Ask a Chinese grandmother what to do about period cramps and the answer is rarely a pill. It is a cup of something hot: ginger simmered with brown sugar, a handful of red dates, perhaps a few goji berries or a spoon of dried longan. It comes with instructions, too. Keep your feet warm. Do not drink anything with ice in it. Skip the watermelon.
These habits travel. They are repeated in Taipei, Kuala Lumpur, Vancouver and San Francisco, usually without anyone asking where they came from or whether they work. This article does both. It explains the idea behind the tradition, lists the ingredients that appear again and again, and then looks at which of them have been put through a trial. The honest summary is that ginger has real evidence behind it, cinnamon and rose tea have a little, and most of the rest is tradition: comforting, low-risk, and untested.
The Tradition of Warmth
Chinese food culture sorts foods by their effect on the body rather than by their temperature on the plate. Some foods are considered warming (ginger, cinnamon, lamb, brown sugar), some cooling (watermelon, cucumber, mung beans, most raw vegetables), and some neutral. The anthropologist Barbara Pillsbury documented how thoroughly this framework governs the postpartum month in her 1978 study of Chinese confinement, "Doing the month", published in Social Science and Medicine: new mothers were kept away from cold foods and cold water and fed warming dishes for weeks. The same logic, scaled down from a month to a few days, governs the period.
The reasoning inside the tradition goes like this. Menstruation is a time when the body is losing blood and is thought to be more open to cold. Cold is believed to slow the flow and tighten things, which is how cramps and clots are explained. Warmth does the opposite: it keeps the blood moving and the pain down. Whether or not you accept the framework, the practical advice it produces is easy to follow and mostly harmless: eat warm, cooked food; drink warm liquids; keep the lower abdomen and feet warm; rest a little more than usual.
The last of those has some unexpected company in modern guidance. The American College of Obstetricians and Gynecologists lists a heating pad or hot water bottle on the lower abdomen among the simplest home measures for period cramps, and warmth applied to the belly is one of the better-supported non-drug approaches in the research on dysmenorrhea, which our article on why period cramps happen covers in detail. The tradition arrived at warmth from a different direction, but it arrived in the same place.
The Kitchen Regulars
Seven ingredients account for most of what gets made in the days around a period. All of them are foods. All of them are easy to find in any Asian grocery, and most in an ordinary supermarket.
Brown sugar ginger tea (红糖姜茶)
The definitive period drink. Fresh ginger, sliced or smashed, simmered in water for ten to fifteen minutes with a lump of dark brown or rock sugar, sometimes with a few red dates thrown in. It is drunk hot, often twice a day in the first days of bleeding. Of everything on this list it is the one with the most research behind it, because the research has been done on ginger (see below). The sugar is traditional rather than functional; a lighter hand with it changes nothing except the sweetness.
Red dates (红枣, jujube)
Dried jujubes are the tradition's all-purpose "blood-nourishing" food, added to teas, congee and soups around a period and throughout confinement. They are naturally sweet, pleasant to simmer with ginger, and a modest source of fiber and potassium. There is no clinical trial of red dates for menstrual symptoms; their place here is cultural and culinary.
Goji berries (枸杞)
Small, slightly sweet and bright orange, goji berries are steeped in hot water or added to soups. The tradition pairs them with red dates and longan in warming teas. As with red dates, they are a food with a long history and no trial specific to periods.
Dried longan (桂圆)
Longan is a lychee-like fruit, dried whole and used in sweet soups and teas. It is considered warming and is a common addition to the ginger tea above. Food, not medicine; no period-specific trials.
Rose (玫瑰花)
Dried rosebuds make a fragrant, gently floral tea that is traditionally offered for low mood and irritability before a period as much as for the period itself. Rose is the one ingredient here besides ginger and cinnamon that has been put into a randomized trial, discussed in the next section.
Cinnamon (肉桂 / 桂枝)
Chinese cooking and Chinese herbal practice use both the bark (rou gui) and the twig (gui zhi) of cinnamon, and both count as strongly warming. Cinnamon twig is also one of the warming ingredients in Wen Jing Tang, the classical recipe traditionally given for cold-pattern cramps. A pinch of ground cinnamon in the ginger tea, or a stick simmered with it, is common. Cinnamon has a small body of trial evidence, also below.
