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Dysmenorrhea (period pain): Treatment, symptoms, advice and help

About dysmenorrhea (period pain)

Dysmenorrhea, often referred to as ‘painful menstruation’, is one of the most common gynaecological problems encountered in women of the reproductive age group.

Although it is not a life-threatening condition, it can be debilitating and psychologically taxing for many women. It is responsible for a significant number of sick leaves. Most women feel it is normal and choose not to seek medical attention, while others choose to self-medicate themselves.

Dysmenorrhea is of two types: primary and secondary. Primary dysmenorrhea, which is most commonly encountered, is menstrual pain that is physiological and is not related to any underlying gynaecological disease. On the other hand, secondary dysmenorrhea is menstrual pain that is generally related to some kind of gynaecological disorder.

Dysmenorrhea (period pain): Incidence, age and sex

About 25% of women suffer from dysmenorrhea. Most women complain of dysmenorrhea during adolescence, usually within four to five years of the first menstrual period. It becomes less painful as age advances.

Signs and symptoms of dysmenorrhea (period pain): Diagnosis

While it is normal for some women to have mild abdominal cramps, about 10% of women experience severe pain. The pain of dysmenorrhea is usually sharp and cramping in nature and located in lower abdomen. Pain may also be present in the back or thighs. It usually begins just 1 or 2 days before or as menstrual bleeding begins, and slowly reduces over one to three days. Pain usually occurs intermittently, ranging from mild to disabling. Other symptoms that may accompany cramping are nausea, diarrhoea, dizziness, fatigue or headache.

Causes and prevention of dysmenorrhea (period pain)

In primary dysmenorrhea, chemicals like prostaglandins are formed in the lining of the uterus during menstruation, which causes the uterine muscles to contract. This decreases the blood flow to uterus, thus depriving it of oxygen. Just like labour pains, these contractions can cause significant pain and discomfort. Some other factors that may contribute to primary dysmenorrhea are a backwardly tilted uterus, lack of exercise, or psychological stress.

Secondary dysmenorrhea may occur due to a number of gynaecological disorders like fibroids of the uterine walls, sexually transmitted diseases, endometriosis (fragments of the endometrial lining found on other pelvic organs), pelvic inflammatory disease, an ovarian cyst or tumour, and the use of an intrauterine device.

Dysmenorrhea (period pain): Complications

Dysmenorrhea can cause severe pain, thereby adversely impacting the quality of life for the affected individual. It may also lead to increased absenteeism from the workplace.

Dysmenorrhea (period pain): Treatment

The treatment depends upon the type of dysmenorrhea. Many women do not seek any treatment for pain because the pain is bearable. However, it is best to seek medical attention and get the same, properly investigated.

Primary dysmenorrhea can be treated with medications such as non-steroidal anti-inflammatory drugs, referred to as NSAIDS. Since primary type is due to prostaglandin secretion, anti-prostaglandins are also used to treat it. Anti-prostaglandins block the effects that prostaglandins have on the body thus preventing severe cramps. Treatment for secondary dysmenorrhea however depends upon the underlying cause of the condition. Therefore, the underlying cause needs to be treated appropriately to reduce the symptoms of secondary dysmenorrhea.