The History of Menstrual Pain

Since the dawn of time, people who bleed have been expected to endure days of pain and inconvenience every month – with limited resources to help. (You might ask yourself whether people who don’t bleed would ever put up with this.) Worldwide, studies show that between 50% and 85% of people with uteruses experience menstrual challenges, with a range of symptoms from mild discomfort to debilitating pain and nausea. Conditions like endometriosis and PCOS may greatly worsen period pain, and getting a diagnosis is often an uphill battle. 

Menstrual pain can be a mere annoyance, or it can greatly disrupt our lives. Why are our options for alleviating it so limited, even in this modern age?

Historically speaking, pain experienced by women and people with uteruses has often been dismissed as unimportant, exaggerated, or even a divine punishment for original sin – which may partly explain the lack of available options. Midol, the last commercial product specifically designed to address period pain, was released in 1911, and newer innovations often involve side effects that can make the cure worse than the problem.

Wandering wombs and menstrual huts: periods in history

When a woman has a discharge of blood which is her regular discharge from her body, she shall be in her impurity for seven days, and whoever touches her shall be unclean until the evening. – Leviticus 15:19

Popular beliefs around gynecological anatomy have always tended towards the strange, incorrect, and, dare we say, hysterical. (The root word of “hysteria” translates to “uterus”, though we often wonder if testerical might be more accurate.) The Greek physician Aretaeus, writing in the 2nd century AD, postulated that the uterus could actually detach itself and take a stroll around the body, causing any manner of “female complaints”. This belief appears to derive from much earlier cultural assumptions – and it persisted in Western medical circles for centuries.

Going even farther back than Aretaeus, the Old Testament claims that the pain of menstruation and childbirth are an illustration of original sin, Eve’s punishment for succumbing to temptation in the Garden, and therefore “just desserts” for people who bleed. This belief, held to a greater or lesser extent across the Abrahamic religions, may be a core reason why menstruation is considered taboo, and menstrual pain dismissed, even in modern, secular societies.

Additionally, many cultures worldwide practice menstrual sequestration, wherein women are expected to separate themselves from their communities during their periods, often staying in a designated place with other bleeding people, forbidden from participating in activities like food preparation. Members of these cultures often express mixed feelings about this custom; although the idea that a person is “unclean” during their period can be extremely hurtful and repressive, a week or so of rest and socializing may be very welcome – especially when it hurts (and it’s actually supportive of pelvic health in the long run). 

And perhaps it could also be a time to share knowledge about what works, and what doesn’t, to ease cramps.

Pills and potions for period pain

Over the centuries, weird beliefs surrounding periods and the pain they can cause have informed some odd, extreme solutions, especially at the hands of medical professionals and purveyors of pharmaceuticals.

One of the oldest treatments for pain of all kinds is opium. Its derivative, morphine, was sold over-the-counter for menstrual pain as recently as the early 1900s. Even heroin began its life as a widely-available pain remedy, marketed by Bayer (yes, the aspirin people) in 1895. And there is no doubt that opiates work for pain; unfortunately, they’re also brutally addictive. Who knows how many people went to the drugstore for a little cramp relief and ended up with a hard-to-kick habit? 

Also on the extreme end, doctors throughout the ages have recommended surgeries for debilitating period pain – including removal of the ovaries, put forth by an American doctor in the mid-1800s. Oophorectomy would be effective, since it ends the menstrual cycle altogether; of course it also ends the possibility of fertility, and causes immediate menopause regardless of the age of the patient.

As science and technology advanced, options for addressing period pain did expand somewhat. Like oophorectomy, contraceptive pills can work by disrupting the menstrual cycle, and were approved by the FDA for debilitating cramps (though not, interestingly, for birth control) in 1957. However, the pill – especially the early pill, with its potent dose of hormones – comes with side effects that can be severe for some, including mood disturbances, loss of libido, and even risk of blood clots.

