Demystifying dysmenorrhea

Women with primary dysmenorrhea have abnormal contractions of the uterus due to a chemical imbalance in the body, writes Dr Suhasini Inamdar

Dysmenorrhea is the medical term for painful menstrual cycles triggered by uterine contractions. Menstrual cramps that are too severe are not common. If anti-inflammatories or hormone therapy are unsuccessful, or if the pain continues for more than a few days, it may be primary dysmenorrhea where no pathology is seen in the genital tract or secondary dysmenorrhea, when pain is due to the pathology like infection, cyst, fibroid, endometriosis. Menstrual pain frequently peaks in a person’s late teens or early 20s, according to studies, so dysmenorrhea research appears to concentrate on younger people.

Painful menstrual cramps

When a chemical named prostaglandin causes the uterus to contract, it causes menstrual cramps (tighten up). During the menstrual cycle, the uterus, the muscular organ where a baby develops, contracts. The uterus contracts more strongly during menstruation. When the uterus contracts too hard, it may push against nearby blood vessels, cutting off the oxygen supply to muscle tissue. When a muscle loses its supply of oxygen for a short period of time, it causes pain.

Contact your healthcare provider if you have serious or irregular menstrual cramps or cramps that last more than two or three days. It’s necessary to get tested because both main and secondary menstrual cramps can be handled. You will first be asked to explain your symptoms as well as your menstrual cycles. A pelvic exam may also be done by the healthcare provider. A speculum is inserted into your vagina during this examination (an instrument that lets the provider see inside the vagina for infections or ulcers, polyps, etc). A bimanual examination is also done to detect any masses, cysts, or if there is a shift of the uterus.

Additional testing, such as an ultrasound or a laparoscopy, may be needed if your doctor believes you have secondary dysmenorrhea. If the tests show a medical condition, the doctor will discuss treatment options with you.

Relief from mild menstrual cramps

To relieve moderate menstrual cramps, try the following: Take an ibuprofen as soon as the bleeding or cramping begins. Ibuprofen belongs to the non-steroidal anti-inflammatory medicine (NSAID) family of medicines. They inhibit the development of prostaglandins. If you can’t take NSAIDs, try acetaminophen or another pain reliever. Apply heat to your lower back or abdomen with a heating pad or a hot water bottle.

When needed, take a break.

Avoid caffeine.

Stop smoking and consuming alcohol.

Massaging your lower back and abdomen is a good idea.

Menstrual pain is also decreased in women who exercise regularly. Make exercise a part of your weekly routine to help avoid cramps. If these interventions don’t work, the doctor will prescribe drugs. Oral contraception can also be prescribed by your healthcare provider, since people who use them experience less menstrual discomfort. If testing indicates that you have secondary dysmenorrhea, the doctor will examine the condition that is causing the pain and how to treat it. Oral contraception, other forms of drugs, or surgery may be used.

Medical treatment

The severity and the root cause of your pain will decide your medical options. If the discomfort is caused by PID or sexually transmitted infections (STIs), your doctor will prescribe antibiotics to treat the infection. Hormonal birth control can also be prescribed by your doctor. Hormonal birth control comes in pill, pad, vaginal ring, injection, implant, and IUD type. Hormones can help you manage your menstrual cramps by avoiding ovulation. Endometriosis and uterine fibroids can also be treated with surgery.
(The author is a consultant obstetrician & gynaecologist.)