Dysmenorrhea means
painful period. Almost every woman must have experienced this to some degree in
her life time. If you have never felt it, you are extremely lucky. DYSMENORRHEA
(DYSM) Starts 6-12 months after menarche, it can even happen after 2 years. This
is due to the fact that it happens when ovarian function matures, that is when
ovaries start to make an egg. It is a very painful spasm in the lower abdomen, backache,
and pain in the legs. In severe cases it even causes nausea, vomiting, diarrhea,
headache, and dizziness. It can make adolescent or a woman totally incapacitated
to attend school or work. It often starts one or two days before bleeding
starts and can last up to 12 or 72 hours. Proves very harmful for studies or
work situations. Many women can manage it easily just by paracetamol or Ibuprofen
or drugs available over the counter. Why does this happen? It is due to tissue damage,
resulting in the production of hormone like chemicals produced locally from
fatty acids called prostaglandin, these help with inflammation and healing. Unfortunately
they also cause severe uterine spasm and blood clots. There are two types of DYSM
primary meaning there is no other pelvic pathology and secondary meaning there
are other pelvic diseases such as, Endometriosis, pelvic infections,
adenomyosis and fibroids. The last two most often happen in older age group and
often associated with heavy bleeding. Endometriosis is the most common cause of
very painful periods in all age groups, if a woman is sexually active sex is
painful, even bowel action can be painful. Very often women need to take medical
advice, about painful periods. When you attend
a clinician he will take a history, do a pelvic examination and see if there is
pain or any pathology. You may require Smear test, blood tests, tests for
sexually transmitted infections and an ultrasound. These are only done depending
on the pathology. If Endometriosis is suspected often an operative procedure called
LAPASCOPY is performed. Here the surgeon looks inside the abdomen with a
telescope under anesthesia and often Endometriosis is treated at the same time
with ablation by laser or electric current. For simple cases life style factors
such as regular exercise, good nutrition rich in calcium, Zn, magnesium, vitamin
D. Avoid constipation. Hot bathes, hot water bottle will provide heat to the
abdomen. Heat packs also are a good source of portable heat to the area. Acupressure
and acupuncture helps. Often the treatment to stop periods is offered such as progesterone
implants injections even intra uterine hormone devices. As it was mentioned at the start that it is
the ovulatory cycles which are painful oral contraceptive pill is an excellent
option if there are no contra indication to use it or having children is not an
issue. In older women, when child bearing is completed with adenomyosis and
fibroids often operative treatment is offered.
