For MENSTRUAL CRAMPS, vitamin B6 has anti-inflammatory and antioxidant effects which lower cramp-inducing inflammation caused by certain prostaglandins. Vitamin B6, pyridoxine, occurs in the body as its active form pyridoxal 5’-phosphate (P5P) and is necessary for multiple metabolic processes within the body. Depletion of vitamin B6 can lead to increased symptoms of menstrual cramping. Clinically, vitamin B6 has a long history as an effective treatment for menstrual pain.
Menstrual cramps are related to the release of certain hormone-like substances known as prostaglandins just before and during menstrual periods. Overproduction of some varieties of prostaglandins within the endometrium is the classic explanation for painful menstrual cramps. Women with dysmenorrhea, or painful periods, often have higher levels of prostaglandins than their pain-free friends.1 Prostaglandins, which increase at the onset of menstruation, will increase inflammation in the body.
For some women with menstrual cramps, painful spasms could result from a build-up of prostaglandins when they are not efficiently cleared. Normal uterine contractions taking place during the period tend to inhibit blood flow to the uterus lining and stronger muscle action can cause throbbing or cramping pains in the lower abdomen. Particular prostaglandins can lead to the muscle tissues of blood vessels and of the uterine wall tightening and cramping excessively, contributing to more pain.
While long supported clinically, there is also ample scientific evidence for taking vitamin B6 for menstrual cramps. One study showed that B6 levels of at least 50mg daily, possibly enhanced by magnesium 200mg daily, seemed to relieve cramping and related anxiety and other symptoms.2 Our patients see positive results for relief of menstrual cramps with daily doses of 25-30mg vitamin B6 including 2-4mg of pyridoxal 5’-phosphate, which may be enhanced by vitamin B5 200-250mg.
The liver breaks down estrogen into one of three metabolites and vitamin B6 encourages estrogen to break down into a more gentle and balancing form. By reducing estrogen dominance, menstrual cramps are diminished. Vitamin B6 is essential for hormone balance, energy release from carbohydrate breakdown, and immune function. It specifically helps with clearing estrogen, progesterone, and testosterone, so a vitamin B6 deficiency can lead to an imbalance of these hormones away from their ideal proportions.
Vitamin B6 has also been shown to decrease menstrual cramps, in studies including at least one randomized controlled trial. A likely mechanism for this is the reduction of estrogen levels, and restoring a good progesterone to estrogen ratio. Elevated estrogen levels with respect to progesterone have been found in women who experience menstrual cramps, compared to women without dysmenorrhea. Vitamin B6 helps to reduce estrogen in proportion to other metabolites so the body can naturally stabilize hormone levels. In one research study, sixty-three women aged 18-49 years with moderate to severe cramps entered a seven-month trial of pyridoxine (vitamin B6) at a dose of 50 mg per day. Of the thirty-two who completed the study, all reported a “significant beneficial effect in symptoms.3
Vitamin B6 is needed for serotonin production which, when low, has been linked to worsened menstrual cramps. Also, B6 is necessary for detoxification processes of the liver which assists in lowering inflammation levels and improved hormone function. Pyridoxine is critical for the production of proteins and other structural molecules; for neurotransmitters and formation of the myelin sheath that wraps around nerve fibers; and for synthesis of hemoglobin, red blood cells, and anti-inflammatory prostaglandins. Impairment of any of these functions can exacerbate menstrual pain.
Vitamin B6 has been associated with lowered plasma levels of C-reactive protein, an indicator of inflammation. It has also been associated with lowered homocysteine levels, another marker of inflammatory activity. B6 also has been shown to have free radical scavenging activities, all of which helps to explain its beneficial effects on menstrual cramps.
Daily doses of B6 can vary, and overdosing should be avoided. Our patients see positive results for menstrual cramps with daily doses of vitamin B6 25-30mg. This can be enhanced by 2-4mg of pyridoxal 5’-phosphate, or vitamin B5 200-250mg.
Vitamin B6 25-30mg, best taken with breakfast or lunch as B-vitamins occasionally increase alertness, which is not ideal at bedtime; or as directed by your healthcare provider.
- Doty, Elizabeth, and Marjan Attaran. “Managing primary dysmenorrhea.” Journal of pediatric and adolescent gynecology 19.5 (2006): 341-344.
- De Souza MC, Walker AF, Robinson PA, Bolland K. A synergistic effect of a daily supplement for 1 month of 200 mg magnesium plus 50 mg vitamin B6 for the relief of anxiety-related premenstrual symptoms: a randomized, double-blind, crossover study. J Womens Health Gend Based Med 2000;9:131-9.
- Doll, Helen, et al. “Pyridoxine (vitamin B6) and the premenstrual syndrome: a randomized crossover trial.” JR Coll Gen Pract 39.326 (1989): 364-368.
- Friso S, Jacques PF, Wilson PW, et al. Low circulating vitamin B(6) is associated with elevation of the inflammation marker C-reactive protein independently of plasma homocysteine levels. Circulation 2001;103:2788-91.
- Whelan, A. M., Jurgens, T. M., and Naylor, H. Herbs, vitamins and minerals in the treatment of premenstrual syndrome: a systematic review. Can.J.Clin.Pharmacol. 2009;16(3):e407-e429.
- Zahradnik HP, Breckwoldt M. Contribution to the pathogenesis of dysmenorrhea. Archives of gynecology. 1984;236(2):99-108.