Small stories, big health lessons (episode seven)

<h4>Why Do My Cramps Feel Worse When I Eat Sugar?</h4> Well,this one isn't a story. Someone asked something along these lines in the previous episode and I decided to write on it. So I'm sure many people have wondered why their cramps sometimes get worse after consuming sugary foods. Your period comes, the cravings begin, and suddenly you are reaching for chocolate, biscuits, ice cream, cake, or a bottle of your favourite soft drink.Then, somehow, it feels as if you won't survive cuz your uterus has suddenly declared war against you. But what exactly is happening?To understand that, we need to start with what causes menstrual cramps in the first place.During menstruation, the lining of the uterus breaks down and is shed. As this happens, substances called prostaglandins are released from the endometrium. Prostaglandins are local hormones/locally acting lipid mediators that act mainly in the area where they are released. They mediate pain and inflammatory responses,and they also protect the lining of your stomach (which is why NSAIDS like Diclofenac and piroxicam worsen peptic ulcers in patients who already have them, because NSAIDS block the synthesis of these hormones.... we'll talk about this some other time). Prostaglandins are involved in making the uterus contract. These contractions help the uterus shed its lining, but when prostaglandin production is high, the contractions can become stronger and more frequent. They can also constrict the blood vessels supplying the uterine muscle, reducing blood flow temporarily. Less blood flow means less oxygen reaching the tissue. The result?Pain. This is one of the major mechanisms behind primary dysmenorrhea, the medical term for painful menstrual cramps. Now, where does sugar come in?This is where things get a little more complicated.Sugar itself is not the culprit,it does not just enter your uterus and tell it "oya,cramp more". There is no straightforward pathway that goes:Sugar → uterus →increased pain. Instead, the concern is what a diet that is relatively high in added sugars may do to the body's metabolic and inflammatory environment.High intakes of added sugars, particularly as part of an overall energy-dense diet, can contribute to metabolic disturbances and inflammatory processes. And since inflammation and inflammatory mediators are involved in menstrual pain, this may influence how severe symptoms feel in some people. And there is another problem. The foods we call “sugary foods” rarely contain sugar alone. That chocolate bar also contains a considerable amount of fat. The soft drink may contain caffeine. The pastries may contain a significant amount of refined carbohydrates and saturated fat. Large amounts of these foods also contribute to bloating and gastrointestinal discomfort. So when someone says, “Every time I eat plenty of sweets during my period, my cramps get worse,” they may genuinely be noticing a pattern. But that does not mean one chocolate bar will automatically cause painful cramps. The evidence linking specific foods, including sugar, to dysmenorrhea is still not strong enough to say that sugar directly causes severe menstrual pain in everyone. Research on diet and dysmenorrhea remains relatively limited and inconsistent. What we do know is that prostaglandins play a major role in menstrual cramps. And that is also why drugs such as ibuprofen and piroxicam can be useful for dysmenorrhea: they inhibit the cyclooxygenase enzymes which are involved in synthesis of prostaglandins, reducing the prostaglandins responsible for much of the uterine contraction and consequently the pain.(Patients with ulcers should still be careful with NSAIDs!) So, should you throw away every chocolate bar the moment your period starts? Probably not.There is still a lot we do not know about exactly how individual foods influence menstrual pain, and your cramps are certainly not determined by one bar of chocolate or one bottle of Coke. But if your menstrual pain is very severe, worsening, interfering with your daily activities, or feels different from what you usually experience, please seek medical attention. Sometimes what looks like ordinary period pain can be secondary dysmenorrhea, which may be associated with conditions such as endometriosis, adenomyosis, fibroids, or even pelvic inflammatory disease. Your period may be uncomfortable, but debilitating pain is not something you are expected to endure. And if you have noticed that certain foods consistently make your period feel worse, it is important that you pay attention to that pattern. Sometimes, your body has been giving you information long before you knew what to call it. So until next time,stay healthy and stay curious 🌿❤️

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