Menstrual comfort

The traditional advice around the cycle is short and bodily: warmth on the lower belly, rest, a warm infusion. The catalogue lists nine species under this topic in that role — lady's mantle and yarrow as the classic 'women's herbs', with German chamomile, small-leaved lime, lemon balm and raspberry leaf.

Common bistort and fenugreek enter the set from other traditions. The frame is supportive for all of them, not aimed at the hormonal control of the cycle.

Menstrual cramps arise from prostaglandins acting on the uterine muscle. Among home measures the oldest one has the best support — local warmth; among medicines, non-steroidal anti-inflammatories where they can be taken.

For herbs the evidence is thin and differs from preparation to preparation. Pain that has to be overridden every month is, moreover, not a question of which tea to choose but a reason to ask why.

Pain that stops the ordinary day or worsens year on year can mean endometriosis — and the sooner it is named, the better.

Heavy bleeding with clots or with anaemia, bleeding between periods and a sudden change in the length or character of the cycle also belong with a gynaecologist.