Dysmenorrhea (or dysmenorrhoea) is a medical condition characterized by severe uterine pain during menstruation. While most women experience minor pain during menstruation, dysmenorrhea is diagnosed when the pain is so severe as to limit normal activities, or require medication.
What is Dysmenorrhea?
Dysmenorrhea can feature different kinds of pain, including sharp, throbbing, dull, nauseating, burning, or shooting pain. Dysmenorrhea may precede menstruation by several days or may accompany it, and it usually subsides as menstruation tapers off. Dysmenorrhea may coexist with excessively heavy blood loss, known as menorrhagia.
Secondary dysmenorrhea is diagnosed when symptoms are attributable to an underlying disease, disorder, or structural abnormality either within or outside the uterus. Primary dysmenorrhea is diagnosed when none of these is detected.
Treatment of DysmenorrheaFor treatment of primary dysmenorrhea, most doctors prescribe antiprostaglandin drugs or NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen, ketoprofen, or naproxen. These drugs inhibit synthesis of prostaglandins, lessen the contractions of the uterus and reduce the menstrual flow. These drugs should be started at the onset of bleeding to avoid inadvertent use during early pregnancy and taken for 2-3 days.
Oral contraceptives are another alternative. By stopping ovulation and decreasing prostaglandin levels, they may eliminate cramps.
Treatment of secondary dysmenorrhea depends on the cause. Endometriosis is the most common cause of secondary dysmenorrhea. Depending on the stage of this disease and the woman's age and desire to have children, the treatment methods vary from conservative drug therapy (androgens, progestins, oral contraceptives and gonadotropin-releasing hormone agonists) to surgical procedures.
If the problem is adenomyosis, a hysterectomy may be necessary.Pelvic inflammatory disease may be treated with antibiotics. Uterine fibroids, fibroid tumors and pelvic tumors are often treated surgically. Cervical narrowing can be corrected with surgery as well.
Occasionally, an IUD (intra-uterine device) may be the cause, and if so, the doctor may prescribe antiprostaglandin drugs, and suggest removing the device and using another form of birth control.
Self CareFor relief of painful menstrual cramps and their associated discomforts, start with a hot bath. The water helps relax the uterus and other tensions that may be contributing to the problem.
Place a heating pad on your abdomen. The flow of heat can provide soothing, temporary pain relief.
Exercise regularly. Aerobic exercise such as walking, swimming, running, bicycling, and aerobic dance may diminish cramping symptoms. For some women, exercise may inhibit prostaglandins or help release endorphins, the brain's natural painkillers.