Tipped and Troubled


Woman experiences horrible lower-back pain a few days before period. The pain ends after menstruation. What could be the cause of this 5-year issue? What can be done for it?

Case #: 
948

Concern:

I will need a recommendation from you regarding pain complaints from female of 40 years. Excruciating pain emanates at the lower level of the vertebral column a few days before menstruation and ends with stoppage of menstruation. This has been going on for over 5 years now.

Discussion:

It appears that the woman has developed a retroverted uterus, or a uterus that points backwards instead of forwards. This is what is causing the horrible pain near the time of menstruation. Pain during menstruation due to tipped uterus is a specific type of dysmenorrhea, and is caused by an excessive level of the prostaglandin E3, which stimulates uterine contractions. The issue is a simple one, in theory, and there is an easy solution.
 
Retro-what-ed?
At any given time, between 20-30% of women have retroverted uteruses. There are several possible causes including childbirth, pelvic adhesions, pelvic surgery, endometriosis, fibroids, or Pelvic Inflammatory Disease. There is usually not a problem with the situation, however, but in some cases women report unusually painful menstruation, and/or sexual intercourse.
 
The reason menstruation is so strangely painful is because the instead of the uterus pointing slightly forward towards the belly, it points backwards towards the rectum and the base of the spine. Thus, the cramping and pain normally associated with menstruation also affects the lower back and rectal area. The clenching and tightening of the nearby uterus, and potentially the intestines, puts a strain on the nerves and muscles of the lower back—resulting in a threefold level of pain. 

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The Good, The Bad, and The Aspirin
Prostaglandin E3 is the culprit of the pain, as it causes the contraction of smooth muscle—eg. the uterus. Prostaglandin E3 is usually seen as a “good” hormone, because it fights inflammation and increases fat metabolism, however, in this instance it is acting out of control.
 
The best way to control the pain before it happens is to take aspirin. Aspirin prevents the formation of prostaglandin E3 because it inactivates the cyclooxygenase enzyme needed for the chemical formation of the prostaglandin. The aspirin molecule covalently bonds in place of the cyclooxygenase, thereby rendering the resultant creation harmless (in terms of pain). Aspirin can certainly manage the pain, but it is not recommended as a long-term solution, because of its method of action.
 
When the aspirin ousts the cyclooxygenase, it’s termed an irreversible inhibitor, and because prostaglandins are needed for other functions in the body, the inability to form them can grow to become an issue.
 
A Solution Rather Than a Fix
To solve the issue of the excess prostaglandins, without deleting them, is to modify the presence of them in the body. Prostaglandin levels can be mediated by the presence of hormones, and a female body well balanced between estrogen, progesterone, prolactin, and oxytocin is one that has a less painful period. I’d suggest beginning an herbal course dedicated to stabilizing hormones during the menstrual period, and one that contains as well the herbs raspberry leaf and crampbark, as they have been used for centuries to treat dysmenorrhea, with excellent results. (TRY: PMS Herbal Relief Formula)  I’m sure that soon this poor woman will no longer be laid up for a week out of the month!

What to do


PMS: Pretty Miserable Syndrome – No More!

Often, the distress and pain associated with PMS is normal and endurable. But for some women, the pain can be a source of agony and stress. Most of the discomfort can be reduced or relieved thanks to a realignment of the body’s hormonal production... Read more
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