Peruth Niyonzima says menstrual periods had become a nightmare for her as they came with nausea, general body weakness, and even diarrhorea that at some point she doubted what her doctor told her that this was natural in women.

Also known as dysmenorrhea or ‘difficult menstruation’, this condition comes when the uterine lining sheds as menstruation and there are very painful contractions by the uterus during the process.

Rachna Pande, a specialist in internal medicine, says dysmenorrhoea can be primary or secondary.

She explains that primary dysmenorrhoea occurs due to hormones and chemical mediators of inflammation, whereas secondary dysmenorrhoea occurs due to pelvic infections, endometriosis, adenomyosis, intrauterine device used for contraception and uterine fibroids, among others, and is common at any age, from menarche to menopause.

She advises that with such conditions, one needs to go for diagnosis and be treated; otherwise the pathological condition can grow.Dr Alba Mayele, from Doctor’s Plaza in Kimironko, Kigali, says that the pain may be localised to the lower abdomen, but it can also be in the lower back, vulva, as well as radiating down the thighs.

"This wave-like pain is often accompanied by headache, dizziness, nausea, vomiting, and diarrhea in some women,” he says.

Mayele adds that the pain can begin up to 24 hours before menses and usually lasts for the first 48 hours once menses begin. In some women the pain may last up to 72 hours once menses begin.

Pande clarifies that with the primary dysmenorrhoea, the condition may improve with birth of the first child and that despite of the pain there is no known health risks associated with painful menstrual pains at this stage.

However, experts say with good nutritional habits and exercise, menstrual cramping can be treated and that one can be relieved of this problem forever.According to Dr Daniel Gahungu, a general practitioner at Polyclinic de l’Etoile in Kigali, getting adequate nutritious foods daily should be top priority.

Gahungu says that, considering that dysmenorrhea is an inflammatory state in the body, it is important to avoid foods that increase inflammation response such as high glycemic foods, including prostaglandin F2-alpha, which are known to increase levels of inflammatory chemicals in the body.

He also says that women who face this problem may consider eliminating dairy products from their diet, explaining that they are congesting to the body and that many doctors have seen a reduction in menstrual cramp pain in women who eliminated dairy products.

"If one chooses dairy products, then she should try to purchase organic raw dairy only to avoid added hormones,” says Gahungu.

Women are advised to also avoid refined carbohydrates and stick to whole grains like oats, millet and brown rice, among others. Only three servings of grains at most a day is recommended.

Gahungu also cautions women to eliminate sugary foods and processed sugar and maybe choose a sweetener if they cannot do away with sugar.

"Red meat and egg yolk consumption should also be reduced to at most 2-3 times a week as these are high in arachidonic acid (AA), which has been found to increase cellular inflammation in some people,” he adds.

Experts also say that, since magnesium deficiency is a leading cause of menstrual cramps, women should ensure to eat foods rich in magnesium to relax muscle tissue which reduces menstrual cramping greatly.

Taking in Omega 6 fatty acids like borage oil and evening primrose oil can boost fertility by improving reproductive cell structure, decrease risk of inflammation and improve the condition of organs in the body.

Pande says eating a lot of fresh fruits and vegetables such as ginger, mint, aloe vera, basil and carrots, which are rich in vitamin A, helps in reducing menstrual pain naturally.

Mayele also adds that hot fomentation in addition to antispasmodic, anti inflammatory drugs, are also known to be useful in relieving dysmenorrhoea.