Dysmenorrhoea can be defined as painful menstruation or painful cramps during menstruation. ‘Dysmenorrhoea’ is a Greek word or rather a combination of three Greek words, dys – meaning difficult, meno – meaning month, and rrheoa meaning flow. Menstrual cramps are pains in the belly and pelvic region, and the pains may either be mild or severe in nature. The cramps may be accompanied by headaches, nausea, constipation, or diarrhoea.

Types of dysmenorrhoea and causes:

1. Primary Dysmenorrhoea (Spasmodic)

Primary or spasmodic dysmenorrhoea occurs in 80% of teenage girls, and is believed to be caused by an increased production and release of a chemical called prostaglandins, and not due to any underlying medical condition. Prior to the onset of a period, prostaglandins in the uterus increase in concentration. As the monthly cycle ends, the lining of the uterus begins to break down and shed. Prostaglandins are released in the uterus causing the smooth muscles in the uterus to contract. These contractions (which are not normal) squeeze the blood vessels and they are unable to receive enough blood or oxygen; this results in pain. The pain, after the first few days of the period, thus, tends to fade. The problem may vary in severity, and may ease with age.

Factors causing primary dysmenorrhoea

  • Sedentary lifestyle
  • Obesity
  • Smoking, alcohol and drug abuse
  • Depression and stress related problems

2. Secondry Dysmenorrhoea (Congestive)

If menstrual pains or cramps start after an initial period of pain-free menses, they are generally due to an underlying genital disease, and this type of dysmenorrhoea is called secondary dysmenorrhoea.

Factors or conditions leading to secondary dysmenorrhoea

  • Endometriosis
  • Fibroma
  • Pelvic inflammatory disease
  • Use of an intrauterine device
  • Congenital structural problems in related organs

Menstrual cramps might not always be the regular contractions but a sign of some underlying medical problems. Pelvic examination and blood and urine sample testing can help to determine the underlying problem that is responsible for secondary dysmenorrhoea. An ultrasound or a laproscopy may also be done to determine any disorders of the uterus and other internal organs.

Menstrual cramps caused due to uterus contractions can be usually be treated effectively with analgesic medications. Your doctor might prescribe non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen, ibuprofen, and acetylsalicyclic acid for relief from pain caused due to menstrual cramps. Hormone medication and oral contraceptives also help reduce severe pain during menses, while anitinauseatic drugs are also sometimes prescribed if there are severe symptoms of dizziness and nausea accompanied by vomiting.
Secondary dysmeorrhoea should be treated after the exact underlying ailment responsible for the condition is identified. Treatment given to cure the underlying illness may, in most of the cases, solve the problem of menstrual cramps. If the underlying cause is fibroids or structural problems in the cervix, surgical procedures may be suggested.

Self help to relieve pain during periods

  • Soothing and gentle massage on abdomen
  • Mild exercises that improve blood flow, de-stress muscles, and reduce pelvic pain
  • Taking a warm water bath may be prove very beneficial, as this soothes the muscles
  • Stress is a major factor causing menstrual cramps; regular meditation may help to treat stress
  • Providing warmth to the abdomen and lower back using heating pads and warm water bottles
  • While taking rest lying on your back, support the knees by placing them on a pillow

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