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Dysmenorrhea: What Is It? Causes, Symptoms & Treatment

So what is dysmenorrhea? The pain and discomfort associated with menstruation is called dysmenorrhea. It is quite a common occurrence so much so that more than half of women who get their periods have some pain for at least 1 to 2 days each month.  When other symptoms like nausea, vomiting, diarrhea, dizziness or headaches are thrown into the fray and start playing havoc, it is not a problem that can be taken lightly. In this article, we will see the types, causes and treatment of dysmenorrhea

What are the types of dysmenorrhea?

Dysmenorrhea can be classified into two types:

1) Primary dysmenorrhea

When severe, cramping pain caused by natural chemicals called prostaglandins comes before or during a period, it is called primary dysmenorrhea.  A chemical imbalance in the body can cause abnormal cramping in women. In the lining of the uterus, prostaglandins cause the muscles and the blood vessels to contract. The level of prostaglandins is high in the first one or two days but as bleeding continues and the lining of the uterus is shed, the level of prostaglandins comes down and the ache ebbs down.

2) Secondary dysmenorrhea

Pain which is caused by a disorder in the reproductive organs is more serious and is called as second dysmenorrhea. This sort of pain tends to escalate over time and it most often than not lasts longer than the normal menstrual cramps. Secondary dysmenorrhea can disrupt the daily activities of a woman and can make her emotionally and physically exhausted.

What are the symptoms of dysmenorrhea?

The symptoms of dysmenorrhea are many and varied. However, it may be possible that a woman will experience all the symptoms or only a few of them.  Symptoms that are most common in women suffering from dysmenorrhea are:

i) Vomiting

ii) Diarrhea

iii) Fatigue

iv) Weakness

v) Fainting

vi) Headaches

vii) Pain radiating down the legs

viii) Nausea

ix) Ache in the lower back

x) Cramps in the lower abdomen

xi) Pain in the lower abdomen

What are some causes of secondary dysmenorrhea?

The causes of secondary dysmenorrhea include the following:

Endometriosis:

When tissue much like the lining of the uterus grows in other areas of the body, such as the fallopian tubes, behind the uterus, on the ovaries and on the bladder, this is known as endometriosis. This tissue too breaks down, bleeds and causes pain in response to changes in hormones, just like the lining of the uterus. The other reasons for this could be scar tissue forming inside the pelvis where the bleeding occurs. These are called adhesions which can cause organs to stick together.

Adenomyosis:

When extra tissue that normally lines the uterus begins to grow in the muscle wall of the uterus, it is called adenomyosis. Older women who have had children usually have this condition.

Fibroids:

Fibroids are extra growths that form on the inside, on the outside, or in the walls of the uterus. These fibroids which are located in the wall of the uterus may cause extreme discomfort.

Faulty reproductive organs:

Pain could also emanate from problems with the fallopian tubes, uterus and other reproductive organs. If a woman is born with certain defects, this can cause discomfort during menstruation.

Ailments:

It is possible that some medical conditions can cause pain during a period such as urinary disorders, Crohn’s disease etc.

What are the tests done to find the cause of dysmenorrhea?

There are many methods that are employed to diagnose the problem.

i) Physical exam, including a pelvic exam

ii) Ultrasound

iii) Imaging tests like a CT scan or MRI scan

iv) Laparoscopy

v) Hysteroscopy

What are the risk factors?

Women might be at a risk for menstrual cramps if they:

i) Started their puberty early, at age 11 or younger

ii) Are below the age of 20

iii) Bleed heavily during periods

iv) Have irregular menstrual bleeding

v) Have a family history of menstrual cramps

vi) Have never had a baby

vii) Smoke

What is the treatment for dysmenorrhea?

There could be many methods that your doctor would recommend to ease the symptoms. The following treatments are used to provide menstrual cramp relief depending on the diagnosis and the severity of the problem.

Hormonal birth control- Dysmenorrhea can be controlled with oral birth control pills as they contain hormones that prevent ovulation.

Pain relievers. Over-the-counter medicines for pain relief and prescription nonsteroidal anti-inflammatory drugs may be recommended by your doctor.

Surgery- Disorders such as endometriosis or fibroids can be corrected with surgery. Endometrial ablation is a procedure to destroy the lining of the uterus, Endometrial resection is a procedure where the lining of the uterus is removed and a Hysterectomy is the surgical removal of the uterus. These are all surgical procedures used to treat dysmenorrhea.

Heat- Heat can reduce pain and using a heating pad or a hot water bottle on your lower abdomen might help reduce the severity of menstrual cramps. Soaking in a hot bath might also ease the pain.

Dietary supplements. Vitamins are essential to a number of vital functions in the body. Vitamins like vitamin E, vitamin B-1, omega 3 fatty acids, magnesium, and vitamin B-6 supplements might reduce menstrual cramps

Alternative treatments– It might be worth trying to resort to alternative treatment options such as Acupuncture, Acupressure or Herbal medicines.

Stress management. Most times, psychological stress might trigger an increase the risk of menstrual cramps and also their severity. It is important to de-stress with meditation or yoga.

Exercise– It is very important to keep yourself fit. Do at least 30 minutes of any form of exercise every day.

It is always advisable to note the dates of your period on a calendar and in case of any abnormality, it is best to get a checkup done as soon as possible in order to understand exactly what is causing the problem.

Written by Bhargavi J