Nutrients in the treatment of dysmenorrhea
In the 1950s, Hudgins reported the results of open trials which suggested that niacin supplementation provided relief of menstrual cramps for about 90% of women whose cramps had been severe enough to require bed rest, heavy sedation or loss of time from work. (1)
Hudgins prescribed 100 mg of the nutrient twice daily and at least 100 mg every 2 to 3 hours during cramps. He believed that the dosage should produce flushing--although he found in a preliminary trial that niacinamide (which does not produce flushing) seemed to work as well. He also believed that the efficacy of niacin was enhanced by the addition of ascorbic acid 300 mg daily and rutin 60 mg daily, and suggested that, by improving capillary permeability, they enhanced the vasodilating effect of the niacin.
Unfortunately, his work was never confirmed by randomized trials, although his extremely high success rate makes it likely that the response was more than a placebo effect.
A group of 556 young women in India with moderate to very severe primary spasmodic dysmenorrhea received thiamine hydrochloride 100 mg daily and placebo in random order for 90 days each. When the results of the 2 active treatment groups were combined, it was found that 87% of the women were completely cured, while for 8% the pain was reduced to almost gone. Moreover, 2 months later, the improvements remained, causing the investigator to suggest that the treatment was curative. (2)
These findings are consistent with those of open trials which found thiamine to have an analgesic effect, although those studies employed much higher dosages. However, thiamine deficiency is fairly common in India, so it is possible that the nutrient is only effective when repleting a deficiency.
In 1955, Lancet published a...