Dysmenorrhea is the pain or discomfort ("cramps") during or just before a menstrual period. Dysmenorrhea can be either primary, with the onset of menarche, or secondary, developing later. There may be cramping lower abdominal pains, which often radiate to the back, or down the inner aspect of the thigh. These may be accompanied by faintness or gastrointestinal symptoms, including loose stools or nausea.

Primary dysmenorrhea

      Menstrual symptoms vary widely amongst individuals, but some suffer more severely than others. Primary dysmenorrhoea occurs almost exclusively in ovulatory cycles.It is severe, disabling cramps without underlying illness. Symptoms may include backache, leg pain, nausea, vomiting, diarrhea, headache, and dizziness. This kind of dysmenorrhea usually affects young woman within two years of the onset of menstruation and lasts one or two days each month. Primary dysmenorrhea may affect up to 75 percent of women at some time, and 5-6 percent may have incapacitating pain. The frequency of cases increases up to age 20 and then decreases with age.
• Prostaglandin production
• Increased myometrial contractility
• Decreased endometrial blood flow
• Leukotrienes
« Vasopressin

Secondary dysmenorrhea

      This develops after menarche and there may be identifiable underlying patholog. It is cramps caused by another medical problem(s) such as endometriosis (abnormalities in the lining of the uterus), adenomyosis (nonmalignant growth of the endometrium into the muscular layer of the uterus), pelvic inflammatory disease, uterine fibroids, cervical narrowing, uterine malposition, pelvic tumors or an IUD (intra-uterine device). This condition usually occurs in older women.
 Treatment is dependent on the cause. Investigation may include thorough examination, ultrasound scan and laparoscopy. Although psychological factors are quoted as being involved in both primary and secondary dysmenorrhoea, the evidence for physical factors is strong. Recurring, debilitating pain may well cause depression and anxiety, rather than depression initiating the pain.


·         Idiopathic
·         Endometriosis
·         Adenomyosis
·         Pelvic inflammatory disease
·         Pelvic venous congestion
·         Cervical stenosis
·         Intrauterine device

Why does it pain on menstruation?

When the menstrual cycle begins, prostaglandins (chemical substances that are made by cells in the lining of the uterus) are released by the endometrial cells as they are shed from the uterine lining, causing the uterine muscles to contract. If excessive prostaglandin is present, the normal contraction response can become a strong and painful spasm. As it spasms, the blood flow is cut off temporarily, depriving the uterine muscle of oxygen and thus causing a "cramp." The cramps themselves help push out the menstrual discharge.
Excessive prostaglandin release is also responsible for contraction of the smooth muscle in the intestinal tract; hence the diarrhea, nausea and vomiting. Headache and dizziness may also be the result of high prostaglandin levels.

Self Care

For relief of painful menstrual cramps and their associated discomforts, start with a hot bath. The water helps relax the uterus and other tensions that may be contributing to the problem.
Place a heating pad on your abdomen. The flow of heat can provide soothing, temporary pain relief.
Exercise regularly. Aerobic exercise such as walking, swimming, running, bicycling, and aerobic dance may diminish cramping symptoms. For some women, exercise may inhibit prostaglandins or help release endorphins, the brain's natural painkillers.

Home Remedies for Dysmenorrhea

1. Use a heating pad to the lower abdomen. Take warm showers or baths. Drink warm beverages.
2. Do light circular massage with your fingertips around the lower abdomen. Walk or exercise daily.
3. Yoga stretches during your period can also help.
4. Seeds of chicory are prepared into a reduction to treat problems of obstructed menstruation.
5. Lemon grass is used in painful and complicated menstruation. It can be taken in the form of a tea.
6. Fish is a good dietary indication for painful periods.
7. Fry asafetida in ghee and add a teaspoonful of it to buttermilk. Have this once a day in case of dysmenorrhea.


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