Condition

Primary Dysmenorrhea (Menstrual Cramps)

Primary dysmenorrhea is painful menstrual cramping with no underlying pelvic condition, caused by prostaglandins, inflammatory chemicals released from the uterine lining that make the uterus contract. Among supplements, vitamin E has the most support, with moderate evidence, and symptoms eased in small trials; a ginger trial also found less pain. Still, the studies were small and ginger rests on one trial.

Sources: PMID 23447916; PMID 11762659; PMID 19216660

Updated 30 September 2026
How we grade
4 studies cited
Primary Dysmenorrhea (Menstrual Cramps) protocol

Supplements studied: 15
Graded outcomes: 10
Trials: 20
People studied: 9,261

Evidence by supplement

Strong
Moderate
Limited
Very limited

15 supplements

Calcium

Calcium: outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People
	PMS Symptoms Small Improvement	Improves (the measure goes down)	Small effect	7 studies	135 people
Studies that measured pms symptoms A pilot study to compare fluoxetine, calcium, and placebo in the treatment of premenstrual syndromeJ Clin Psychopharmacol · PMID 23963058 Effect of Combined Use of Calcium and Vitamin B6 on Premenstrual Syndrome Symptoms: a Randomized Clinical TrialJ Caring Sci · PMID 26989667 Dietary calcium and manganese effects on menstrual cycle symptomsAm J Obstet Gynecol · PMID 8498421 and 4 more on the Calcium page
	Depression Symptoms Small Improvement	Improves (the measure goes down)	Small effect		49 people

Vitamin E

Vitamin E: outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People
	Dysmenorrhea Symptoms Small Improvement	Improves (the measure goes down)	Small effect	3 studies	498 people
Studies that measured dysmenorrhea symptoms A randomised placebo-controlled trial to determine the effect of vitamin E in treatment of primary dysmenorrhoeaBJOG · PMID 11762659 A randomised controlled trial of vitamin E in the treatment of primary dysmenorrhoeaBJOG · PMID 15777446 Evaluation of the effect of vitamin E on pelvic pain reduction in women suffering from primary dysmenorrheaJ Reprod Med · PMID 23447916
	Menstrual Flow	Improves (the measure goes up)			278 people

Saffron

Anxiety Symptoms: improves
Estrogen: changes; see studies
Cortisol: improves

Saffron: outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People
	Anxiety Symptoms Small Improvement	Improves (the measure goes down)	Small effect	6 studies	47 people
Studies that measured anxiety symptoms Crocus sativus L. versus Citalopram in the Treatment of Major Depressive Disorder with Anxious Distress: A Double-Blind, Controlled Clinical TrialPharmacopsychiatry · PMID 27701683 The effects of alcoholic extract of saffron (Crocus satious L.) on mild to moderate comorbid depression-anxiety, sleep quality, and life satisfaction in type 2 diabetes mellitus: A double-blind, randomized and placebo-controlled clinical trialComplement Ther Med · PMID 30477839 A double-blind, randomized and placebo-controlled trial of Saffron (Crocus sativus L.) in the treatment of anxiety and depressionJ Complement Integr Med · PMID 27101556 and 3 more on the Saffron page
	Estrogen	Changes; see studies		1 study	47 people
Studies that measured estrogen Psychological and neuroendocrinological effects of odor of saffron (Crocus sativus)Phytomedicine · PMID 21242071
	Cortisol	Improves (the measure goes down)			47 people
	Testosterone	Improves (the measure goes up)			47 people

Vitamin D

Cramps: improves
Pelvic Pain: improves
PMS Symptoms: improves

Vitamin D: outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People
	Cramps Small Improvement	Improves (the measure goes down)	Small effect	1 study	897 people
Studies that measured cramps High dose vitamin D supplementation can improve menstrual problems, dysmenorrhea, and premenstrual syndrome in adolescentsGynecol Endocrinol · PMID 29447494
	Pelvic Pain	Improves (the measure goes down)		1 study	510 people
Studies that measured pelvic pain Vitamin D for primary dysmenorrhea and endometriosis-related pain - A systematic review of registered RCTs.PLoS One · PMID 40257970
	PMS Symptoms	Improves (the measure goes down)			897 people

Valerian

Pain: improves
PMS Symptoms: improves

Valerian: outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People
	Pain Small Improvement	Improves (the measure goes down)	Small effect	1 study	100 people
Studies that measured pain Effects of valerian on the severity and systemic manifestations of dysmenorrheaInt J Gynaecol Obstet · PMID 21959068
	PMS Symptoms	Improves (the measure goes down)		1 study	100 people
Studies that measured pms symptoms The effect of Valerian root extract on the severity of pre menstrual syndrome symptomsJ Tradit Complement Med · PMID 27419099

Boron

Dysmenorrhea Symptoms: improves
PMS Symptoms: changes; see studies

Boron: outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People
	Dysmenorrhea Symptoms Moderate Improvement	Improves (the measure goes down)	Moderate effect	1 study	118 people
Studies that measured dysmenorrhea symptoms Effects of boron supplementation on the severity and duration of pain in primary dysmenorrheaComplement Ther Clin Pract · PMID 25906949
	PMS Symptoms	Changes; see studies			118 people

