Many women reach for over-the-counter medication when they have menstrual woes. However, doing so can lead to other health problems such as stomach bleeding or liver trouble. Are there any ways women can manage their menstrual cycles holistically?

Absolutely! It all begins with knowing the signs something is wrong and then identifying how to treat the underlying problem. Here are 12 tips I used to manage my period problems holistically. May they help you find relief as well.

1. Recognize the Signs of PMS

Do you find yourself growing moody month after month? If so, this is one important sign your hormones need attention. Other signs of PMS include:

• Teenage women tend to break out on their foreheads whereas women over 20 often break out in chin zits once per month (my curse). The occasional pimple or two indicates nothing more than a clogged comedo, or pore. However, sizable breakouts may indicate an underlying hormonal imbalance.
• Weight gain. If you typically gain weight before your period, it could be bloating, or it could indicate insulin resistance. Examining your diet may provide answers. Diets high in refined carbohydrates and alcohol often lead to the condition.
• PMS increases the amount of androgen your body produces. This is the female equivalent of male testosterone, so if you find yourself testy before your period, blame your hormones (and gain a greater understanding of males who feel this way all the time).
• Women with PMS often feel more blue or anxious than normal before their periods. Feeling suicidal, however, suggests you suffer from premenstrual dysphoric disorder, a more serious medical condition, so seek professional care.

2. Understand the Underlying Causes

If you suffer from an unusually heavy menstrual flow, an underlying disorder may cause your troubles. The average menstrual period lasts between 2-7 days and uses no more than one pack of regular tampons, so if you’re bleeding more than that, it’s time to give your OB/GYN a call.

If your bleeding persists for 10 days or more or is unusually heavy, you may suffer from uterine fibroids, polycystic ovarian syndrome or a host of other ailments. This proves particularly true if your heavy bleeding comes replete with overwhelming fatigue, gastrointestinal distress or severe cramping. If you’re young and trying to conceive, certain conditions can impact your overall fertility so do not delay the appointment.

3. Follow a Plant-Based Diet

Multiple studies confirm the benefits of a plant-based diet for human health. When farmers raise animals for slaughter, they often treat them with hormones which carry over to the humans who consume them. Therefore, consuming meat, particularly at certain times during your cycle, can lead to additional distress. To get healthy plant-based protein, up your intake of vegetables during your menstrual cycle, particularly iron-heavy vegetables like broccoli.

If you do choose to eat more plant-based foods, exercise caution with those containing soy. You may benefit from additional consumption if you’re trying to extend the length of your cycles, not trying to conceive. However, for women hoping to get pregnant, soy consumption can lead to decreased production of follicle stimulating hormone (FSH). This suppresses egg production and maturation in a study conducted by the American Journal of Clinical Nutrition.

4. Consume More Calcium

One recent double-blind study indicated supplementing with calcium during PMS and menstruation may ease symptoms. If you follow a vegan diet, discuss the best supplement to take with your physician. Some supplements extract calcium entirely from plant-based sources such as deep, leafy greens.

If you consume dairy, upping your consumption in the week prior to your period can ease symptoms. You need not consume much extra — an additional serving of cheese or yogurt suffices. Yogurt also contains probiotics, which further ease menstrual bloating and gastrointestinal discomfort.

5. Eat More Fiber

My RN sister and I often joke about the “periodic poops.” Contractions in the uterus due to menstruation can stimulate nerves in other parts of the abdominal cavity, leading to more frequent urges to go. Combined with the need for the body to shed excess water weight, and this can get messy.

Save yourself toilet-scrubbing time by upping your fiber intake prior to your period and throughout the cycle. Fiber adds bulk to number two, meaning less diarrhea if you’re prone to it during this time of month. If you find fiber makes you gassy, try gradually adding more into your diet.

6. Make Omega-3’s Your Friend

Omega-3 fatty acids are crucial for brain health, meaning if you suffer mood swings during your cycle, you do well to stock up on eggs, fatty fish and avocados (especially if you’re vegan or vegetarian on the latter). A recent Danish study indicated menstrual discomfort decreased in women who took a daily fish or seal oil supplement. Brussel sprouts, walnuts, flaxseed and hemp seed oil provide additional plant sources of these vital nutrients.