Black sesame, eggs and the "nourishing" foods
Beyond the teas, the traditional period plate leans on foods thought to rebuild what bleeding takes away: eggs (often poached in the ginger tea itself), black sesame, dark leafy greens, liver and red meat. Whatever the framework, that list happens to be rich in iron, which is the nutrient that menstruation genuinely draws down.
What the Evidence Says
Here is where the tradition meets the trial literature. The standard for the claims below is a randomized controlled trial or a systematic review of them, and the quality of each is reported with the finding.
Ginger: the best-supported ingredient
Ginger has been tested for period pain in a series of small randomized trials, mostly from Iran, and pooled in several meta-analyses. A 2016 systematic review in Evidence-Based Complementary and Alternative Medicine by Chen, Barrett and Kwekkeboom identified six trials. In the three that could be pooled against placebo, ginger lowered pain by about 1.5 cm on a 10 cm scale; in the two that compared it with the painkiller mefenamic acid, there was no difference between the two. The authors concluded that ginger "could be an effective treatment for menstrual pain," and in the same paragraph warned that the trials were few, small, of poor methodological quality and highly varied in design.
A 2015 meta-analysis in Pain Medicine by Daily and colleagues reached a similar conclusion from four pooled trials, in which ginger was given at 750 to 2,000 mg a day during the first three to four days of the period. No trial has tested the tea itself; all used powdered ginger in capsules, and what a cup delivers depends on how much root goes in and how long it simmers.
The 2016 Cochrane review Dietary supplements for dysmenorrhoea, by Pattanittum and colleagues, is the most cautious of the lot. Looking across every herb, vitamin and mineral that had been trialed, it found no high-quality evidence that any of them worked, and only low-quality evidence for a handful, ginger among them. So the fair summary is: ginger is the one traditional period ingredient with repeated positive trials, the trials are small and imperfect, and a cup of ginger tea is a reasonable thing to try alongside, not instead of, whatever your clinician recommends.
Cinnamon: one decent trial
A 2015 randomized, double-blind trial at Ilam University of Medical Sciences in Iran gave 114 students with primary dysmenorrhea either cinnamon capsules (420 mg three times a day), ibuprofen (400 mg three times a day) or placebo for the first 72 hours of their period. Both cinnamon and ibuprofen reduced pain severity and duration compared with placebo; ibuprofen worked faster, and by eight hours there was no significant difference between the two. One trial in one population is not a verdict, but it is more than most kitchen ingredients can claim.
Rose tea: a single Taiwanese trial
In 2005, researchers in Tainan randomized 130 adolescents with primary dysmenorrhea to drink rose tea daily for 12 days around their period over six months, or to a control group. The rose tea group reported less menstrual pain, distress and anxiety at one, three and six months. The trial was not blinded (you cannot hide a cup of rose tea), so expectation may explain some of the effect. It is, nonetheless, the only trial of rose tea for periods, and it was positive.
Everything else
Red dates, goji, longan and brown sugar have no trials for menstrual symptoms. That is not evidence they do nothing; it is an absence of evidence, which is a different thing, and it is the honest label for most of what the tradition recommends. They are foods, they are pleasant, and the warm cup they go into is itself a small comfort.
Nutrients Worth Knowing About
Iron
Menstruation is the main reason women of reproductive age need more iron than men. The National Institutes of Health sets the recommended daily allowance for women aged 19 to 50 at 18 mg, more than twice the 8 mg for men, and heavy periods push needs higher still. Iron from meat, poultry and fish is absorbed well; iron from plants (lentils, tofu, dark leafy greens, black sesame) is absorbed less well but better with vitamin C alongside. The traditional "nourishing" period plate of eggs, greens and liver is, in modern terms, an iron-replacement meal.
