DYSMENORRHEA

What is dysmenorrhea?

Dysmenorrhea (menstrual cramps) is the medical term for pain associated with menstruation. Simply put menstrual pain. It is the most common menstrual disorder; and the pain usually occurs in the lower abdomen.
For some women, the discomfort is mild and merely annoying and for others, severe enough to interfere with everyday activities for a few days every month.

Types of dysmenorrhea

There are two types of dysmenorrhea: "primary" and "secondary".

Primary dysmenorrhea

 This is common menstrual cramps that are recurrent and are not due to other diseases. Pain usually begins 1 or 2 days before, or when menstrual bleeding starts, and is felt usually in the lower abdomen. Pain typically last 12 to 72 hours, and may be accompanied by nausea, vomiting, fatigue, and even diarrhea. Common menstrual cramps usually become less painful with age and may stop entirely after childbirth.

Secondary dysmenorrhea

This is a pain that is caused by a disorder in the woman's reproductive organs. Pain usually begins earlier in the menstrual cycle and lasts longer than common menstrual cramps(primary). The pain is not typically accompanied by nausea, vomiting, fatigue, or diarrhea. Conditions that can cause secondary dysmenorrhea amongst others include:

Ø  Endometriosis - A condition in which the tissue lining the uterus (the endometrium) is found outside of the uterus.

Ø  Fibroids  - Growths on the inner wall of the uterus

Ø  Adenomyosis – A condition where the lining of the uterus grows into the muscle of the uterus.

Ø  Pelvic inflammatory disease - An infection caused by bacteria that starts in the uterus and can spread to other reproductive organs.

Ø  Cervical stenosis - Narrowing of the opening to the uterus

Risk factors

Ø Age less than 30

Ø Early puberty, at age 11 or younger

Ø  Heavy bleeding during periods (menorrhagia)

Ø Irregular menstrual bleeding (metrorrhagia)

Ø A woman who has never given birth

Ø Family history of dysmenorrheal

Ø Smoking

 Symptoms of dysmenorrhea

Ø  Throbbing or cramping pain in your lower abdomen that may be intense

Ø  Dull, constant ache

Ø  Pain that radiates to your lower back and thighs

Some women may also experience:

Ø  Nausea

Ø  Loose stools

Ø  Headache

Ø  Dizziness

What causes common menstrual cramps?

Menstrual cramps are caused by contractions (tightening) in the uterus (womb) by a chemical called prostaglandin. The uterus contracts throughout a woman's menstrual cycle and more strongly during menstruation. This can result in the uterus pressing against nearby blood vessels, cutting off the supply of oxygen to the muscle tissue of the uterus. Pain usually results when part of the muscle (uterus) briefly loses its supply of oxygen.

Treatment

Menstrual cramps are treatable. The following may be recommend:

Ø  Pain relievers - such as acetaminophen, ibuprofen or naproxen sodium starting the day before you expect your period to begin.

Ø  Hormonal birth control. Oral contraceptive pills (OCPs) contain hormones that prevent ovulation and reduce the severity of menstrual cramps.

Ø  Surgery - menstrual cramps caused by an underlying disorder, such as endometriosis or fibroids, can be corrected by surgery and may help reduce symptoms. Surgical removal of the uterus (Hysterectomy) also may be an option if you're not planning to have children.

Ø  Other treatment modalities will be dependent on the cause as in secondary dysmenorrheal.

 Lifestyle and home remedies

Things you may want to try at home include

Ø  Place a heating pad or hot water bottle on your lower abdomen or back.

Ø  Rest when needed and reduce stress.

Ø  Avoid foods that contain caffeine.

Ø  Avoid smoking and drinking alcohol.

Ø  Massage your lower back and abdomen.

Ø  Exercise may ease the pain of menstrual cramps.

Alternative medicine

These haven’t been well-studied for treating menstrual cramps, however, they include:

Ø  Acupuncture

Ø  Transcutaneous electrical nerve stimulation(TENS)

Ø  Herbal products such as fennel, pycnogenol etc.

Ø  Acupressure

If you have severe or unusual menstrual cramps or cramps that last for more than two or three days, contact your health care provider. If secondary dysmenorrhea is suspected, further tests may be needed.  Both primary and secondary menstrual cramps can be treated, so it's important to get checked.