One thing I love about herbalism is that every herbalist has different herbs, practices and tactics that they favor. There is so many varieties and examples to learn from! Some seem to be more into tonics, others use simples (single herbs) in almost homeopathic dosages, but most all have specific remedies for symptoms while reiterating the need to support the body systems over the long term.
No matter how you look at it, suggested herbal formulas from trusted herbalists are a good place to start. They can also be used as guidelines when formulating for the individual. After going over a few examples from a few different herbalists, the beginning herbalist gains knowledge through researching the materia medica and action categories mentioned.
Let’s look at a few formulas to get some ideas, starting with some from Rosemary Gladstar. She reiterates that you should stick to an herbal program at least four months. Here is a “Hormonal Regulator Tea” from Herbal Healing for Woman, p 117. Decoct, and drink 3-4 cups for 3 weeks out of the month. As you can see, it is not simply herbs for the reproductive system. It offers much support for the liver, which has to process all the hormones circulating in the body, and supports the digestive system, inflammation, and enriches the blood.
- 1 part wild yam
- 1 part ginger
- 2 parts dandelion root (raw)
- 2 parts burdock root (raw)
- 2 parts licorice
- 2 parts sassafras
- 1 part yellow dock
- 1/4 vitex
It is also important to include sufficient calcium, as a low amount has been linked to cramping, as blood levels of calcium drop off 10 days before menstruation. Again, there are more than just calcium-rich herbs in here! There are nervines, blood and uterine tonics and emmenagogues. “High Calcium Tea” (p 118):
- 2 parts oatstraw
- 1 part horsetail
- 2 parts comfrey
- 2 parts nettle
- 4 parts peppermint
- 2 parts pennyroyal
- 4 parts raspberry leaf
For acute cramping, she recommends the following “Cramp-T”
- 1 part cramp bark or black haw
- 1 part pennyroyal
- 1 part valerian
- 1/2 part ginger
A tincture of valerian, about 1/2 teaspoon every twenty minuets until the pain decreases. Another handy remedy to have around is pennyroyal essential oil, to rub a few diluted drops on the abdomen during cramping. Please be cautions with pennyroyal essential oil and never take it internally, because it is extremely toxic internally.
Now let’s take a look at David Winston’s recommendations. In my last entry, I asked, “…I don’t know if all anodyne work on the same parts of the body…”. Well, Winston has cleared that up for me. Here is “Aspirea Compound” (32)
- willow bark
- meadowsweet herb
- St. John’s wort
- Jamaica dogwood
- indian pipe
It has anti-inflammatory herbs (willow, meadowsweet, St. John’s wort), Jamaica dogwood which is analgesic and antispasmodic which Winston says is “especially for dysmenorrhea…”, and indian pipe which “…creates a feeling of separation from the pain” (32). I have tried this formula for other types of pain with great success (tooth ache, back spasm), but have yet to use it for cramps. It is very relaxing.
“Full Moon – Woman’s Antispasmodic Compound”
- PA-Free Petasites root
- Black haw
- wild yam
- Jamaica dogwood
- cyperus root
- Roman chamomile flowers
Winston’s notes: for mild to severe dysmenorrhea and some of the accompanying symptoms, take acutely, not daily. Here we see lots of antispasmodics at work.
“J. Kloss Anti-spasmodic Compound” (p4 6)
- black cohosh
- skunk cabbage
This is an example of a classic formula that works well as is, or can be adapted to suit individual needs. I have seen and used a couple variations of this formula (Dr. Christopher has one), one with blue vervain, blue cohosh instead of myrrh and skunk cabbage for treating epilepsy in a dog (2 drops a day for 3 months) and a severe tension headache (1/4 teaspoon every hour), both times it worked great. In the later, I sipped miso soup to quell the nausea that came with the lobelia and vervain.
Here is one more set of examples from David Hoffmann’s Medical Herbalism from page 387 -8.
- black haw
- black cohosh
This is a basic formula that covers the many of the action categories mentioned in the last entry. All are antispasmodic, al are nervine, and black cohosh is uterine tonic. The dosage is 5mL of tincture as needed, so when pain is approaching and in full swing. If a woman has secondary dysmenorrhea caused by pelvic lesions (from endometriosis or pelvic inflammatory disease) the dosage is 5 mL of the following tincture taken three times a day, rather than just symptomatically:
- cramp bark
- wild yam
- black cohosh
Again, all herbs are antispasmodic, cramp bark and black cohosh are nervines with black cohosh being the uterine tonic.
a purple garden variety of black cohosh
Dysmenorrhea is basically period pain. Doctors will often diagnose period pain as “primary dysmenorrhea”, which means the pain cannot be contributed to any other cause or disease. The typical method for dealing with period pain within the medical model is prescribing hormonal birth control. Much less infrequently pain medications are prescribed; over-the-counter pain-relievers are typically suggested.
Dysmenorrhea is not just a case of “grin and bear it”. It can seriously effect a woman’s ability to function in her daily life. While I am a big fan of resting, nourishing, and turning inwards during the moon time, I acknowledge that there are many woman who’s life is not set up to take such personal time (or rather our society is not set up to take such personal time). And besides, pain is pain, and for most everything besides menstruating and childbirth, we see pain as a sign that something is wrong with the body. Most women I know with dysmenorrhea can’t help but wonder if something is wrong with their body when their uterus is cramped.
