What to Take for Menstrual Cramps

In my video Ginger for Migraines, I described how ginger works as well as the leading “drug” in the treatment of migraines, “one of the most common causes of pain syndromes,” affecting as much as 12 percent of the population. Twelve percent is “common”?

How about menstrual cramps, which plague up to 90 percent of younger women? You can tell this study was written by a guy because he emphasizes the absenteeism and all the “lost productivity” for our nation. Menstrual cramps also just really hurt.

Can ginger help? As I discuss in my video Benefits of Ginger for Menstrual Cramps, women took a quarter teaspoon of ground ginger powder three times a day during the first three days of menstruation, and pain dropped from seven on a scale of one to ten down to a five, whereas there was no significant change in the placebo group, as you can see at 0:56 in my video. Most women in the placebo group said their symptoms stayed the same, whereas those unknowingly in the ginger group said they felt much better.

A subsequent study found that even just an eighth of a teaspoon three times a day appeared to work just as well, dropping pain from an eight to a six and, in the second month, down to a three. The “alleviation of menstrual pain was more remarkable during the second month of the intervention,” and study participants had only been taking the ginger for four days, not the whole month, suggesting it might work even better if women use ginger every period. 

What about the duration of pain? As you can see at 1:52 in my video, a quarter teaspoon of ground ginger powder three times a day not only dropped the severity of pain from about a seven down to a five but also decreased the duration of total hours in pain from 19 hours down to about 15 hours, indicating that three quarters of a teaspoon of ginger powder a day for three days is a safe and effective way to produce pain relief in college students with painful menstrual cramps, compared to placebo, capsules filled instead with powdered toast. But women don’t take breadcrumbs for their cramps. How does ginger compare with ibuprofen? An eighth of a teaspoon of ginger powder four times a day for three days versus 400 milligrams of Motrin were put to the test, and the ginger worked just as well as the drug of choice, as you can see at 2:40 in my video.

If you do take the drug, though, I was surprised to learn that it may be better to take drugs like ibuprofen and naproxen on an empty stomach because that may speed up the pain relief and help keep people from taking higher doses.


I’ve touched on this effect before in Ginger for Nausea, Menstrual Cramps, and Irritable Bowel Syndrome. What else can this amazing plant do? See, for example:

What else can really help with cramps, PMS, and cyclical breast pain? Check out:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

The Benefits of Ginger for Osteoarthritis

If ginger is so effective against migraines and also helps with the pain of menstrual cramps, what about osteoarthritis? I explore this in my video Ginger for Osteoarthritis.

An all too common disorder, osteoarthritis produces chronic pain and disability. The first major study, published in 2000, showed no benefit of ginger extract over placebo, but that study only lasted three weeks. The next study, in 2001, lasted six weeks and, by the end, was able to show significantly better results compared to placebo. However, because the placebo did so well, reducing pain from the 60s down to the 40s on a scale of 1 to 100, ginger reducing pain further down into the 30s was not especially clinically significant, so an editorial in the official journal of the American College of Rheumatology concluded that “ginger should not be recommended at present for treatment of arthritis because of the limited efficacy.”

Since that time, there have been a few other trials that showed more impressive results, such that ginger is now considered “able to reduce pain and disability” in osteoarthritis. How does it compare to other treatments? Since osteoarthritis is a chronic disease, it’s especially important to weigh the risks versus the benefits of treatment. The commonly used anti-inflammatory drugs can carry serious cardiovascular and gastrointestinal risks. For example, nearly half of the osteoarthritis patients on drugs like ibuprofen were found to have major injuries to the lining of their small intestines. That risk can be reduced by taking additional medication to counteract the side effects of the first drug.

Ibuprofen-type drugs reduce our stomach lining’s ability to protect itself from stomach acid, so blocking acid production with a second drug can lower the risk. However, ginger can actually improve stomach lining protection. Indeed, at the kinds of doses used to treat osteoarthritis—about a quarter- to a half-teaspoon a day—ginger can be considered not just neutral on the stomach, but beneficial. So, ginger can be as pain-relieving as ibuprofen but without the risk of stomach ulcers.

What about topical ginger treatment, as in externally applying a ginger-soaked cloth or patch to the affected joint? In a controlled study, compress versus patch, both showed remarkable and lasting pain relief for osteoarthritis sufferers. What was missing from the study, though, was a control group: There was no placebo patch. I don’t care if ginger has been applied externally to painful joints for a thousand years. The placebo effect has been shown to be remarkably effective in osteoarthritis in providing pain relief. So, until there’s a controlled study on topical ginger, I’m not going to believe it.

There wasn’t such a study until… 24 men stuck ginger slices on their scrotum.

