When you can't sleep around your period, every month

What follows combines several patients' visits into one composite story. It is not about any one person, and anything that could identify someone has been removed.

How do patients usually come to us?

Patients tell us it always takes them a long time to fall asleep, but around their period it gets especially bad, and they wake two or three times before dawn.

About a week before, they become irritable, their appetite rises, and their breasts and lower back feel heavy; then lower back pain continues until the second day of their period.

Painkillers don't work as well as they used to, and they tried sleep aids, but the grogginess the next day was even harder.

Why look at sleep and period pain together?

Because often they're not two separate problems but come from the same place. When the blood's ability to circulate weakens, it shows up in both.

When circulation in the lower belly slows, strain builds up in the muscles and ligaments around the uterus, and the pain spreads to the lower back. At night, the same state shows up as shallow sleep.

What do we look at?

We gently press on the belly. We check whether there's tenderness over the digestive area and whether the lower belly feels knotted.

We also look at the color inside the lower eyelids. If it's pale with almost no red, we read it as the blood not doing its job well.

In Korean medicine, this state is called blood deficiency.

We also ask about mealtimes. Many have been unable to eat on time and have lived on delivery food for a long time. Then absorption slows and the whole body wears out.

How do we treat it?

We work on both building up the blood so it can do its job and helping circulation in the lower belly. We don't just aim to suppress the pain.

We see setting regular mealtimes as part of treatment. If absorption is sluggish, whatever you take in gets used less.

If you're taking sleep aids, we won't tell you to stop. Once your sleep becomes stable, cutting back can be discussed with the doctor who prescribed them.

How did things go?

For many, everyday sleep changes first. Pain around the period tends to change little by little over several cycles.

So we don't judge by just one cycle. We look at it together over several.

What are the limits of this approach?

Period pain has other causes too, such as uterine fibroids or endometriosis. What we look at is one of those paths.

If the pain suddenly gets much worse, the amount of bleeding changes a lot, or you have pain unrelated to your period, see an OB-GYN first.

To people with the same symptoms

1. Sleep problems and period pain often come from the same place.
2. When circulation in the lower belly slows, the pain spreads to the lower back.
3. The color of the lower eyelids can give us some clues.
4. We won't tell you to stop the sleep aids you're taking.
5. If the pain suddenly worsens or bleeding changes, see an OB-GYN first.

We start by sorting out what kind of insomnia it is. Trouble falling asleep and waking up during the night point to different places to look.

If sleep problems are wrecking your days, come see us once. We start by sorting out whether you can't fall asleep or keep waking up. Each points to a different place to look.

There are many possible causes, so the same treatment can lead to different courses for each person.