Why does it pain during menstruation?
During the menstruation the thickened inner lining of the uterus releases prostaglandins (hormone like substances which have effects on various organs in the human body). These prostaglandins cause painful cramps in the uterus. As the uterine lining gets shed during menstruation the levels of these PGs decreases and the cramps subside.
What are the symptoms of dysmenorrhoea?
Dull continuous lower abdomen pain, cramping pain of low or high intensity, which starts 2-3 days before the start of the periods and peaks around 24 hours after the onset of the periods. It usually subsides during the third day of the menstruation. It can radiate to thighs and lower back. It may be accompanied by nausea, headache, dizziness and loose stools.
What are the types of dysmenorrhea?
There are two types of dysmenorrhea: primary dysmenorrhea and secondary dysmenorrhea.
What is primary dysmenorrhea?
Primary dysmenorrhea is “menstrual cramps” that occur during a normal menstruation due to the release of the prostaglandins. This kind of dysmenorrhea also may improve as we get older and after giving birth due to maturation of the hypothalamic-pituitary-gonadal axis (which controls sexual organs development and reproduction).
What is secondary dysmenorrhea?
Secondary dysmenorrhea is pain that is caused by any disorder in the 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.
- Endometriosis—In this condition, tissue from the lining of the uterus is found outside the uterus, such as in the ovaries and fallopian tubes, behind the uterus, and on the bladder. Like the lining of the uterus, endometriosis tissue breaks down and bleeds in response to changes in hormones. This bleeding can cause pain, especially right around menstruation. Scar tissue called adhesions may form inside the pelvis where the bleeding occurs. Adhesions can cause organs to stick together, resulting in pain.
- Adenomyosis—Tissue that normally lines the uterus begins to grow in the muscle wall of the uterus.
- Fibroids—Fibroids are growths that form on the outside, on the inside, or in the walls of the uterus
- Pelvic inflammatory diseases – An infection caused by bacteria that starts in the uterus and can spread to other reproductive organs.
What are the investigations required to find out the cause for secondary dysmenorrhea?
A thorough medical history including signs and symptoms, Ultrasound and laparoscopy in some cases.
What are the treatment options available?
Pain relievers, hormonal medications (birth control pills), proper rest and relaxation methods are advised. If the pain persists even after medication, treatment will focus on finding and removing the cause by surgery.
What are the complications?
Certain conditions associated with menstrual cramps can have complications, such as in the case of endometriosis fertility will be affected. Pelvic inflammatory disease can scar the fallopian tubes, increasing the risk of a fertilized egg implanting outside of the uterus (ectopic pregnancy).