DYSMENORRHEA

 

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.