Period pain causes monthly misery for many people. Although pain relief and hormonal treatments can be effective, they often have unwanted side effects. Anecdotal evidence suggests that a change in diet to reduce the intake of gluten-containing foods might be the answer for some. Medical News Today talked to young women who have tried this approach, and we also explore the science behind the claims.

“I’d be woken by a cramping feeling in my lower belly, so I’d quickly get up and take some pain[relievers]. But before they got working, I would be lying on the floor with agonizing cramps spreading down my legs and up my back, shaking, sweating, and trying not to vomit. Then I’d be wiped out for the rest of the day.”

Eighteen-year-old Eve’s* monthly ordeal will be familiar to many young women. More than 80% of women experience some pain during menstruation, and for almost 20% of women, the pain is bad enough to impact their daily life.

The good news is that period pain generally reduces as a person gets older, and many people who menstruate find that decreases after having children.

According to Dr. Polly Cohen, who specializes in women’s health, that 20% is almost certainly an underestimate: “Period pain is definitely under-reported. Most women think it’s a normal part of being female, so just put up with it or search on the internet for ways to cope rather than going to their doctor.”

Why do periods hurt? 

Less than 2% of mammals menstruate — humans, some monkeys and bats, and even the tiny spiny mouse, which, incidentally, also experiences pre-menstrual syndrome. What they have in common is that they invest a lot in pregnancies for only one or two babies.

When an embryo is developing, it gets all its nutrients through the placenta, which attaches to the wall of the mother’s uterus. The thick lining that builds up during the menstrual cycle stops the placenta causing lasting damage to the uterine wall.

If an egg is not fertilized, that lining breaks down and is shed, and a new lining grows to prepare for the next chance of pregnancy. That is why some mammals experience menstruation, the process through which this “unused” endometrial tissue is shed from the body.

“The pain is from the inflammatory response when the uterus lining is shed,” Sally King of Menstrual Matters, a nonprofit online information hub, told MNT.

“When the lining cells are shed, blood vessels in the uterus rupture, which is why blood is lost with the cells,” she explained.

Before modern times, females did not have many periods, as they likely spent most of their adult lives pregnant or breastfeeding. Therefore, they might only have around 100 periods in their lifetime.

Now, most have more than 400 periods between puberty and the menopause. If these cause serious pain every month, it can have a real impact on their lives.

“The problem is that periods have always been a taboo subject,” Dr. Cohen also told us. “We need to get people talking about them.”

The treatment of period pain

“For doctors, treating period pain is usually trial and error,” Dr. Cohen said.

“To start with, we need to work out whether it is primary pain, which has no clear clinical cause, or secondary pain, where there’s an underlying condition, such as endometriosis or fibroids, which would need treatment.”

– Dr. Polly Cohen

“For primary pain, we start with paracetamol [acetaminophen]. If that doesn’t help, we move up to the nonsteroidal anti-inflammatory drugs (NSAIDs) — ibuprofen, then mefenamic acid,” she added.

For some people, these work well, but they are not a long-term solution.

“Taking NSAIDs for a long time can cause stomach problems like ulcers, so we then go to hormonal controls — the birth control pill or coil — which can work well for some women,” Dr. Cohen explained.

But what if you have tried all these and, still, nothing seems to work? Eve told MNT that she had gone from acetaminophen through several NSAIDs to the birth control pill:

“Pain[relievers] take a while to get working, so unless you know when the pain is going to hit, you’ll have about half an hour of agony until they kick in, which then leaves you exhausted for the rest of the day. Birth control pills had no effect on my period pain. I really didn’t know what to try next.”

A change in diet?

“After I left school, I got a job in Germany looking after two little boys,” Eve told us. “One of them [had celiac disease] so had to avoid gluten in his diet. Because even a tiny amount of gluten could make him seriously ill, the whole household was gluten-free.”

“I was so busy looking after the boys that I’d been there a couple of months before I realized that I had barely noticed my periods,” Eve went on to say. “The mum is a doctor, so I asked her if the gluten-free diet might have been stopping the pain.”

“She said she hadn’t been able to find any clinical research about it, but that the girl who had worked for them before me had noticed the same thing — no period pain and much shorter, lighter periods.”

– Eve

While in Germany, Eve followed a gluten-free diet with the family but ate normally out of the house: “I wasn’t avoiding wheat entirely […] but I was definitely eating a lot less than usual. But for those 6 months, I had almost no period pain.”

Paige*, 21, told us a similar story: “My period pain was so bad, I was referred for an ultrasound to check if I had endometriosis. Fortunately, I don’t have that.”

She then tried reducing her gluten intake.

“As a student,” she reflected, “it’s easy to live off pasta and bread, but I found alternatives, like rice, quinoa, and rye bread.”

“The difference was amazing,” Paige said. “My periods are so much easier, and I don’t have the awful side effects — spots, breakthrough bleeding, and weight gain — I got when I tried the birth control pill.”

What does the science say?

“There’s little scientific evidence to suggest that period pain is affected by wheat or gluten in the diet,” said Sally King, “but we do know that an anti-inflammatory diet can reduce period pain and blood loss.”

“And high-inflammatory diets, with lots of processed foods, caffeine, alcohol, and meat can certainly worsen pain and other cyclical symptoms,” she noted.

“I do find my periods are worse if I have had junk food or too much alcohol, too,” said Paige. “But cutting down on gluten in my regular diet has certainly helped a lot.”

Some researchers have already observed a link between gluten, wheat, and inflammation, so Dr. Cohen agreed that this could be why the change in diet worked.

“We have seen associations between diet and period pain,” she told MNT. “One study found that a low fat, vegan diet reduced period pain, but it was a small study, so we can’t draw any firm conclusions,” she cautioned.

“The problem with diet studies is that it is very hard to control for other factors; that’s why so few are done in this area,” Dr. Cohen went on to explain.

“I want to be a doctor, so thought I would try experimenting on myself,” Eve said. “When I got back from Germany, I tried eating normally, with a fair amount of pasta and bread. I had the most painful period ever — the pain lasted for 4 days and completely floored me.”

Switching back to a low gluten diet has seen her near pain-free again, she told MNT.

However, a gluten-free diet may not work for everyone. Dr. Cohen said that, as a doctor, she could not tell patients to go gluten-free to combat period pain without more scientific evidence, as restricting one’s diet could have other unexpected effects on health.

For Eve, “[i]t’s hard to cut out wheat and gluten completely, but I’m going to experiment with how much I can eat and whether just cutting it out at certain times of the month works,” she said.

“I’ve told my sisters and a couple of friends who have bad period pains to cut down on gluten, and they have really found it makes a difference,” she told us.

An underlying cause for the period pain must be ruled out before a person tries changing their diet, and they should make any such decisions only after consulting their physician.

However, cutting down on wheat or gluten may be worth a try, according to Dr. Cohen. “Since the pain is due to inflammation, and wheat products cause inflammation in some people, it might help,” she said.

* We have changed the names of some contributors to protect their identities.

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