Men with inflamed testicles applied six to ten paper-thin slices of ginger “over the affected testes,” and, evidently, the ginger group healed nearly three times faster than the control group. Unfortunately, the original source is in Chinese, so I can’t get further details, as is the only other controlled study on topical ginger I could find, whose title apparently translates to “Evaluation of point plaster therapy with ginger powder in preventing nausea and vomiting occurred after platinum-based interventional chemotherapy.” We know ginger powder taken orally can be a miracle against chemo-induced vomiting, but what about stuffing it in your belly button?

The external application of ginger powder to the so-called point of Shenque, which is the navel, was compared to the control group, who got potato powder in their belly buttons instead. The ginger group evidently had significantly less nausea and vomiting. Unfortunately, only the abstract is in English, so I can’t tell how effectively the researchers blinded the patients to the treatment. Presumably, it would be easy to tell whether or not you were in the ginger or placebo group simply by the smell, but perhaps the researchers controlled for that? Until we know more, I would suggest those who want to try ginger use it in the stomach, rather than on the stomach.


What other dietary interventions can help with arthritis? See, for example:

What else can ginger do? Check out:

If the placebo effect is really that powerful, should doctors prescribe them? They already do. See my video The Lie That Heals: Should Doctors Give Placebos? for more on this.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Fennel Seeds vs. Ginger for Menstrual Cramps and PMS

Ninety percent of women report having painful menstrual cramps at least some of the time. Around the Mediterranean, fennel seeds have been traditionally used to relieve painful menstruation. We call them seeds, but they’re actually whole little fruits. I discuss their effectiveness in the treatment of menstrual cramps in my video Fennel Seeds for Menstrual Cramps and PMS. It’s hard to create placebo seeds, so researchers used fennel seed extract to put it to the test. The women started out rating their pain as six out of ten, which then went down to a four within an hour after the taking the fennel seed extract. Fifty-two percent of the women rated the fennel seed treatment as excellent, compared with only 8 percent of those in the placebo group who were just unknowingly given placebo capsules just containing flour.

But women don’t take flour for cramps; they take drugs such as ibuprofen. Mefenamic acid is in the same class of nonsteroidal anti-inflammatory (NSAID) drugs and may actually work better than ibuprofen, but it is not available over the counter. How did it do against an extract of fennel seeds? In a head-to-head study, most women started out in severe pain but ended up pain-free after treatment, and the fennel worked just as well as the drug class considered the treatment of choice––but without the drug’s side effects, which include diarrhea, rashes, autoimmune anemia, and kidney toxicity.

The drug also doesn’t help with the other symptoms of bad periods. During menstruation, women can feel nauseated, out of sorts, weak, achy, and diarrheic. But when put to the test, fennel seeds seemed to help; however, the control group wasn’t given a placebo, so we don’t know how much of that was a placebo effect.

One downside of taking fennel is that women bleed about 10 percent more. Menstrual cramps are caused by the uterus contracting so hard its blood supply is compromised, and we think fennel works through muscle relaxation. It also helps with infant colic, which is thought to be due to intestinal spasms. The advantage of fennel there, too, is the lack of side effects, unlike the drug commonly used for colic. Indeed, dicyclomine hydrochloride can work a little too well to get your baby to stop crying––by developing side effects like death.

Ginger is effective for cramps and reduces bleeding when an eighth of a teaspoon of ginger powder is taken three times a day during one’s period. This is important since up to 18 million young women in the United States experience iron deficiency anemia due to heavy menstrual bleeding. In a study, the amount of blood loss was estimated using a scoring system that gave points for level of saturation and clot size. On ginger, they went from half a cup per period down to a quarter cup. Ginger appears to be a highly effective treatment for the reduction of menstrual blood loss. It is cheap, at only about 6 cents a month, easy to use, and may have fewer side effects than medications and invasive approaches, even sometimes fewer than placebo! The researchers used lactose (milk sugar) for the sugar pills, which may have caused the reported flatulence.

Ginger may also work better for premenstrual syndrome (PMS). An eighth of a teaspoon twice a day of ginger powder for a week before one’s period yields a significant drop in PMS mood, physical, and behavioral symptoms, whereas fennel may help with PMS anxiety and depression but not with the emotional or physical symptoms.


Other dietary interventions that may help include a reduction in salt and animal fat consumption, which I address in my video Dietary Treatment for Painful Menstrual Periods.

We should use whatever works––because sometimes, evidently, PMS symptoms can lead to death. Case in point: Christine English who, at that time of the month, ran down her husband. Accepting PMS as a defense, the court released her with one year of probation.

For more on treating menstrual pain and PMS, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: