Pain or discomfort during or just before a menstrual period is called Dysmenorrhea. When the menstrual cycle begins the uterine muscles contact due to the release of chemical substances called prostaglandins be the cells in the lining of the uterus. If an excessive amount of this chemical is produced the contraction becomes a strong and painful spasm. The spasm temporarily cuts off blood flow depriving the uterine muscles of oxygen. This causes a cramp. Contractions of the smooth muscles of the intestinal tract are also caused by the excessive release of prostaglandin. This causes diarrhea, nausea, and vomiting. Furthermore high levels of prostaglandin can also cause headaches and dizziness.
DysmenorrheaDysmenorrhea may affect up to 75% of women at one time or another. Incapacitating pain is experienced by 5-6% of women.
A doctor may be able to diagnose whether the cramps are caused by Dysmenorrhea by looking at the patients’ medical history and pelvic exam alone. The pelvic exam is normal between menses during primary Dysmenorrhea. Examination during menses may produce no abnormal results and only a slight discomfort.Dysmenorrhea
There may be findings during a physical exam in the case of secondary dysmenorrhea. Additional tests such as radiologic studies (ultrasound) and laparoscopy (a tiny flexible lighted tube is inserted into an incision just below the navel to view the internal abdominal and pelvic organs) may be needed to be performed.
Most doctors prescribe antiprostaglandin drugs or NSAID’s (non-steroidal anti-inflammatory drugs) for the treatment of primary dysmenorrhea. NSAID’s include aspirin, ibuprofen, ketoprofen or naproxen. These drugs lessen the contractions of the uterus and reduce menstrual flow but inhibiting synthesis of prostaglandins. To prevent inadvertent use during early pregnancy these drugs should be started at eh onset of bleeding. Stopping ovulation and decreasing the levels if prostaglandin also helps eliminate cramps. To do these oral contraceptives may be helpful.Dysmenorrhea
The cause of secondary dysmenorrhea determines the treatment that can be applied. One of the most common causes of secondary dysmenorrhea is endometriosis. Conservative drug therapy such as androgens, progestins, oral contraceptives and gonadotropin-releasing hormone agonists or even surgical procedures may be needed depending on the age of the patient and the stage of the disease.Dysmenorrhea
A hysterectomy may be needed in case the problem is adenomyosis. Pelvic inflammation may be treated with antibiotics. Surgery can often treat uterine fibroids, fibroid tumors and pelvic tumors as well as cervical narrowing.
A hot water bath can do wonders to ease menstrual cramps as can a heating pad. Regular exercise helps control the cause of the problems.