Dysmenorrhea: Painful Periods

Symptoms, Causes and Treatment

Excessive painful periods with intense cramping is a condition called dysmenorrhea. Many women suffer from dysmenorrhea with every menstrual period and the pain can range from mild discomfort to disabling pain. Often women will find their pain to lessen after giving birth the first time but some women continue to experience significant pain even after having children.

What Causes Menstrual Cramps?

Period cramps occur when the uterus contracts during your menstrual cycle. Your uterus is a muscle that may contract quite strongly during your period. 

Dysmenorrhea includes: 

• Achy sensations in the lower abdomen or lower back
• Feeling pressure or cramping
• Pain in the hips and inner thighs
• Having an upset stomach, sometimes even vomiting
• Diarrhea or loose stools 

Dysmenorrhea can be described as primary or secondary depending on the causes. Primary dysmenorrhea is due to abnormal uterine contractions as a result of a chemical imbalance. Primary dysmenorrhea begins with the first and can continue with every period until menopause. 

Secondary dysmenorrhea often develops later in a woman’s life and is associated with medical conditions. Secondary dysmenorrhea is very often caused by endometriosis and pelvic inflammatory disease. Other causes of secondary dysmenorrhea include uterine fibroids, an abnormal pregnancy, miscarriage, or ectopic pregnancy, or a variety of infections, polyps and tumors in the uterus.

What Methods are used to Diagnose Dysmenorrhea?

Your gynecologist can diagnose dysmenorrhea. Diagnosis begins with a complete pelvic exam and health history. In some cases dysmenorrhea requires an ultrasound or MRI to diagnose. It is also possible to diagnose cause of dysmenorrhea through laparoscopy and hysteroscopy. For the laparoscopy procedure, a thin tube-like scope is inserted into the abdominal wall. The tube contains a light and a lens that allows your doctor to get a better look at the uterus.  A hysteroscopy is a visual examination of the cervix and uterus using a hysteroscope that is inserted into this area via the vagina.

What Relieves Dysmenorrhea Pain?

Women with mild menstrual cramps may find relief with over-the-counter medications such as ibuprofen, acetaminophen or naproxen sodium. Speak with your doctor about medication might provide the best relief and the dosage. Don’t wait until the pain is severe to begin seeking treatment. 

Heat may also help your lower back and uterus area feel better and relieve some of the pain. Taking a warm bath can be soothing and using a heating pad may help your muscles relax. It’s important to not put a heating pad or hot water bottle directly on skin. 

The follow may also reduce your pain:

• Rest
• Avoiding caffeine and salt
• Don’t smoke
• Avoid alcohol
• Massage
• Exercise 

It’s important to not stop exercising during your period. Women who exercise routinely tend to have less pain during their periods. If you don’t exercise regularly, try walking, yoga, or some other form of movement to keep your circulation moving and reduce your menstrual discomfort. 

If you are still suffering from pain from dysmenorrhea, make sure to discuss this with your doctor. Strong pain medications may be necessary in your specific case. 

Oral contraceptivesmay also be used to treat dysmenorrhea. Studies have shown that women who take birth control pills to have less pain associated with menstruation.

DR VANDANA BINWAL

Senior Consultant, Obstetrics and Gynecology

Swastik Hospital and Research Centre, Jaipur

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