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 womans 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 dont 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
- » endometriosis (uterine tissue that grows outside the uterus, in
the ovaries and other locations). Endometriosis is the most common
reason for secondary dysmenorrhea
- » adenomyosis (uterine tissue growing into the uterine wall).
- » endometrial polyps (growths in the uterine lining).
- » fibroids (growths in the uterus).
- » narrowing of the cervix (the entrance to the uterus) as it opens
into the vagina.
- » pelvic inflammatory disease (PID).
- » 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 theres 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.