Magnesium
Magnesium is often suggested for premenstrual bloating and cramps. The evidence is thin and old. A 1998 crossover trial of 38 women found that 200 mg a day of magnesium reduced premenstrual symptoms of fluid retention (bloating, breast tenderness, swelling), but only in the second month of taking it and not in the first. Nothing larger has settled the question since. Magnesium-rich foods (nuts, seeds, beans, whole grains, dark chocolate) are a reasonable place to start before anyone reaches for a magnesium supplement.
Omega-3 fats
A 2022 meta-analysis of randomized trials in the European Journal of Clinical Pharmacology found that omega-3 fatty acids reduced the severity of primary dysmenorrhea, with a large pooled effect and, as usual in this field, considerable variation between trials. The mechanism is plausible: omega-3s compete with the fatty acids that the body turns into the prostaglandins that drive cramps. Oily fish twice a week is the food version.
Calcium
Calcium has the best evidence of any nutrient for premenstrual symptoms, with a large trial behind it; our article on PMS goes through it. The Office on Women's Health summarizes the position as "studies show that calcium can help reduce some PMS symptoms, such as fatigue, cravings, and depression," and points to milk, cheese and yogurt as sources. Tofu set with calcium, canned fish with bones, and leafy greens work for those who do not do dairy.
Vitamin B1 (thiamine)
One large 1996 trial in India gave 556 girls with moderate to severe cramps 100 mg of thiamine daily for 90 days and reported dramatic improvement. It has never been repeated, which is why the Cochrane reviewers file it under low-quality evidence. Worth knowing about; not worth building a plan on.
A Simple Week-Before Menu
Pulling the tradition and the evidence together, here is what a sensible week before and during a period looks like. Nothing on it comes in a capsule, and all of it is food you would eat anyway. It is an illustration of how the pieces fit together, not a plan to follow.
| When | What | Why |
|---|---|---|
| Every morning, the week before | A warm breakfast: congee or oats with red dates and a few goji berries, or eggs with greens | Warm, cooked food is the tradition's first rule; the eggs and greens cover iron |
| Mid-afternoon | A cup of ginger tea (fresh ginger simmered 10 to 15 minutes), with or without brown sugar; swap in rose tea some days | Ginger has the best trial evidence of any traditional ingredient; rose has one positive trial |
| Dinner, twice a week | Oily fish (salmon, mackerel, sardines) with vegetables | Omega-3 fats, which a 2022 meta-analysis linked to less period pain |
| Snacks | A handful of nuts or pumpkin seeds; yogurt or a glass of milk; a square of dark chocolate | Magnesium and calcium from food rather than capsules |
| Day 1 to 3 of the period | Ginger tea morning and evening; a hot water bottle on the lower abdomen; lighter, warm meals | Where the ginger trials concentrated their dosing; warmth is the tradition's answer and a supported home measure |
| All week | Go easy on caffeine, salt and sugar | The Office on Women's Health advises avoiding them in the two weeks before a period |
The Fourth Trimester makes teas from dried culinary and herbal ingredients, drawn from recipes traditionally prepared in China around the menstrual cycle. That is the tradition behind our Premenstrual Tea.
Explore the Menstrual Cycle rangeWhat to Go Easy On
The tradition's list of things to avoid is long and includes most raw fruit, anything from the fridge, seafood, and in some families bananas and pears. Modern guidance is shorter. The Office on Women's Health says that avoiding foods and drinks with caffeine, salt and sugar in the two weeks before a period may lessen many PMS symptoms, and recommends regular aerobic activity and about eight hours of sleep a night. Caffeine can worsen breast tenderness and sleep, salt holds fluid at a time the body is already holding fluid, and sugar highs and crashes amplify the mood swings of the luteal phase, which our luteal phase article explains.
Alcohol is worth a mention the tradition does not make: it disturbs sleep, which is already fragile before a period, and it is a diuretic, which does nothing for bloating. None of this means abstinence. It means that the week before a period is a poor time for a third coffee or a salty takeout, and a good time for a hot cup of something from the list above.