Fortunately, some progress has been made. Today, most people suffering from menstrual pain reach for NSAIDS – nonsteroidal anti-inflammatory drugs like ibuprofen, aspirin, and acetaminophen. They work by inhibiting the body’s production of prostaglandins, the inflammatory chemicals that cause cramping and work to expel the menstrual flow. NSAIDS aren’t perfect – they can cause kidney, liver or gastrointestinal problems when taken in excess – but they’re a definite improvement on earlier remedies like Warren’s Styptic Balsam, a formula popular in the 19th century, which consisted of sulphuric acid, turpentine and alcohol. (No thanks.)

Mother Nature and menstrual pain

For all the medical and religious authorities’ theorizing, people who menstruate have historically treated their period pain at home, using natural remedies and techniques that were widely available, often growing right out of the ground. And modern science often provides evidence that these remedies work.

Aspirin, for instance, is derived from the bark of the willow tree, which has been used to relieve all kinds of pain for millennia. Black cohosh, a flowering plant native to North America, was used by Native Americans to relieve gynecological complaints, and later became popular in Europe as well – and is still widely used today as a supplement. Cramp bark and black haw, different species in the same genus, have also been used to relieve cramps for centuries. Even common kitchen herbs like ginger, catnip, fenugreek, and chamomile find their way into teas that soothe when the cramps threaten to overwhelm.

In addition, techniques like vaginal steaming have been in use since long before Gwyneth Paltrow made them notorious. Ancient Mayan midwives had patients in their care sit over an herbal steam to relax their pelvises and improve circulation and blood flow. And abdominal massage, practiced worldwide, also has scientific support for easing cramps.

Although it’s always a good idea to consult with a doctor before beginning any new regimen, people who suffer from menstrual pain often report achieving relief via these very old practices – and one of the oldest is new again, owing to a recent bout of sanity in the legal realm.

Cannabis and cramps: the mother of them all

Cannabis and hemp have been part of the human pharmacopoeia for untold hundreds of years. Persian texts from the 9th century AD specifically describe cannabis’ effectiveness for uterine cramps, and sixteenth-century Chinese texts also recommend the use of cannabis for menstrual disorders. And more recently, even Queen Victoria was famously prescribed cannabis for her problem periods, with her personal physician writing in The Lancet that cannabis “is one of the most valuable medicines we possess”.

Cannabis’ use for menstrual challenges is becoming more widely substantiated by science – and the anecdotal evidence is overwhelming. Worldwide and throughout history, untold numbers of people who bleed have reached for the herb when they felt cramps coming on – and given the absence of physical dependency, coupled with effective pain relief, it’s no wonder that this unassuming leafy shrub has remained so popular. Studies seem to show that CBD, the now-famous non-intoxicating cannabinoid, even works by inhibiting the production of prostaglandins – the same way NSAIDs do, without the tummyache or other side effects.

Of course, until recently cannabis and hemp were widely illegal, owing to some pretty questionable historical context. The decades of suppressed access to this remedy, and the fact that women's gynecological pain is one of the least prioritized areas of scientific research, highlights the unfortunate gender pain gap, and some researchers are looking to change that. With legalization has come exciting new research and more refined methods of use, providing improved access to relief to many. (We’re thrilled to be part of a groundbreaking study about cannabinoids and menstrual relief – click here to participate!)

You’re not alone!

Modern times have brought about a widespread relaxing of taboos when it comes to sexual health. Although most of us still aren’t comfortable moseying to the restaurant restroom with a tampon casually in hand, the Internet has facilitated communication between people who bleed – and let many of us know that we’re not alone, we do have options, and that we shouldn’t put up with having our pain dismissed by the people who are supposed to look out for us.

Thankfully we have access to knowledge, both modern and ancient, that can help us find the tools we need – and deserve – for relief. 

As much as we might secretly want to hide away in a tent during our periods, that isn’t an option for many of us. But if we educate ourselves on the options available, we might find ourselves in a very big tent indeed – one containing all the people who bleed, their stories and knowledge.

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