WHAT IS DYSMENORRHEA?
Dysmenorrhea is the medical term for pain with menstruation. There are two types of dysmenorrhea: “primary” and “secondary”.
Primary dysmenorrhea is common menstrual cramps that are recurrent (come back) and are not due to other diseases. Pain usually begins 1 or 2 days before, or when menstrual bleeding starts, and is felt in the lower abdomen, back, or thighs. Pain can range from mild to severe, can typically last 12 to 72 hours, and can be accompanied by nausea and vomiting, fatigue, and even diarrhea. Common menstrual cramps usually become less painful as a woman ages and may stop entirely if the woman has a baby.
Secondary dysmenorrhea is pain that is caused by a disorder in the woman’s reproductive organs, such as endometriosis, adenomyosis, uterine fibroids, or infection. Pain from secondary dysmenorrhea usually begins earlier in the menstrual cycle and lasts longer than common menstrual cramps. The pain is not typically accompanied by nausea, vomiting, fatigue, or diarrhea.
WHAT CAUSES DYSMENORRHEA (PAIN OF MENSTRUAL CRAMPS)?
Menstrual cramps are caused by contractions (tightening) in the uterus (which is a muscle) by a chemical called prostaglandin. The uterus, where a baby grows, contracts throughout a woman’s menstrual cycle. During menstruation, the uterus contracts more strongly. If the uterus contracts too strongly, it can press against nearby blood vessels, cutting off the supply of oxygen to the muscle tissue of the uterus. Pain results when part of the muscle briefly loses its supply of oxygen.
HOW DOES SECONDARY DYSMENORRHEA CAUSE MENSTRUAL CRAMPS?
Menstrual pain from secondary dysmenorrhea is caused by a disease in the woman’s reproductive organs. Conditions that can cause secondary dysmenorrhea include:
- Endometriosis – A condition in which the tissue lining the uterus (the endometrium) is found outside of the uterus.
- Adenomyosis – A condition where the lining of the uterus grows into the muscle of the uterus.
- Pelvic inflammatory disease – An infection caused by bacteria that starts in the uterus and can spread to other reproductive organs.
- Cervical stenosis – Narrowing of the opening to the uterus.
- Fibroids (benign tumors) – Growths on the inner wall of the uterus.
SYMPTOMS OF DYSMENORRHEA
Symptoms of menstrual cramps include:
- Throbbing or cramping pain in your lower abdomen that can be intense
- Pain that starts 1 to 3 days before your period, peaks 24 hours after the onset of your period and subsides in 2 to 3 days
- Dull, continuous ache
- Pain that radiates to your lower back and thighs
Some women also have:
- Nausea
- Loose stools
- Headache
- Dizziness
CAUSES OF DYSMENORRHEA
During your menstrual period, your uterus contracts to help expel its lining. Hormone like substances (prostaglandins) involved in pain and inflammation trigger the uterine muscle contractions. Higher levels of prostaglandins are associated with more-severe menstrual cramps.
Menstrual cramps can be caused by:
- The tissue that lines your uterus becomes implanted outside your uterus, most commonly on your fallopian tubes, ovaries or the tissue lining your pelvis.
- Uterine fibroids.These noncancerous growths in the wall of the uterus can cause pain.
- The tissue that lines your uterus begins to grow into the muscular walls of the uterus.
- Pelvic inflammatory disease.This infection of the female reproductive organs is usually caused by sexually transmitted bacteria.
- Cervical stenosis.In some women, the opening of the cervix is small enough to impede menstrual flow, causing a painful increase of pressure within the uterus.
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Dr. Ajibade,
B.Sc. Public Health & Alternative Medicine (Cameroon); Diploma in Naturopathy (USA); Diploma in Acupuncture (India & Sri Lanka); mLASTMB (Lagos), mNCPNM (Nigeria), mNANTMP (Nigeria), mACTMPWA(West Africa).
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