Dysmenorrhea – Menstrual Pain or Pain in abdomen due to cramps
If the symptoms last longer than 5 days and if you think that is unusual, please speak to your gynaecologist immediately because the problem may be due to secondary dysmenorrhea that can indicate problem with any of the reproductive organs.
Typically, almost girl after reaching certain age (12 or 13 years etc) start menstruating (having periods). This is because, during the cycle, the endometrium layer forms in the inside the uterus. The ovaries release an egg in the middle of menstrual cycle and the egg waits for sperms to fertilize it for a period of 24 hours. If the egg is not fertilized, at the end of the menstrual cycle, the endometrial layer sheds off in the form of viscous blood and fluids.
During this shedding, the girl/woman experiences cramps in the abdomen. Normal amount of bleeding and pain is very common during this time but some women experience a lot of unusual pain and heavy bleeding that may indicate other medical conditions inside her body. Primary dysmenorrhea refers to recurring pain during menstruation and secondary dysmenorrhea is caused due to problems in reproductive organs. Both the conditions are treatable.
What is dysmenorrhea or menstrual cramps?
Dysmenorrhea is a clinical term for pain during periods (menstrual pain) due to abdominal cramps. As said, there are two types of dysmenorrhea, primary dysmenorrhea and secondary dysmenorrhea.
Primary dysmenorrhea is common and usual pain that accompanies with menstrual bleeding every time. This sets in a day or two before the start of the periods and can last until the end of the periods. The person may also have the feeling of nausea, fatigue, diarrhoea etc. As the person ages, menstrual cramps and pain may reduce. Some women feel significantly less pain after giving birth to a baby.
Secondary dysmenorrhea is unusual pain that starts much before the actual start date of the periods. This pain is not accompanied by other symptoms such as nausea or diarrhoea etc. This lasts longer than the periods and is most often due to an infection or other problem in the reproductive system of the woman.
Why are menstrual cramps painful?
In order for the periods to start, the body releases a hormone called ‘prostaglandin’. This hormone is responsible for making the uterus contract. The contraction takes place throughout the menstrual cycle but at the time of periods, the uterus contracts more to shed the endometrial layer. Due to the excess contraction, the blood vessels in the nearby muscles gets pressed resulting in loss of blood supply to the muscles surrounding the uterus. The loss of blood supply to the muscles causes brief pain in the abdominal area.
How secondary dysmenorrhea cause pain?
Secondary dysmenorrhea can be caused by any of the following:
- Endometriosis: A condition where in the endometrium layer that should grow inside the uterus grows outside of it. They too bleed during menstruation resulting in excess bleeding and pain.
- Adenomyosis: The lining of the uterus grows into the muscles surrounding it, making the uterus bigger than normal. This too causes excess pain and bleeding during menstruation.
- Pelvic Inflammation Disorder: When the uterus is infected (by bacteria), it can spread to the organs inside the pelvic region. This can cause more pain and also hurt during sex.
- Cervical Stenosis: Cervix is the opening of the uterus inside the vagina. Narrowing of the cervix is called Cervical Stenosis and that too can cause pain.
- Fibroids: Benign (non cancerous) tumors that can grow inside or outside of the walls of the uterus.
Diagnosis of dysmenorrhea
If you are experiencing excessive pain and bleeding for no apparent reason, you should contact your gynecologist or a good gynecologist near you immediately. Diagnosis of dysmenorrhea starts with questioning of your doctor followed by a physical examination of your abdomen area.
For further investigation, a speculum may be inserted inside of the vagina to look for tumours, fibroids etc and to observe the positioning and size of the reproductive organs. If the doctor finds any lumps, he/she may collect a piece of it and send it for testing. Further tests may be advised by your gynecologist, if he/she suspects any other medical problems with uterus or any other part in the pelvis region.
Usage of tampons may also cause dysmenorrhea. In such cases, typical symptoms include fever, vomiting, diarrhea, dizziness, fainting etc. This condition must not be taken easy because, it is sometimes a life threatening one.
How to treat mild menstrual cramps?
- Taking a pain killer can help reduce the pain. Non steroidal, anti-inflammatory drugs such as ibuprofen can help in reducing the production of prostaglandins. Acetaminophen is also another drug used to reduce the pains of uterus cramping.
- Place heating pad or massage the lower back area
- Avoid caffine, alcohol.
- Get enough rest and if you feel like resting your back, you should.
- Avoid smoking and alcohol.
Women who work out regularly have less pain. Make regular exercising a part of your life every day. Healthy weight can also help in maintaining a healthy and sound body. If your gynecologist sees any problem with any of the reproductive organs, he/she will communicate the same to you and you will be put on appropriate medication or even a surgery like laparoscopic Myomectomy (for removal of fibroids) may be recommended.
Other activities that can help you with treating menstrual cramps include:
- Yoga and/or Meditation to relax your mind and body
- Acupuncture from an experienced professional
- Massage (especially your back and lower back).
Menstrual cramps can’t be prevented. Primary dysmenorrhea is unavoidable. Pain killers or anti inflammatory drugs such as ibuprofen may be used to manage symptoms during this period. If you think you are having unusually high amount of bleeding or pain, you should see a good gynecologist near you immediately.