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Dysmenorrhea

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Dysmenorrhea Or Painful Periods:

Dysmenorrhea is a medical term for painful menstruation or menses or periods. Pain during menses is the most disturbing and frequent gynecological complaint of women during her reproductive life, affecting day-to-day activities in this busy world. Dysmenorrhea or painful menses or periods may be due to cramps and congestion of the uterus or ovaries. Usually, it occurs just before and during menses. Pain may be mild to severe which varies from person to person in location and occurrence. Sometimes pain may be very excruciating in the lower abdomen, accompanied by anxiety, fear, fainting, vomiting, loose stools and the person may collapse with a mild degree of shock.More than 40 percent of girls fear menses in relation to discomfort and pain. About 80 percent of the time, cramps are part of the primary dysmenorrhea syndrome. Although not a serious medical problem, it is usually meant to describe a woman with menstrual symptoms severe enough to keep her from functioning for a day or two each month.

 

Types And Causes Of Dysmenorrhea Or Painful Periods: 

►Primary Dysmenorrhea:

It usually occurs in girls and young females and tends to improve with increasing age. The patients have complaints of pain ever since the periods started. The pain is usuallyspasmodic or colicky in character and is worse on first 2, 3 days of menses and eases as the flow establishes. There is no underlying medical problem.

 

Causes:

The pain is due to the spasm of uterine muscle caused by excessive secretion of prostaglandins.Prostaglandins are the hormones secreted by the cells in the uterus. Patients suffering from primary dysmenorrhea or painful menses or periods have high levels of prostaglandins.

 

Secondary Dysmenorrhea: 

It is due to some underlying pelvic disease. Symptoms of dysmenorrhea or painful periods or menses usually appear after few years of painless menstruation. The pain experienced is very variable but is usually dull aching pain.

The common causes of secondary dysmenorrhea are:

 Adenomycosis (Uterine Tissue Growing Into The Uterine Wall).

 Endometrial Polyps (Growth in the Uterine Lining).

 Endometriosis (Uterine Tissue That Grows Outside the Uterus, In the Ovaries and Other Locations).

 Fibroids (Growths in the Uterus).

 Narrowing of the Cervix As It Opens Into The Vagina.

 Pelvic Inflammatory Disease (PID).

 Use of an IUD.

Dysmenorrhea is a very common, acute complaint which should be evaluated medically. But in most of the cases, proper medical attention is not given due to home therapy and advice from older women. Also, in most of the cases, its pain is wrongly diagnosed as appendicitis and the innocent, normal appendix gets assaulted by surgery. Likewise, some intestinal problems are maltreated or left untreated thinking it is pain related to periods. In the era of ultrasound scan, diagnosis can be easily made. It mainly helps to rule out the emergency conditions like ectopic pregnancy or appendix mass or chocolate cysts of ovaries, and so on. Also, examination and history of pain for a patient gives added points for diagnosis. The occurrence and point of the pain also help in diagnosis. In case of difficulty in diagnosis, it is mostly found to be hormonal. The nature of the pain also helps in diagnosing the type of dysmenorrhea or painful menses or periods and its causes. Constant lower abdomen pain and backache denotes congestive dysmenorrhea. Cramping pains often denote spasmodic dysmenorrhea. Hysteroscopy and laparoscopy also give an idea of the patient's condition. Blood tests and culture and sensitivity tests are to be done to rule out sexually transmitted diseases such as gonorrhea, syphilis and so on.

 

Treating and Preventing Dysmenorrhea:

Your doctor may prescribe medications or other remedies depending on the cause of the dysmenorrhea.

Primary dysmenorrhea is usually treated by medication such as an analgesic medication. Many women find relief with nonsteroidal anti-inflammatory drugs (NSAIDs).Doctors may prescribe hormone medications.Oral contraceptives also may also help reduce the severity of the symptoms.Nausea and vomiting may be relieved with an antinausea (antiemetic) medication, but these symptoms usually disappear without treatment as cramps subside. Implantable contraception and the Mirena IUD, which release low levels of the hormone progesterone, have also been found to be very helpful in decreasing pain.

Women who do not respond after three months of treatment with NSAIDs and hormonal contraceptives may have secondary dysmenorrhea. Treatment for secondary dysmenorrhea will vary with the underlying cause. Diagnostic laparoscopy, other hormonal treatments, or trial of transcutaneous electrical nerve stimulation (TENS) are potential next steps. Surgery can be done to remove fibroids or to widen the cervical canal if it is too narrow.You may also wish to consider alternative therapies such as hypnosis, herbal medications, or acupuncture.