Dysmenorrhea, is the term for painful periods or menstrual cramps. Although menstruation is often painless, many women suffer from discomfort or pain in association with periods at some time during their reproductive years. There are two types of dysmenorrhea:

Primary or spasmodic dysmenorrhea: in this variety no disease or other medical cause can be found for the pain and other symptoms.Primary dysmenorrhea frequently affects women in their teens and early 20s, who have never had a baby.

Features of primary dysmenorrhea: include backache, diarrohea, dizziness, headache, nausea, vomiting, and a feeling of tenseness. Severe pain occurs only in minority, but their is no doubt that it can be incapacitating. The pain colicky in nature, usually starts on the first day of the period. It may last for several hours or continue throughout the first and second day. Often the menstrual flow is scanty at first, and then the pain becomes easier when the flow is properly established.

The symptoms are caused by prostaglandin, a natural hormone produced by cells in the uterine lining. The level of prostaglandin increases in the second half of the menstrual cycle. When a woman’s period begins, the cells in the

uterine lining release prostaglandin as they are shed. Women with severe primary dysmenorrhea have significantly higher prostaglandin levels in their menstrual fluid than do other women.

The only good thing that can be said about primary dysmenorrhea is that usually the symptoms don’t last very long. Some women experience symptoms for up to one or two days, but rarely longer.

Secondary dysmenorrhea is caused by a physical condition. Women who suffer from it tend to be older than those with primary dysmenorrhea. Some conditions that may be responsible for secondary dysmenorrhea are

1. endometriosis (uterine tissue that grows outside the uterus, in the ovaries and other locations). Endometriosis is the most common reason for secondary dysmenorrhea
2. adenomyosis (uterine tissue growing into the uterine wall).
3. endometrial polyps (growths in the uterine lining).
4. fibroids (growths in the uterus).
5. narrowing of the cervix (the entrance to the uterus) as it opens into the vagina.
6. pelvic inflammatory disease (PID).
7. use of an intrauterine device (IUD).

Features of secondary dysmenorrhea: The type of pain experienced is very variable. It may preceed the onset of period for about a week. The pain is often a dull ache felt equally on both sides of the lower abdomen and back, sometimes extending down the thighs.

TESTS AND TREATMENTS
primary dysmenorrhea, a pelvic examination and/or other tests like an ultrasound examination are done to be sure there’s no other causes for the symptoms.

If everything is normal, then generally analgesics like aspirin ibuprofen, or naproxen are recommended. The most effective medical treatment is to use the birth-control pill.It acts by stopping the ovulation and decreases prostaglandin levels. Regular exercise can also help minimize pain and cramping.

secondary dysmenorrhea, in these cases the underlying cause must be treated. To find the cause, the doctor may

• perform a pelvic exam.
• ask about the problem and general health.
• do X-ray and ultrasound examinations.
• advise dilation and curettage (D & C), a minor surgical procedure to open the cervix and remove tissue for microscopic testing.

Premenstrual Syndrome