When to Talk to a Clinician
Food and tea belong to the "mild and ordinary" end of period symptoms. See a clinician if your pain is severe enough to stop you working or sleeping, if it is new or getting worse, if it does not respond to over-the-counter painkillers, if your periods are very heavy (soaking a pad or tampon every hour, or passing clots the size of a quarter or larger), if you bleed between periods, or if you have pain during sex. These can be signs of endometriosis, fibroids or other conditions that no tea will address and that respond well to care once diagnosed. If you take blood thinners, are pregnant or trying to conceive, or have a condition you are managing, ask before adding any herb, including ginger and cinnamon in larger-than-culinary amounts, to your routine.
Frequently Asked Questions
Does ginger tea help with period cramps?
Several small randomized trials and meta-analyses suggest ginger reduces period pain, with effects in some trials comparable to the painkiller mefenamic acid. The trials used ginger powder in capsules rather than tea, were small and of limited quality, and the 2016 Cochrane review rated the evidence low. A daily cup of fresh ginger tea during the first days of a period is a reasonable, low-risk thing to try.
Why does Chinese tradition avoid cold food during a period?
Chinese food culture classifies foods as warming, cooling or neutral by their effect on the body. Menstruation is seen as a time when the body is losing blood and is vulnerable to cold, which is believed to slow the flow and worsen cramps, so cold and raw foods are avoided and warm, cooked foods and hot drinks are favored. The practice is traditional rather than proven, though warmth on the abdomen is a supported home measure for cramps.
What should I eat the week before my period?
Warm, cooked meals with iron-rich foods such as eggs, greens, lentils or red meat; oily fish twice a week for omega-3 fats; calcium from dairy, calcium-set tofu or leafy greens; nuts and seeds for magnesium; and a daily cup of ginger or rose tea. Go easy on caffeine, salt and sugar, which the Office on Women's Health advises limiting in the two weeks before a period.
References
Pillsbury, B.L.K. (1978). "Doing the month": confinement and convalescence of Chinese women after childbirth. Social Science and Medicine, 12(1B), 11-22. PubMed
American College of Obstetricians and Gynecologists. Dysmenorrhea: Painful Periods (FAQ). ACOG
Chen, C.X., Barrett, B. & Kwekkeboom, K.L. (2016). Efficacy of oral ginger (Zingiber officinale) for dysmenorrhea: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2016, 6295737. PMC
Daily, J.W., Zhang, X., Kim, D.S. & Park, S. (2015). Efficacy of ginger for alleviating the symptoms of primary dysmenorrhea: a systematic review and meta-analysis of randomized clinical trials. Pain Medicine, 16(12), 2243-2255. PubMed
Pattanittum, P. et al. (2016). Dietary supplements for dysmenorrhoea. Cochrane Database of Systematic Reviews, 3, CD002124. PubMed
Jaafarpour, M., Hatefi, M., Khani, A. & Khajavikhan, J. (2015). Comparative effect of cinnamon and ibuprofen for treatment of primary dysmenorrhea: a randomized double-blind clinical trial. Journal of Clinical and Diagnostic Research, 9(4), QC04-QC07. PubMed
Tseng, Y.F., Chen, C.H. & Yang, Y.H. (2005). Rose tea for relief of primary dysmenorrhea in adolescents: a randomized controlled trial in Taiwan. Journal of Midwifery and Women's Health, 50(5), e51-e57. PubMed
National Institutes of Health, Office of Dietary Supplements. Iron: Fact Sheet for Health Professionals. NIH ODS
Walker, A.F. et al. (1998). Magnesium supplementation alleviates premenstrual symptoms of fluid retention. Journal of Women's Health, 7(9), 1157-1165. PubMed
Mohammadi, M.M., Mirjalili, R. & Faraji, A. (2022). The impact of omega-3 polyunsaturated fatty acids on primary dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials. European Journal of Clinical Pharmacology, 78(5), 721-731. PubMed
Gokhale, L.B. (1996). Curative treatment of primary (spasmodic) dysmenorrhoea. Indian Journal of Medical Research, 103, 227-231. PubMed
Office on Women's Health, U.S. Department of Health and Human Services. Premenstrual syndrome (PMS). womenshealth.gov