Painful menstruation

Written By:


  • What is Dysmenorrhoea (painful menstruation)?

    Dysmenorrhoea is the clinical term for painful menstrual periods when cramps are frequent and severe. Primary dysmenorrhoea results from uterine contractions that occur normally during periods, whereas secondary dysmenorrhoea may be related to a medical condition, such as endometriosis (a condition in which the endometrium or the lining of the uterus, grows in areas outside the uterus) causing pain and infertility.

  • What are the causes?

    Primary dysmenorrhoea usually begins 2 to 3 years following the onset of menses. It is caused by prostaglandin-induced uterine contractions. Dysmenorrhoea is a common gynaecological complaint in adolescents, but the majority of cases are not associated with a disease and the physical examination is normal. Abnormal conditions associated with secondary dysmenorrhoea include endometriosis, pelvic inflammatory disease, fibroid (non-cancerous growths, in the uterus). Secondary dysmenorrhoea most commonly begins in women in their 20s. Increasing frequency of sexually transmitted diseases among adolescents has increased the percentage of dysmenorrhoea cases associated with the disease. Primary dysmenorrhoea often gets better after age 25 and after vaginal childbirth. The duration of secondary dysmenorrhoea depends on its cause and on the effectiveness of any available treatment.

  • What are the symptoms?

    Many women experience lower abdominal pain that generally begins several hours prior to the onset of a menstrual period, but may begin as much as 1 or 2 days in advance. The pain lasts one or more days into the period and then subsides. Pain may be mild to severe and may be associated with nausea and vomiting and changes in bowel habits (either constipation or diarrhoea).

  • How is it diagnosed?

    Dysmenorrhoea is diagnosed with various examinations and tests. The doctor will first need to take a detailed history, focusing on the past details of the menstrual pain. She will need to perform a physical examination, including an internal examination to see if there are possible abnormalities causing the pain. A Pap smear, blood tests and cultures may be taken. In addition, an ultrasound of the pelvis may be done to check for other abnormalities. If the menstrual pain is not relieved with medication or if a secondary cause of dysmenorrhoea is suspected, a surgical procedure called a laparoscopy may need to be performed.

  • What is the treatment?

    The initial treatment is focused on the relief of pain. Anti-inflammatory drugs may be helpful; this includes aspirin, nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen and indomethacin. In some severe cases, and with disorders such as endometriosis, oral contraceptives may be helpful. They are used in this case to regulate the hormone levels in the body. They may be prescribed even for girls who are not sexually active.Women who continue to have severe dysmenorrhoea despite the use of NSAIDS and/or oral contraceptives may require laparoscopy for further evaluation. Mild analgesics are usually effective in treating dysmenorrhoea and oral contraceptives generally control severe cases. Dysmenorrhoea associated with a disease state responds to treatment of the primary problem. A doctor should be contacted if the menstrual cramps are severe or if the discomfort lasts for more than 2 or 3 days.In addition to medical therapy, there are a number of other ways that can help ease the pain of menstrual periods like: Regular exercise Direct heat application in the form of a heating pad, hot water bottle or warm bath may be soothing. Massage of the lower abdomen and/or lower back Relaxation exercises Adequate sleep Drinking plenty of water Avoiding caffeine as in coffee, tea, sodas and chocolate just before and during the period Eating plenty of green leafy vegetables and whole grains

  • How is it prevented?

    There are no specific preventive measures for dysmenorrhoea. Avoiding sexually transmitted diseases will decrease disease-associated dysmenorrhoea.