7. Go Under the Needle

Acupuncture can relieve a host of ailments including PMS and menstrual distress. Acupuncture works on a meridian of chi, or vital energy, which runs through the body. The practice enjoys a long history of success in Asian medicine and comes with no side effects, so why not give it a go?

I tried acupuncture a few years ago for menstrual relief. I’m afraid of needles, so the experience made me anxious from the get-go. However, the stickers truly were so tiny, I felt no discomfort during insertion, and after the practitioner placed them, I fell immediately into a deep R.E.M. sleep cycle. I awoke feeling much better with my pain all but gone.

I highly recommend acupuncture for treating menstrual pain, as it comes free from the risk of stomach bleeding or liver damage over-the-counter medications carry. If nothing else, you’ll score a sweet 30-minute nap out of the deal!

8. Try Getting Frisky

The rumors are true: having an orgasm can alleviate menstrual pain. Orgasm causes the uterus to contract, but in a different fashion. After the rapid-fire throbbing of sexual relief, the organ relaxes a bit, easing painful cramps.

No partner? No problem. A host of toys exist on Amazon to give you a little solo pleasure. And since the retail giant already packs their wares in plain, discreet packaging, there’s no need to worry your neighbors will spy your new little friend laying on your porch while you’re at work. I will not confirm nor deny allegations I’ve used this method successfully — but I will tip a wink.

9. Massage Away Pain

Honestly, who doesn’t love a good massage? Even if the therapist (or your partner) doesn’t kneed your belly like a purring Tom cat, you can’t help but feel relief from another’s healing hands.

This is, honestly, my favorite holistic method of relief for menstrual pain. Even if I can only afford a 10-minute shoulder rub at a mall kiosk, I come away feeling pampered. And having someone touch you like you’re the only girl in the world boosts your mood instantly, so if you’ve got the menstrual blues, give this cure a try. For added benefit, have the loving hands include a touch of essential oil in with the carrier. Which leads us to…

10. Turn to Aromatherapy

Yes, aromatherapy truly can help alleviate menstrual pain. To be honest, I don’t know if my own relief with this method stems from masking the scent of my coworkers’ stinky reheated cod or the therapeutic aroma itself. However, science offers some answers.

In one Turkish study, lavender essential oil significantly reduced the menstrual pain of 156 students who received massage using it. Other oils you can try include cinnamon, which reduces inflammation in the body when taken internally, or rose oil, the gentle scent of which improves mood and reduces stress as well. If anxiety comes as a part of your period, try bergamot or ylang-ylang as well, as anecdotal evidence supports the use of both in easing symptoms.

11. Herbal Teas Can Help

Did you know most medications stem from plants? I realize I’m a bit of an odd duck as an amateur herbalist, but considering such preparations have a history stemming before the written word, I take confidence in certain remedies.

If stomach upset is one of your symptoms, try ginger tea. Ginger enjoys a long history with herbalists, but many commercial colas contain no real ginger at all. A single root costs mere pennies at farmers markets and groceries, so brew your own at home.

Raspberry leaf tea can alleviate muscle spasms, including smooth muscle like the uterus. The leaf enjoys popular use in Europe for managing female hormonal health. Cramp bark also alleviate spasms in smooth muscle tissue, and trusty chamomile calms frazzled hormonal nerves.

12. Reach for the Hot Water Bottle

Your grandmother was correct — a hot water bottle truly alleviates menstrual cramping and pain. If using one in the workplace causes raised eyebrows among ignorant male colleagues, you can tuck one between your shirt and belly to hide it from view but still reap the benefits. Warmth greater than 40 degrees Celsius turn on heat receptors instead of pain ones in the area of the body where applied. Hot water bottles also work at night when the use of electric heating pads and blankets proves inadvisable due to fire risk.

Regulating Your Menstrual Cycle Holistically

Menstrual discomfort can cause lost days at work, decreased productivity and an overall negative outlook. However, by following the tips above, you can alleviate this pain without the use of drugs complete with harmful side effects.