low-fat feta cheese and yogurt is high.
- People prefer to consume fish instead of meat.
- The high content of vegetables, fresh fruits and olive oil guarantees a high intake of beta-carotene, vitamins B6, B12, C, and vitamin E, polyphenols, and various minerals.
- Finally, wine is consumed in moderation.
While the data looks pretty good for the Mediterranean diet, often these studies are done in countries where this is their primary diet – so of course food quality is a big factor here. It is important to remember that food quality differs in various continents and we cannot simply translate healthy foods in Europe and expect the same results from those versions of foods in Canada (I am speaking mostly about bread and cheese!). There is no one right way to eat for all of us, but there is certainly a valuable take away from the principles of a Mediterranean diet to reduce your overall inflammation. A food sensitivity test or an elimination diet can give you some clarity and direction when it comes to identifying which foods cause an inflammatory reaction in your body.
You will also notice the Mediterranean diet does not include processed foods and refined sugar. In fact, the greater your sugar intake the higher your CRP level can go. A high intake of rapidly digested carbohydrates and refined sugar strongly impacts the inflammatory process.
Not surprisingly, it also leads to weight gain. Excess body fat has a strong association with low grade systemic inflammation, and this effect is particularly strong in women. Achieving and maintaining a healthy body weight is a great way to approach reducing your inflammation and working towards a smoother cycle.
Physical inactivity and psychological stress also lead to higher inflammation levels, emphasizing what we already know but sometimes dismiss: the importance of staying physically active and addressing our stressors.
If you are experiencing menstrual pain, know that you don’t necessarily need to! You can actually have a pain free period and zero PMS. It’s not only possible, it is very achievable. The first step is to be properly assessed for hormonal dysregulation and rule out more serious conditions like endometriosis, adenomyosis, fibroids, and cysts. These conditions also benefit from lower inflammation, but do require additional hormonal regulation.
Naturopathic medicine has an abundance of tools to help you have an easy cycle, and you can book an appointment with me here. But, remember that working on the basics of diet, exercise, and stress management is a powerful place to start.