Dysmenorrhoea or painful menstruation means menstrual periods accompanied by sharp, irregular, or dull aching pain, usually in the lower abdomen. Pain starts several days before menstruation or may accompany it, and usually lessens as menstruation progresses. It may coexist with excessively heavy blood loss (menorrhagia). The pain is severe enough to limit normal activities & requires medication.
What are the Types and Features of Dysmenorrhoea?
Dysmenorrhoea can be of two types:
Primary dysmenorrhea refers to menstrual pain that occurs in otherwise healthy women. The pain is fluctuating spasmodic or 'labor-like' cramp. This type of pain is not related to any specific problems with the uterus or other female reproductive organs. Symptoms begin within or shortly (6 months) after the first menstrual period (menarche). It begins a few hours before or with menses and is most intense during the first 24-36 hours. It lasts for 2-3 days. The pain generally occurs in the lower abdominal region and may spread to the thighs and back. There could be associated nausea, vomiting, dizziness, or diarrhea.
Secondary dysmenorrhoea or congestive dysmenorrhoea is menstrual pain that is caused due to some underlying disease or structural abnormality either within or outside the uterus (e.g., pelvic inflammatory disease, fibroids, endometriosis, retroverted uterus, etc.). Symptoms begin at a later age, approximately 2 or more years after the first period. The pain begins several hours before menses. There could be a history of IUCD (intrauterine contraceptive device) or repeated pelvic infection or presence of a pelvic disease or structural abnormality on examination.
What is the Cause of Dysmenorrhoea?
Primary dysmenorrhoea occurs during regular menstruation due to increased cramping of the uterine muscle. Chemicals named prostaglandins, released during menstruation, are thought to be a major factor in primary dysmenorrhoea. Secondary dysmenorrhoea can be caused due to an underlying disease or structural abnormality.
Is Dysmenorrhoea common?
The incidence of dysmenorrhoea is greatest in women in their late teens and 20s, then declines with age. It affects approximately 50% of menstruating women, and 15% are unable to perform daily routine activities for up to 3 days. It is the leading cause of lost time from school and work among women of childbearing age. Although some pain during menstruation is normal, excessive pain is not. Smoking, depression, anxiety, disruption of social networks, and heavy menses, all can increase the risk of dysmenorrhoea.
What are the Symptoms of Dysmenorrhoea?
Pain is the main symptom of dysmenorrhoea, which could be cramping pain or a dull ache, but many women may experience other symptoms, including:
How is Dysmenorrhoea Diagnosed?
The cause, of dysmenorrhoea, is determined by medical history, including the symptoms of menstrual cycles and a pelvic examination. Based on these results, the doctor may suggest some additional tests such as certain blood tests, ultrasonography, etc. to rule out any abnormalities related to the female reproductive organs, etc.
How is Dysmenorrhoea Treated?
· Take plenty of fluids like water, fruit juices, coconut water, etc. before your periods.
· Exercising regularly, aerobic workouts such as walking, jogging, biking, or swimming, help produce chemicals that block pain and can make one feel better.
· A warm bath or a heating pad or hot water bottle on the abdomen can be soothing.
· Make sure you get enough sleep before and during your periods to help cope with any discomfort.
· Meditate or practice yoga that can help cope with pain.
· Treatment may also include medications called NSAIDs (non-steroidal anti-inflammatory drugs), that prevent the formation of prostaglandins, thus making cramps less severe. NSAIDs work best if taken at the first sign of your period or pain. They should usually be taken for only 1 or 2 days and alcohol should be avoided during this time. Women with bleeding disorders, liver damage, stomach disorders, or ulcers should not take NSAIDs.
· Other medications are those that relax the muscles of the uterus. In some cases, a mix of treatments works best.
· Birth control pills may also be prescribed that will make your periods less painful. If the cause of dysmenorrhoea is found, the treatment will focus on managing the problem. Contact your doctor to discuss what suits you the best.
How can a Woman tell if She has a more serious problem?
Talk to the doctor if you have any of the following symptoms:
· Painful periods that started later in life
· Pain at times other than the first couple of days of your period
· Unusual vaginal discharge or bleeding
Pain that doesn't go away when you take medicine to relieve it.