Krill Oil

Breast Tenderness: improves
Irritability: improves
PMS Symptoms: improves

Krill Oil: outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People
	Breast Tenderness Small Improvement	Improves (the measure goes down)	Small effect	1 study	70 people
Studies that measured breast tenderness Evaluation of the effects of Neptune Krill Oil on the management of premenstrual syndrome and dysmenorrheaAltern Med Rev · PMID 12777162
	Irritability	Improves (the measure goes down)			70 people
	PMS Symptoms	Improves (the measure goes down)			70 people
	Stress Signs and Symptoms	Improves (the measure goes down)			70 people

Ginger (Zingiber officinale)

Dysmenorrhea Symptoms: improves
PMS Symptoms: changes; see studies

Ginger (Zingiber officinale): outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People
	Dysmenorrhea Symptoms Small Improvement	Improves (the measure goes down)	Small effect	1 study	150 people
Studies that measured dysmenorrhea symptoms Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrheaJ Altern Complement Med · PMID 19216660
	PMS Symptoms	Changes; see studies		1 study	70 people
Studies that measured pms symptoms Effect of treatment with ginger on the severity of premenstrual syndrome symptomsISRN Obstet Gynecol · PMID 24944825

Palmitoylethanolamide

Pain

Palmitoylethanolamide: outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Pain No effect		NoneNo effect	1 study	67 people
Studies that measured pain Palmitoylethanolamide (Levagen+) for acute menstrual pain: a randomized, crossover, double-blind, placebo-controlled trial.Women Health · PMID 39910730

Chaste tree

PMS Symptoms: improves

Chaste tree: outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	PMS Symptoms	Improves (the measure goes down)		9 studies	217 people
Studies that measured pms symptoms Treatment of premenstrual tension syndrome with Vitex agnus castus controlled, double-blind study versus pyridoxinePhytomedicine · PMID 23195474 Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS)Arch Gynecol Obstet · PMID 11129515 Efficacy and safety of Vitex agnus-castus extract for treatment of premenstrual syndrome in Japanese patients: a prospective, open-label studyAdv Ther · PMID 24604699 and 6 more on the Chaste tree page

Vitamin B6

PMS Symptoms: improves

Vitamin B6: outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	PMS Symptoms	Improves (the measure goes down)		5 studies	76 people
Studies that measured pms symptoms The effects of vitamin B6 supplementation on premenstrual symptomsObstet Gynecol · PMID 3299182 Pyridoxine (vitamin B6) therapy for premenstrual syndromeInt J Gynaecol Obstet · PMID 17187801 Pyridoxine (vitamin B6) and the premenstrual syndrome: a randomized crossover trialJ R Coll Gen Pract · PMID 2558186 and 2 more on the Vitamin B6 page

Ginkgo Biloba

PMS Symptoms: improves

Ginkgo Biloba: outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	PMS Symptoms	Improves (the measure goes down)		2 studies	143 people
Studies that measured pms symptoms Value of standardized Ginkgo biloba extract (EGb 761) in the management of congestive symptoms of premenstrual syndromeRev Fr Gynecol Obstet · PMID 8235261 A randomized, placebo-controlled trial of Ginkgo biloba L. in treatment of premenstrual syndromeJ Altern Complement Med · PMID 19678774

Lavender

Dysmenorrhea Symptoms: improves

Lavender: outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Dysmenorrhea Symptoms	Improves (the measure goes down)		1 study	44 people

Lemon Balm

Cramps: improves

Lemon Balm: outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Cramps	Improves (the measure goes down)		1 study	110 people

Yarrow

Dysmenorrhea Symptoms: improves

Yarrow: outcomes studied for Primary Dysmenorrhea (Menstrual Cramps)
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Dysmenorrhea Symptoms	Improves (the measure goes down)		1 study	96 people

Key findings

PMS SymptomsCalciumImproves (the measure goes down)
Dysmenorrhea SymptomsVitamin EImproves (the measure goes down)
Anxiety SymptomsSaffronImproves (the measure goes down)

The Primary Dysmenorrhea (Menstrual Cramps) protocol

2 primary supplements · 5 supporting supplements

Magnesium250–400 mg daily, starting a few days before menstruation
Omega-3 Fatty Acids1–2 g EPA/DHA daily

See the full protocol

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Studies cited

4 studies from PubMed

Effectiveness and safety of light therapy for treating primary dysmenorrhea: A systematic review and meta-analysis of randomized controlled trials.Complement Ther Med · PMID 40840565
Comparative Effectiveness of Different Exercises for Reducing Pain Intensity in Primary Dysmenorrhea: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials.Sports Med Open · PMID 38816591
Manual Therapy in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis.J Pain Res · PMID 38736680
Long Term Effects of Acupuncture for Primary Dysmenorrhea: A Systematic Review and Meta-Analysis.J Pain Res · PMID 41114388

Evidence by supplement

Key findings

The Primary Dysmenorrhea (Menstrual Cramps) protocol

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Studies cited

Related conditions

Supplement stack for Primary Dysmenorrhea (Menstrual Cramps)