Dysmenorrhea, a condition that marks painful menstruation, is often witnessed by adolescent girls and women of reproductive age. One begins to experience these symptoms with the onset of menstruation or a little earlier and they typically last for around three days. The degree of severity of pain often varies.
Most Common Symptoms of Menstrual Cramps are-
There are two types of dysmenorrhea, defined on the basis of the causative factors.
It refers to menstrual cramps resulting from the normal process of menstruation. It is not due to any underlying gynecologic disorder. The pain begins one or two days prior to the beginning of menstrual bleeding. It lasts for almost two to three days and is accompanied by nausea, vomiting, fatigue or diarrhea. The primary target group is adolescent girls. It recedes with age and specifically post delivering a baby after which the cervix enlarges. Other factors resulting in primary dysmenorrhea include a retroverted uterus, early menarche (onset of menstruation in adolescent girls), smoking, high-stress levels, alcoholism, poor lifestyle with lack of exercise, and obesity.
However, if the menstrual cramps are due to an underlying gynecologic disorder, it refers to Secondary dysmenorrhea. The pain begins earlier in the menstrual cycle and lasts longer than the common menstrual cramps. There are no peripheral symptoms of nausea, vomiting, fatigue or diarrhea. The possible causes include, fibroids, endometriosis, sexually transmitted infection (STI), ovarian cyst, benign tumors, inserted contraceptive devices and pelvic inflammatory disease (PID).
The abdominal pain witnessed during menstruation is actually the abdominal cramps caused by uterine contractions. A hormone-like substance called as prostaglandin is released during the uterine contractions. It causes pain and inflammation. If the prostaglandin levels are particularly high, women experience frequent uterine contractions causing severe pain.
As the uterine lining is shed, the contractions push the blood tissues through the cervix and out of the body. If the cervical canal is narrow, severe pain is experienced while the clots or blood tissues pass through it. The cramps initiate before the menstrual period, peak 24 hours later and start subsiding after a day or two.
Most adolescent girls experience painful menstrual cramping one or two years after attaining menarche. With age, the menstrual cramps are known to ease out. After childbirth, most women do not experience painful menstruation, particularly because of the enlargement of the cervix.
Painful menstruation may call for a doctor visit so as to identify any underlying disorder. A pelvic examination, ultrasound and blood or urine test may be required. Both primary and secondary dysmenorrhea can be easily managed as well as treated. This is possible medically as well as through natural ways.
Medical treatment of dysmenorrhea aims at providing symptomatic relief as well as inhibits the underlying processes that cause the symptoms. Dysmenorrhea has to be graded according to the severity of pain and degree of limitation of daily activity. This helps devise the treatment strategy. The medical treatment commonly used includes,
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However, if a woman does not respond to the above line of treatment, she may be suffering from secondary dysmenorrhea, whose treatment depends on the underlying cause. Specific measures (surgical or medical) may be required to treat pelvic conditions (such as endometriosis). Uterine Artery Embolization may be done to curb the growth of fibroids. Surgical removal of fibroids may also be undertaken. Hysterectomy is the last resort wherein the entire reproductive system is surgically removed. Periodic use of analgesics may be required as a supporting therapy.
Thus, a doctor visit to identify the possible cause of dysmenorrhea followed by adopting the correct line of treatment makes dysmenorrhea an easy to manage the condition.
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