Dysmenorrhea - Types, Risk Factors, Cause, Signs, Symptoms, Diagnosis and Treatment

What Is Dysmenorrhea?

Dysmenorrhea is referred to as painful cramps experienced in the lower abdomen before and during the periods. Mild discomfort or pain during menstruation is considered to be normal. And if there is excessive pain, then it is time for consultation.

What Are the Types of Dysmenorrhea?

Dysmenorrhea is of two types, primary and secondary.

• Primary Dysmenorrhea: It is the recurrent lower abdominal pain or cramps that occur commonly during menstruation. This pain typically occurs a day or two before or during the onset of periods. Pain may vary from mild to severe, typically lasting 12 hours to 72 hours. Pain may be felt in the lower abdomen, thigh, or back. A few symptoms like nausea, vomiting, fatigue, and diarrhea are characteristic of dysmenorrhea. Menstrual cramps may reduce as you become old or even stop after the first pregnancy.

• Secondary Dysmenorrhea: It is abdominal pain or cramps due to an infection in the female reproductive organ. Pain begins typically with menstruation and lasts even after the menstruation. Symptoms of primary dysmenorrhea like nausea, vomiting, fatigue, and diarrhea are not seen in this type. Still, they may have pain during intercourse, a large uterus, and resistance to effective treatment.

Who Is at Risk for Painful Menstruation?

The following factors increase the risk of painful menstruation:

• Overweight.

• Smoking.

• Alcoholic (alcohol can prolong menstrual pain).

• Women younger than age 30.

• Early puberty at the age of 11 or younger.

• Heavy bleeding during periods.

• Irregular menstruation bleeding.

• Family history of menstrual cramps.

• Women who have not given birth.

What Are the Causes of Menstrual Cramps?

Menstrual cramps occur when a chemical called prostaglandin contracts the uterus. The uterus is a hollow muscular organ where the baby grows. If the uterus contracts strongly during the menstrual period, there is pressure against the nearby blood vessels, causing a cut-off oxygen supply. This lack of supply of oxygen to the uterus causes pain and cramps.

How Does Secondary Dysmenorrhea Cause Menstrual Cramps?

Any infections or problems in reproductive organs cause secondary dysmenorrhea. These are the conditions causing menstrual cramps.

• Endometriosis: Endometriosis is when tissues lining the uterus grow outside the uterus, usually on the fallopian tubes, ovaries, or over the tissue lining the pelvis. These tissues bleed during menstruation, causing pain and swelling.

• Uterine Fibroids: Fibroids in the uterus are non-carcinogenic growth inside, outside, or in the uterus walls, which causes abnormal menstruation or pain. Fibroid causes the uterus to become more prominent than usual, with increased and prolonged bleeding and pain.

• Pelvic Inflammatory Disease (PIV) - It is an infection caused by sexually transmitted bacteria that starts in the uterus then gradually spreads to other organs like fallopian tubes and ovaries, causing pain and inflammation.

• Cervical Stenosis: Cervical stenosis is a rare condition causing the cervix to be small or narrow because of scarring or lack of estrogen after menopause. Cervical stenosis may slow down the menstrual flow, which increases the pressure in the uterus leading to pain.

• Premenstrual Syndrome: Premenstrual syndrome (PMS) is a common condition caused by hormonal changes. PMS normally occurs one to two weeks before menstruation, and symptoms leave after bleeding begins.

What Are the Signs and Symptoms of Dysmenorrhea?

The symptoms differ for each person. These are some common symptoms seen in women with dysmenorrhea.

• Throbbing or cramping pain in the lower abdomen.

• Pain in legs.

• Lower back pain.

• Nausea and vomiting.

• Fatigue.

• Headache.

• Dizziness.

• Cramping in the lower abdomen.

When to Consult a Doctor for Menstrual Pain?

Consult a doctor when,

• Menstrual cramps or pain is so severe that your daily activity interferes with every month.

• The onset of menstrual cramps after the age of 25 years.

• Symptoms progressively worsen.

How Can Dysmenorrhea Be Diagnosed?

Diagnosis of painful menstrual cramps is carried out by evaluating the medical history and complete physical and pelvic examination. Doctors take the complete history of the menstrual cycle then perform a pelvic examination. Using their fingers, they feel any lumps or changes in the uterus and ovaries. Vaginal fluid samples may also be taken for testing. If there are any symptoms of secondary dysmenorrhea, doctors suggest further tests and treatments.

Below are the tests to be carried out to rule out the underlying disease.

• Ultrasound Examination - The image of the internal organs are collected using high-frequency sound waves.

• Laparoscopy - It is a minor procedure in which a laparoscope is used to see into the pelvic and abdomen area. A laparoscope is an instrument that is thin and has a lens and light attached to its tip, which helps find any abnormalities in the pelvic and abdominal area.

• Magnetic Resonance Imaging (MRI) - This imaging technique provides detailed images of organs and structures within the body using large magnetic radio frequencies.

• Hysteroscopy - Hysteroscope is an instrument used to insert into the vagina to visually examine the canal of the cervix and the inside of the uterus.

What Are the Home Remedies That Relieve Menstrual Cramps?

Several home remedies help in reducing painful menstrual cramps, which include:

• Having a warm bath.

• Massaging the abdomen with oil.

• Using heating pads on the painful area.

Although these home remedies provide some relief,relying on it entirely is not advisable. It is always recommended to consult with a healthcare provider.

What Lifestyle Modifications Help Reduce Dysmenorrhea?

The following are a few lifestyle changes that help in reducing the intensity of dysmenorrhea:

• Regular exercise and maintaining an average weight.

• Health and nutritious diet.

• Performing yoga and meditation.

• Including supplements like vitamin B6, vitamin B1, vitamin E, omega-three fatty acid, calcium, and magnesium.

• Reduced intake of salt and sugar.

• Quit smoking and alcohol.

What Is the Treatment for Dysmenorrhea?

Treatment of dysmenorrhea depends on evaluating factors like age, health condition,

cause and extent of the disease, patient's tolerance for medications, and therapy. These are a few common medications prescribed by doctors:

• Non-steroidal anti-inflammatory drugs (NSAIDs).

• Pain killers.

• Antidepressants - They regulate the mood swings associated with dysmenorrhea.

• Hormonal Birth Control - These are available as a pill, patches, vaginal rings, implants, and injections which helps to prevent ovulation and control pain.

• Surgery - It is the last option if other medical treatments are unsuccessful. It helps to remove uterine fibroids or cysts.

• Hysterectomy - It is surgical removal of the uterus, which is carried out when all other treatment modalities do not help.

Conclusion:

Dysmenorrhea is expected due to lifestyle changes like increased junk food intake and reduced physical activity. If these painful cramps spoil your day-to-day activities it is advisable to consult a physician. Few lifestyle changes and medical treatment can reduce dysmenorrhea.