Dysmenorrhea (Painful Periods) – Causes, Symptoms, Treatment

You are going about your daily activities as usual. Suddenly you start feeling back pain, bloating, tiredness, low mood etc.  You look at the date on your calendar and remember that it is nearing your “that time of the month” and hence all these symptoms have again started!  If you have only these symptoms and they pretty much disappear after your periods start, then consider yourself lucky as some women can experience pretty severe cramps, pain just before and during their periods.  Let us learn more about these painful cramps during periods, what causes them and what the treatment is.

What Is Dysmenorrhea?

Painful period in medical term is called as “dysmenorrhea.”  These painful cramps are caused by contraction of uterine muscles due to release of hormone-like substance called prostaglandins during menstruation.  Contraction of uterus press against nearby blood vessels there by cutting off oxygen supply to the muscle tissues, causes pain. There are 2 types of dysmenorrhea.

• Primary dysmenorrheal
• Secondary dysmenorrhea

What Is Primary Dysmenorrhea?Primary dysmenorrhea starts usually at menarche, that is, when girls first begin their periods at the age of 11-13.  Primary dysmenorrhea occurs without any underlying disease, it is common and it recurs every month.  It begins 1 or 2 days before the periods or on the first day of periods.  The cramps and pain may be felt around your abdomen, back, thighs accompanied by fatigue, nausea, vomiting, Headache or Diarrhea.  As mentioned above, these cramps occur due to the uterine muscles contraction.  There are no abnormal findings on examination as they do not signify any underlying disease and become less severe with women age and after delivery.  They disappear completely later on in life.

Primary Dysmenorrhea Treatment1. Medication :  Simple analgesics like aspirin, paracetamol and NSAIDS (non-steroidal anti-inflammatory drugs) help alleviate pain in primary dysmenorrhea.

2. Herbal Supplements and Home Remedies :  Some herbal products like ginger, fenugreek, fennel, dill, cinnamon are found to help reduce pain during periods.  Food rich in thiamine and vitamin E when consumed is also said to be very beneficial.  Fish oil also is found to be helpful.  Acupuncture treatment is also found to be helpful in alleviating pain during periods.

3. Other Measures That Help Reduce Symptoms Are

• Place a heat pad or hot water bag over your abdomen
• Get proper rest
• Avoid spicy and fried food during those days
• Avoid too much caffeine
• Do gentle stretching exercise, yoga and meditation
• Exercise regularly
• Do not smoke or drink alcohol as it may worsen your pain and cramps
• Avoid Stressors
• Drink lot of water

When Do You Need To Visit Your Doctor For Primary Dysmenorrhea?

• Usually primary dysmenorrhea occurs every month just before periods start and stops after first or second day of menstrual cycle.
• If you do not get relief with symptomatic measures, your doctor will prescribe you analgesics, muscle relaxants (antispasmodics that suppress muscle spasms) for your discomfort and pain.  Good news is that you do not have to suffer lifelong.  Some girls might wonder why their moms do not suffer from this when they have their periods, it is because this type of dysmenorrhea disappears as you age and after you have pregnancies and deliveries, you just forget what kind of pain it was.

What Is Secondary Dysmenorrhea?

Secondary dysmenorrhea is a condition wherein periods are painful just like in primary dysmenorrhea, but it may be due to some underlying pathological condition.  If it is left untreated, it may continue for a long time unless and until the underlying condition is diagnosed and treated.  This may occur at any age.  You might not be having painful periods usually early in your age, but later on you may start having painful periods and this may become a regular phenomenon for you due to an underlying condition which you are unaware of.

Read more on Excessive Menstrual Bleeding

How Do You Know You Have Secondary Dysmenorrhea?You have never had pain during your periods before, and you observe that you start having pain and cramps during your periods all of a sudden and associated with it your bleeding pattern changes, you have heavier and longer lasting periods, irregular periods or pain in your pelvic region and this continues every month.  This is the time to ponder about what is going on and why?  This is the time you need to visit your gynecologist and get yourself examined for any underlying condition that is causing all of this.  Your doctor will do a pelvic examination and do a few tests to reach a diagnosis.

A Few Underlying Conditions That May Cause Secondary Dysmenorrhea Are

• Pelvic Inflammatory Disease or PID :  It is the infection of your fallopian tubes, may affect your cervix, uterus and ovaries.
• Ovarian Cyst or Tumor :  Presence of ovarian cysts can make your periods very irregular and heavy.
• Using Copper IUD or Intrauterine Device (Birth Control) :  Copper IUDs can cause intense cramping and pain and also cause irregular bleeding.
• Uterine Fibroids :  Fibroids are benign tumors developing in the uterine wall that may be the cause of painful and irregular periods.
• Adenomyosis :  the tissue lining the uterus starts growing within its muscular wall leading to pain and cramps during periods.
• Endometriosis :  Here, the tissue from the uterine lining is found outside of the uterus in the ovaries and fallopian tubes, which breaks down and bleeds around the time of menstruation.

How Is Dysmenorrhea Diagnosed And Treated?

• Your doctor will diagnose first whether you are having primary or secondary dysmenorrhea by taking a thorough medical history, which includes your age, your menstrual cycle history and family history.
• She will do a pelvic examination.
• She may do an ultrasound scan, which helps to better diagnose the underlying condition.
• Treating the underlying condition like fibroid, cyst etc. helps treat secondary dysmenorrhea.
• Hysterectomy (removal of uterus) may be done if all other treatments fail to treat secondary dysmenorrhea.

Conclusion

Painful periods do not happen to each and every girl/woman.  Some fortunate ones do not at all suffer from any pain during their periods.  Some may suffer a bit of pain and cramps that can be cured by just symptomatic treatment or lifestyle modifications.  For some, pain and cramps last just a day or two along with their normal menstrual cycle and disappears with age.  Severe cases of pain and cramping along with heavy and irregular periods may indicate some underlying condition.  Visiting your doctor early on and getting diagnosed and treated helps improve your health and lifestyle to a greater extent.