Menstrual Condition (Dysmenorrhea)

Dysmenorrhea

What is Dysmenorrhea?

Dysmenorrhea is the medical term for painful menstruation, most common of gynaecological dysfunctions.It is also known as painful periods or menstrual cramps, which are throbbing in the lower abdomen, caused by uterine contractions. For some women, the discomfort is only annoying, while for others menstrual cramps can be severe enough and meddling with everyday activities. Some women also have nausea, loose stool, headache and dizziness.

Etiology

According to etiological factors, it is divided into two parts.

  • Primary Dysmenorrhea

It is defined as cramping in the lower abdomen just before or during menstruation due to less prostaglandin secretion. Common menstrual pain can range from mild to severe and lasts in 12 to 72 hours.

  • Secondary Dysmenorrhea

It is due to disorder in woman’s reproductive organs, in which pain usually begins earlier in the menstrual cycle and lasts longer. Some causes are like:

  • Endometriosis
  • Pelvic infection
  • Congenital abnormalities
  • Ovarian Cyst
  • Uterine Fibroids
  • Adenomyosis
  • Psychological factors
  • Intrauterine Device
  • Cervical stenosis

Both types can be treated.

Clinical Manifestation

  • Pain may be caused by increased uterine contractility (tightening) by chemical called Prostaglandin and uterine hypoxia.
  • Nausea
  • Vomiting
  • Diarrhea
  • Headache
  • Chills
  • Tiredness
  • Nervousness
  • Lower backache

Diagnostic Evaluation

  • Physical examination
  • Pelvic ultrasound
  • Hysteroscopy and Laparoscopy
  • Chlamydia and gonorrhoea test for infection

Medical Management

In the case of dysmenorrhea your doctor will prescribe the following medical management.

  • Non-steroid anti-inflammatory drugs such as ibuprofen, naproxen, and veldecoxib.
  • Hormonal contraceptives to decrease contractility and menstrual flow.
  • Local heat, such heating pad to increase blood flow and decrease spasm.
  • In some cases DNC (dilation and curettage)

Risk Factors

Risk factors for dysmenorrhea may include the following:

  • Age less than 30
  • Start of puberty
  • Heavy bleeding during periods
  • Irregular menstrual bleeding
  • Family history
  • Smoking
  • Obesity
  • Diet
  • Depression and Abuse

Complications

Menstrual cramps don’t cause other medical complications, but they can disturb your everyday activities. Certain conditions associated with worse menstrual cramps can have complications such as:

  • Endometriosis can cause infertility
  • Pelvic inflammatory disease can blemish the fallopian tubes
  • Increased risk of a fertilized egg implanting outside of the uterus (ectopic pregnancy)

Prevention

  • Quit smoking
  • Losing weight can reduce the severity of cramps
  • Medication can prevent and treat dysmenorrhea
  • Birth control and anti-prostaglandin medications may prevent cramps
  • Avoid salt and caffeine
  • Avoid alcohol
  • Massage the lower back and abdomen.

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