Pain and symptoms vary from woman to woman, so it is important to treat the individual, not the condition.
Furthermore, pain and symptoms vary from month to month, as harmony within the menstrual cycle is reached through a process of changes and adjustments. Therefore, herbal formulas should be updated accordingly. At the same time, keep in mind that when working with the endocrine system treatment should be for at least 3 months but often as long as a year or more. Each month the ovaries alternate hormone production, so to ensure an herbal treatment (or conventional, for that matter) is effective let the left, then right, then back to left ovaries do their thing (thus the 3 month recommendation). I also think a quarter of a year is a fair time frame to let your body, mind and spirit go through their natural cycles a number of time, establish rhythms, process emotions, and adjust to physical surroundings and seasons.
It may be tempting to stop taking herbs after a month or so when you a) notice an improvement and b) don’t see any improvement. At this time, especially if you are in the “b” category, keep on! Figure out your dosages and preparations and stick with them. Tinctures? Teas? How often? When I was fist getting into herbs I would stop treatments when I felt they were not working, “so why bother?”, I thought. While it was true they weren’t making horrible cramps disappear, there were many other benefits to be had. Some signs of improvement may be a more regular cycle, less PMS, pre-bleeding spotting, blood clots, nausea, teeth-shattering (yes, some women find they shiver and their teeth-shatter..sounds like a cold condition to me!), more energy and vitality, and simply better able to cope with their cycle no matter how tumultuous it may be.
When creating a formula for dysmenorrhea, you may wish to include: (from Ruth Tricky in Woman, Hormones and the Menstrual Cycle)
- A uterine tonic, as they normalize the uterine tissue
- Antispasmodics, relaxing, pain-relieving, prostaglandin-inhibiting herbs based on symptoms
- Emmenagogues may be used with late or slow starting periods
- Most always use warming herbs
- Don’t forget to balance emotional and mental tension with nervines, and treat any other body system that may be out of balance and aggravates dysmenorrhea
Regulates and normalizes the uterine tissue. Add when there is a heavy, dragging type of pain, pain towards the end of the cycle, some types of pain during sex (of a congested, heavy nature). They often provides nutrition, minerals and can be astringents so the do actually tone (by precipitating excess proteins in cell walls).
Examples: Raspberry leaf, nettle, shepherd’s purse, lady’s mantle, ect…
Improves the action of antispasmodic herbs when the period if aggravated by cold, relived by heat, lower abdomen feels relatively cool to the touch, relived by movement of the hips.
Examples: Ginger, cinnamon can be added to other herbal formulas, or taken alone, but drink them warm. Many Chinese patent formulas include cinnamon to warm the interior and promote a healthy circulation of blood.
Ginger tea – grate or chop 1 inch of ginger into a saucepan. Add about 2 1/3 cups of water. Bring to a boil, reduce to low simmer, cover. Simmer for 20 minuets. Turn off heat and let cool slightly before straining and drinking. You may add honey to taste and sip while emerged in a hot bath; doesn’t that sound divine?
Hormone regulating herbs
The goal here is to regulate the hormones, which reduceds pain by indirect action on prostaglandins.
Examples: Vitex angus-castus (chastetree berries) is very useful for congestive dysmenorrhea, and pain with PMS. A picky herb about dosing…when I get the correct does I will let you know. Everyone seems to have different suggestions.
Paeonia lactiflora (peony), Cimicifugia racemosa (black cohosh) are both antispasmodics and have the potential to competitively inhibit the activity of estrogen.Verbena officinalis (blue vervain) is a sedative, traditionally used for menstrual disorders with a hormonal origin. Schisandra berries.
Blue vervain flowers close up
These are relaxing herbs, used for both physical and mental/emotional tension or anxiety accompanying pain.They potentate antispasmodic and pain-killing herbs, as some are antispasmodics themselves.
Examples: Valerian, peony, corydalis, vervain, chamomile, agrimony, hops, lemon balm, lavender…
These have analgesic effects. Much weaker than conventional analgesics, so they must be prescribed with other herbs that actually attempt to correct the imbalance. I don’t think anodynes work on all systems and complaints, except for corydalis.
Examples: Wild lettuce, pulsatilla, corydalis, valerian, feverfew (463)…
Don’t over look the liver
Congestive period pain with heavy, dull, dragging pain has historically been treated with liver herbs and bitters, as well as those who are “irritable, hot-headed, constipated, headaches, heavy fiery-red flow”. Liver herbs most likely work through an indirect effect on hormone imbalance by improving the liver’s ability to excrete estrogen from the bowel and through the liver and bile.
Examples: Barberry and other bererine-containing herbs are useful, as are many other ‘liver’ herbs like dandelion root, burdock, Oregon grape, yellow dock. Yellow dock and dandelion in particular (especially when combined with blackstrap molasses) can encourage the body to use iron stores more efficiently, thus relieving fatigue following blood loss.
Tricky, Ruth. Woman, Hormones, and the Menstrual Cycle.