Menstrual Cramps - Dysmenorrhea

Dysmenorrhea is characterized by severe uterine pain during menstruation. While many females experience minor pain during menstruation ( which is normal ), dysmenorrhea is diagnosed when the pain is so severe as to limit normal activities, or require medication.

Secondary dysmenorrhea is diagnosed when symptoms are attributable to an underlying disease, disorder, or structural abnormality ( such as fibroids, endometriosis, infection, ovarian cysts, etc ). Primary dysmenorrhea is diagnosed when none of these are detected.

Signs and Symptoms

The main symptom of dysmenorrhea is pain centering in the lower abdomen, which may radiate to the thighs and lower back. Pain is described as sharp, throbing, dull, burning or shooting. Other symptoms may include nausea and vomiting, diarrhea, headache, and fatigue. Symptoms of dysmenorrhea usually begin a few hours before the start of menstruation, and may continue for a few days. Dysmenorrhea may be accompanied with heavy menstrual flow.

Etiology

In a systematic review, these were some risk factors for dysmenorrhea:

Age of less than 30 years

Low body mass index

Tobacco use

Early menarche (<12> )

Longer menstrual cycles

Heavy menstrual flow

nulliparity

Premenstrual syndrome

Sterilisation

Pelvic inflammatory disease

Sexual abuse

Other psychological factors.

Why does this happen?

Prostaglandins are chemical mediators of inflammation. They are released during menstruation, due to the destruction of the endometrial cells. This release of prostaglandins and other inflammatory mediators in the uterus is thought to be a major factor in primary dysmenorrhea. Females with primary dysmenorrhea have increased activity of the uterine muscle with increased contractility and increased frequency of contractions

How are painful periods treated?

With the information above, it is natural to treat menstrual cramps with NSAIDS ( antiinflammatories ) because they inhibit the production of prostaglandins, these medications include naproxen, ibuprofen and mefenamic acid. These can provide relief for the pain associated with high prostaglandin release. Newer medications that inhibit prostaglandins are COX - 2 inhibitors such as Celebrex. You can also try using heating pads or taking a warm bath.

Other prescription medication that might help in menstrual pain are oral contraceptics and other hormonal treatments such as Depo-provera( bear in mind they are hormones and thus can have side effects ).

And if the treatments don't work?

If none of these treatments work, your doctor might want to check for secondary dysmenorrhea, looking for ovarian cysts or endometriosis. An ultrasound test lets your doctor see if you have ovarian cysts. A minor surgery called a laparoscopy is used to check for endometriosis. This is a way of looking inside your uterus by making a small cut in your skin and putting a thin tube inside.

Alternative Medicine

Chinese Medicine is very effective for symptomatic relief of menstrual pain such as with the use of acupuncture, moxibustion ( see picture ), herbs such as Dong quai, etc.

The following herbs and supplements are sometimes effective: Vitex, Vitamin B6, MAgnesium and Calcium. Get a good Omega 3 Fatty acids supplement such as Borage Oil, Evening Primrose Oil or Fish Oil. Use Milk Thistle as a liver detoxifier.

Video of how to treat Menstrual cramps with the use of physical means