dysmenorrhoea

 

 

 Menstrual periods mean different things to different people. Some people scarcely feel any pain or discomfort at all, while to others the very mention of the word evokes feelings of an unwanted time of the month.

There are some women who go through a lot of pain during menstruation. The clinical name for this condition is dysmenorrhoea. In Greek, this means 'difficult monthly flow."
The discomfort is caused by a cramping of the uterus, especially due to unusually high levels of substances called prostaglandins. These are hormone-like substances, which stimulate womb contractions. The woman may also be too sensitive to normal levels.

Primary dysmenorrhoea

The most common type is primary dysmenorrhoea, which is an extreme form of discomfort most women feel just before or on the first few days of their period. Generally, it appears six to twelve months after menarche, when the ovulatory cycles have been established. The pain usually consists of lower abdominal cramps and backache. The person also suffers from nausea, vomiting, chills and diarrhoea. Gastrointestinal disturbances may also occur. The symptoms tend to decrease with age and after a full-term pregnancy. In primary dysmenorrhoea, it is rather difficult to pin a cause to the condition.

Secondary dysmenorrhoea

Secondary dysmenorrhoea appears several years after menarche and is most common is women who've never had children. The symptoms tend to decrease with age and after a full-term pregnancy. It makes a sudden appearance in women whose early menstrual periods have been relatively pain-free. The pain lasts through the menstrual period and may be associated with discomfort before the onset of menstruation. An underlying medical problem such as endometriosis or pelvic inflammatory disease is often the root of the discomfort.
The pain may begin two to three days before the start of the menstrual period, and radiate from the abdomen to the back and legs, lasting throughout the period. The pain can be sharp or dull and may be felt in the abdomen, back, vagina, or thighs. The pain can also be accompanied by headache, nausea, constipation or diarrhea and the urge to urinate frequently. It can be so severe that some women may faint, vomit, or stay in bed.
In secondary dysmenorrhoea, one can isolate a cause responsible for the condition. Some of these causes are endometriosis, fibroids, pelvic infection, stress and psychosexual difficulties, previous pelvic surgery disrupting the area, ovarian cancer (rarely), thyroid disorder, having an intra-uterine device, stopping the contraceptive pill, giving birth to a first or second baby, miscarriage/abortion, entering the climacteric and approaching menopause. A history of infertility could also be responsible.
Women suffering painful menstrual periods should seek medical attention. A doctor may prescribe medication or recommend measures to ease or prevent the pain.


Incidence

About 10 percent of adolescent and young adult women experience pain during their periods. This pain is so severe that it interferes with normal daily activities. While the severity of this pain usually decreases with age or after childbirth, painful periods can happen to women of any age.
Most women respond to non-steroidal anti-inflammatory drugs (N-SAID) many of which are available over the counter. However, they should be taken before cramps start, or at the first sign of bleeding. Doctors may also prescribe medications that inhibit the formation of prostaglandins.
Regular exercise throughout the month also helps relieve painful periods. Patients also find it beneficial to cut down on the intake of caffeine, salt, and alcohol also help.


Treatment

Any treatment must take into consideration the patient's age, desire for conception, severity of symptoms and extent of the disease.
In case of primary dysmenorrhoea, the application of heat to the lower abdomen and the use of OTC medications often helps in relieving the discomfort.
Since dysmenorrhoea is caused by prostaglandins, chemicals that are released from female organs with the normal period, treatment would involve reducing the prostaglandins in the body before the period begins, as well as during menstruation. It is important to start the treatment before the period begins.
The point is that there is always something that can be done about painful periods. No one should endure the pain simply because there is no way to deal with it. It may take a few months to find the correct treatment, but it is worth finding what works for you.