Up to 90% of reproductive women around the world describe experiencing painful menstrual periods (dysmenorrhea) at some point. Younger women struggle more than older women. Dysmenorrhea can lead to absenteeism and presenteeism to the tune of about $2 billion annually.
Dysmenorrhea can be partially explained by increased prostaglandin production resulting in increased uterine contractions and cramping pain. While NSAIDs are believed to exert their therapeutic benefit by reducing prostaglandin production through Cyclooxygenase-2 inhibition, some of my patients either prefer not to or cannot take standard therapies (NSAIDs or hormonal therapy) and still struggle with symptoms.
The next step was to find an alternate treatment method. Ginger root is used throughout the world as a seasoning, spice, and medicine. Ginger has been shown to inhibit COX-2 and has been studied for its potential role in reducing pain and inflammation. As a result, ginger may have a role in the treatment of dysmenorrhea.
James W. Daily, PhD , conducted a systematic review of the literature on the efficacy of ginger for treating primary dysmenorrhea ( Pain Med. 2015 Dec;16[12]:2243-55 ).
It included all randomized trials investigating the effect of ginger powder on younger women. Included studies evaluated ginger efficacy on individuals aged 13-30 years. Most included studies excluded women with irregular menstrual cycles and individuals using hormonal medications, oral or intrauterine contraceptives, or a pregnancy history. Dosing was 750-2,000 mg ginger powder capsules per day for the first 3 days of the menstrual cycle.
Four studies were included in the meta-analysis, which suggested that ginger powder given during the first 3-4 days of the menstrual cycle was associated with significant reduction in the pain visual analog scale (risk ratio, –1.85; 95% confidence interval: –2.87 to –0.84; P = .0003).
I am not a consistent proponent of alternative therapies but mostly because it is difficult for me to keep up on the evidence for these treatment options. In this case, my bias is that individuals in this age group are much more willing to engage with alternative therapies and offering them may build trust.
For these patients, offering ginger powder may engage patients in self-help and help them appreciate you as a clinician willing to embrace alternative therapies. The hard part is recommending a brand that you know and trust, complicated by the lack of oversight and quality control for over-the-counter, nontraditional therapies.
Dr. Ebbert is a professor of medicine and general internist at the Mayo Clinic in Rochester, Minn. and a diplomate of the American Board of Addiction Medicine. The opinions expressed are those of the author and do not necessarily represent the views and opinions of the Mayo Clinic. The opinions expressed in this article should not be used to diagnose or treat any medical condition, nor should they be used as a substitute for medical advice from a qualified, board-certified practicing clinician. Dr. Ebbert has no relevant financial disclosures about this article.
