Dysmenorrhoea is the medical term for pain associated with menstruation (periods). It is also known as menstrual cramps and is the most commonly reported menstrual disorder. More than one half of women who menstruate have some pain for 1-2 days each month.
Menstrual cramps (period cramps) are usually sharp but may be throbbing or cramping pains or a dull and constant ache in the lower abdomen which may radiate to the legs. Many women experience menstrual cramps just before and during their menstrual periods. Pain tends to peak 24 hours after onset of menses and subside after 2 to 3 days.
For many women, the painful experience is merely annoying. For most of them, menstrual cramps can be severe enough to interfere with everyday activities for a few days every month.
Dysmenorrhoea is generally accompanied by headache, nausea, constipation, diarrhoea, lower back pain and frequent urination. Vomiting is also experienced by some.
Dysmenorrhoea usually happens for the first time a year or two after a girl first gets her period, and become less painful with age and may stop entirely after you have your first baby.
There are two types of dysmenorrhoea:
It is common menstrual cramps that are not due to other diseases and are recurrent in nature. Pain usually starts 1 or 2 days before, or when menstruation starts, and is felt in lower abdomen, back, or thighs.
It typically last for 12 to 72 hours and pain can range from mild to severe.
This kind of menstrual cramps becomes less painful with age and may disappear entirely after a woman has a baby.
This type is due to some physical cause or a disorder in a woman’s reproductive organs, such as:
It is most often observed in women aged 30-45 years. Pain from secondary dysmenorrhoea usually begins earlier in the menstrual cycle and lasts longer than common menstrual cramps. This pain is not typically accompanied by nausea, vomiting, fatigue or diarrhoea.
Primary dysmenorrhoea is caused by abnormal contraction (tightening) of the uterus (where a baby grows) by a chemical called prostaglandin.
The uterus contracts throughout a woman’s menstrual cycle and during menstruation it contracts more strongly, pressing against the nearby blood vessels which cuts off the oxygen supply to the muscle of the uterus resulting in pain or menstrual cramps.
Some other factors contributing to primary dysmenorrhoea may include:
Secondary dysmenorrhoea is caused by other medical complications of woman’s reproductive organ, most often endometriosis. Endometriosis generally causes internal bleeding, infection and pelvic pain.
Other causes of secondary dysmenorrhoea may include:
Symptoms of dysmenorrhoea may include:
These symptoms may overlap with symptoms of other medical conditions. It is always advised to consult your doctor for proper diagnosis of dysmenorrhoea.
This is because of prostaglandins. These are the chemical signals that bodies produce in women. These are sent to the uterus to tell it to contract. This causes expelling of the uterine lining toward the end of your menstrual cycle.
But not all women feel the same. If your body sends enough of prostaglandins to the uterus, some of them may move to the bowel, which is close to the uterus. They may then ask the bowel also to contract, causing them to expel whatever is contained there.
Therefore, not all women experience frequent bowel movements in their periods. Some girls feel the effects of prostaglandin on their bowels as nausea. Some may get diarrhea. And others are not affected by it at all.
The population which is at greater risk of dysmenorrhoea include:
Various pathological conditions such as endometriosis and pelvic inflammatory disease serve as risk factors for secondary dysmenorrhoea.
If you are experiencing severe or unusual menstrual cramps or cramps that last more than 2 or 3 days, contact your doctor. Both primary and secondary menstrual cramps can be treated, so it’s important to get diagnosed.
Your doctor will review your medical history and perform a physical exam such as a pelvic exam.
During the pelvic exam, your doctor will check for any abnormalities or defect in reproductive organs – vagina, cervix, and uterus and look for any signs of infection. A small sample of vaginal fluid may be taken out for testing.
If your doctor suspects an underlying disorder for your secondary dysmenorrhoea, he/she may recommend for further testing. If a medical problem is found, your doctor will discuss treatments.
Various diagnostic tests may include:
Dysmenorrhoea can be treated. Your doctor will determine specific treatment for your menstrual cramps based on:
Your doctor may recommend one of the following:
Your doctor may recommend over-the-counter pain relievers such as aspirin and ibuprofen or prescription non-steroidal anti-inflammatory drugs (NSAIDs) such as acetaminophen and mefnamic acid to treat symptoms of pain in dysmenorrhoea.
Birth control pills contain hormones that prevent ovulation and reduce the severity of menstrual cramps.
If menstrual cramps are of secondary kind, which are caused by an underlying disorder such as endometriosis or fibroids, surgery is employed to correct the problem that may help in reducing your symptoms.
Surgical removal of uterus (hysterectomy) is also an option if you are not planning to have baby in future.
Endometrial ablation (procedure to destroy the lining of the uterus) and endometrial resection (procedure to remove the lining of the uterus) are also helpful in relieving in severe symptoms of menstrual cramps.
Some alternative therapies have been proved to be beneficial for many women who do not respond to NSAIDs and oral contraceptives or if these agents are contraindicated in them.
Some of such therapies are:
Adapting to a healthy lifestyle is important for the prevention of dysmenorrhoea. Following strategies can be followed to prevent or relieve it at home.
Dysmenorrhoea doesn’t cause any other medical complications, but it can interfere with daily life, work, and social activities.
Certain conditions associated with dysmenorrhoea may have their own complications. For example, endometriosis can cause fertility problems. Pelvic inflammatory disease can scar your fallopian tube and increase the risk of ectopic pregnancy (implantation of fertilized egg outside of your uterus).