Dysmenorrhea is the medical term for the pain and cramping that women feel just before and during their periods. In most cases, the pain and cramps fade away after two or three days. Moderate discomfort during periods is normal, but in many cases, women experience such severe pain and discomfort that it interferes with their day-to-day life and activities. Pain and cramps during periods are normal, and in most cases manageable without medication. It is thought that about 15% of women have pain that is severe enough to affect their normal lives, but some studies suggest this number could be higher because many women do not report the extent of the pain and cramps. There are medications and other forms of treatments available that can help alleviate the pain and cramping.

Types of Dysmenorrhea

Dysmenorrhea can take two forms.

1. Primary Dysmenorrhea: This refers to the pain and cramps felt due to the normal menstrual cycle which are not caused or exacerbated by any associated medical condition. Moderate to severe pain is typically felt in the thighs, back and abdomen. This is the most common form of dysmenorrhea.
2. Secondary Dysmenorrhea: This refers to painful periods that are due to a medical condition that affects the reproductive system. Secondary dysmenorrhea usually starts earlier than the primary form and also lasts longer. While widespread, this is less common than primary dysmenorrhea.

Causes of Dysmenorrhea 

The pain and cramps are caused by the contractions of the uterus which are necessary to shed the uterine lining and pass out the blood and tissue that come out of the vagina during a period. The contractions are caused by the increasing levels of a chemical called prostaglandin and as the levels fall, the severity of the pain and cramps reduces. Opinions vary about the reason why some women experience more severe dysmenorrhea than others, but it is thought that metabolic variations and different levels of prostaglandin may be responsible.

Symptoms of Dysmenorrhea

The severity of the symptoms varies from person to person, but in general they include:

• An aching or throbbing pain in the abdomen, often with varying degrees of intensity.
• Pain in the lower back, hips and thighs.
• Feeling of pressure or bloating in the abdomen or the midriff area in general.
• In some cases, there may be bouts of nausea, dizziness, diarrhea and headaches.

The symptoms typically develop one or two days before the period begins and subside within two days of periods.

The Effects of Secondary Dysmenorrhea 

Secondary dysmenorrhea is caused by medical conditions that affect the reproductive organs. These include:

1. Endometriosis
2. Adenomyosis
3. Fibroids
4. Pelvic inflammatory disease
5. Cervical stenosis
6. Congenital conditions that affect the uterus, ovaries or fallopian tubes.

Your doctor will be able to give you detailed information about these and other conditions that may cause unusually painful periods and the treatments available.

Diagnosing Dysmenorrhea

If a woman experiences pain and cramps during her periods that affect her normal activities and last for more than three days, a doctor should be consulted. Some women suffer more than others, but if the doctor thinks that the problem is severe enough to warrant further investigation, various diagnostic procedures may be done. These include obtaining a detailed medical history, understanding the specific nature of the pain and cramps, a pelvic examination, laboratory testing of vaginal fluid, blood and so on. If the tests do not show any other medical condition associated with the symptoms, the diagnosis will be of primary dysmenorrhea.

However, if there are grounds to think that other health issues are contributing to the severity of the problem, additional procedures may be ordered, including:

1. Ultrasound
2. Hysteroscopy
3. Laparoscopy

These and other tests will enable the doctor to confirm the nature of the other medical issues that are causing secondary dysmenorrhea.

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Also Read: What is Menopause? - When It Needs Treatment

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Dysmenorrhea Treatment 

Depending on the exact nature and extent of the medical problem, the doctor will advise one or more of the following treatments:

• Nonsteroidal anti-inflammatory drugs (NSAIDs), also known as pain relievers, are often the first course of treatment. These can consist of common over-the-counter medicines, or, if something stronger is required, prescription medication as advised by the doctor.
• Hormonal treatments, including birth control may be advised. Hormonal medications have been shown to reduce the severity of menstrual pain. Birth control options include pills, the patch and the vaginal ring.
• If secondary dysmenorrhea is caused by other medical conditions, such as fibroids or endometriosis, medication or surgery to correct the problem may be recommended.

There are many things a woman can do herself to relieve the pain and cramping. These include:

1. Resting as much as possible during the days of pain and cramps.
2. Using a hot water bottle or heating pad on the lower back and abdomen to relieve the pain.
3. Lower back and abdominal massage.
4. Avoiding drinks containing caffeine.
5. Avoiding alcohol.
6. In many cases, yoga, acupuncture and acupressure have been effective in reducing the pain and cramps.
7. A diet that includes anti-inflammatory foods such as ginger, nuts and leafy green vegetables and drinking green tea will allow the body to handle the pain better.
8. In some cases, supplements such as magnesium and vitamin D have been known to reduce inflammation and pain.
9. Regular exercise and stopping smoking and other forms of tobacco use will allow the body to deal with the pain and cramps more effectively.

If you feel that the pain (and/or discomfort) that you experience during your periods is abnormal or if you feel the days of your period are so uncomfortable that your routine activities and ability to function are affected, then you should not hesitate to contact a medical specialist. Going to a leading multispecialty hospital with a gynecology department staffed by highly qualified gynecologists and where state-of-the-art medical equipment and procedures are available to provide the best treatment is the best course of action. Whatever the cause of the menstrual cramps and pain, the specialists at the gynecology department will be able to provide medical guidance to minimize the extent of the problem and reduce its effect on your normal life.

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