What is menstrual cramp/pain?
Dysmenorrhea is referred to as menstrual cramps which are caused by contractions of the uterine. Common menstrual cramps are often referred to as primary dysmenorrhea, while menstrual cramps associated with a disorder in the reproductive organs are known as secondary dysmenorrheal but both could be treated.
Menstrual cramps are one of the annoying parts of your period. This primary and secondary dysmenorrhea is the two main types of dysmenorrhea.
In primary dysmenorrhea, its menstrual cramps are recurrent (do resurfaces) and are not associated with any medical disorder. The pain usually starts 1 or 2 days before the actual menstruation, or when menstrual bleeding begins and is being felt around the lower abdomen, back, or thighs.
Some people could experience mild to severe pains which can typically last 12-72 hours depending on the girl’s body. Pain is usually accompanied by vomiting and nauseating feelings, fatigue, and even diarrhea. However, these common menstrual cramps appear less painful as a woman ages and may stop completely when a woman has its first baby.
Consequently, medical disorders like adenomyosis, endometriosis, uterine fibroids, or infection bring about secondary dysmenorrheal in most women. Secondary dysmenorrhea pains usually start earlier in the menstrual cycle and stay longer than common menstrual cramps. Its pains are not accompanied by vomiting, nausea, diarrhea, or fatigue.
What are the causes of painful menstrual cramps?
Menstrual cramps arise from the tightening in the uterus (usually a muscle) by a chemical known as prostaglandin. The uterus which is a site for the development of a baby contracts throughout a woman’s menstrual cycle. While a woman is menstruating, the uterus contracts more strongly.
However, if the uterus tightens too strongly, it can press against nearby blood vessels, stopping the supply of oxygen to the muscle tissue around the uterus. Since the part of the muscle loses its supply of oxygen, it can then bring about pains and menstrual cramps.
Also, the pain usually occurs right before menstruation begins, as the level of prostaglandins increases in the uterus lining. The levels are high usually during the first day of the menstrual period. As menstruation continues and the uterus lining is shed, the levels decrease. This implies that pain decreases as the levels of prostaglandins decrease.
How secondary dysmenorrhea cause menstrual cramps
Menstrual pain associated with dysmenorrhea is usually caused by disorders in the woman’s reproductive organs. The following are conditions that can bring about secondary dysmenorrhea in women:
Adenomyosis: This is a condition where the lining of the uterus grows into the muscle of the uterus.
Endometriosis: It’s a medical condition where the tissue lining the endometrium (the uterus) is seen outside of the endometrium like in the ovaries and fallopian tubes, behind the uterus, and on the bladder.
Cervical stenosis: Simply narrowing of the opening to the womb.
Pelvic inflammatory disease (PID): It is a bacterial infection that begins in the uterus and can spread to other reproductive organs.
Fibroids: These benign tumors are growths found in the inner wall of the uterus.
Symptoms of menstrual cramps
The following are the likely symptoms to look out for if you suspect it is dysmenorrhea:
- Experiencing aching pain in your abdomen which may be severe sometimes
- Pain around the hips, lower back, and inner thighs
- Feeling of pressure in your abdomen
When cramps are intense, you may experience the following symptoms:
- Stomach upset (sometimes accompanied with vomiting)
- Having loose stools
Diagnosis and test to determine the causes of dysmenorrhea
If you have dysmenorrhea, your medical doctor will review your medical history together with your symptoms and menstrual cycles. You’ll be asked to undergo a pelvic exam, an ultrasound exam or in some cases, a laparoscopy may be done. In laparoscopy, your medical doctor performs this surgery by looking inside your pelvic region.
A pelvic examination does entail your doctor inserting a speculum (an instrument used to view inside the vagina) and analyze your vagina, cervix, and uterus. However, your doctor will check and feel any lumps or changes, and a small sample of your vaginal fluid may be taken for testing.
Furthermore, if secondary dysmenorrhea is suspected, more tests may be required. If a medical disorder is discovered, your medical doctor will discuss the optimal treatments for you. Where you use tampons and experience the following symptoms, visit your doctor right away for medical assistance:
- Feeling dizzy, fainting, or almost fainting
- Fever usually above 102oF
- Having a rash that appears like a sunburn
The above symptoms can be associated with toxic shock syndrome, a life-threatening sickness.
Both primary and secondary menstrual cramps can be treated effectively, so it’s vital to get checked regularly.
Management and treatment of dysmenorrhea
Can I feel relieved from mild dysmenorrhea (pain with mild menstrual cramps)?
Here are the following ways you could feel relieved from mild menstrual cramps:
- For optimal relief, you can take ibuprofen as soon as cramping or bleeding begins. Aspirin or other pain relievers like acetaminophen can also help.
- Have adequate rest where necessary.
- Refrain from smoking and drinking of alcohol.
- Place a heating pad or hot water bottle on your lower back or belly.
- Never consume foods that have caffeine.
- Try massaging your lower back and abdomen to alleviate the pains.
A woman who indulges in regular exercise often experiences less menstrual pain. Why not indulge in regular exercise weekly to help prevent cramps.
If the above tips do not relieve your pain, meet with your medical doctor to prescribe some suitable medications to ease the pains like ibuprofen or another (NSAIDs) nonsteroidal anti-inflammatory medication (a higher dose than is found over-the-counter).
NSAIDs work effectively if taken at the first sign of your menstrual period or pain. They can be taken for only 1 or 2 days. Women with bleeding disorders, aspirin allergy, asthma, stomach disorders, liver damage, or ulcers are advised never to take NSAIDs.
In some cases, oral contraceptives may be prescribed because women who take oral contraceptives tend to experience a less menstrual cramp.
Are there any birth control methods to help control dysmenorrhea?
Yes, there are like the birth control methods that have progestin and estrogen. They include the pill, vaginal ring, and the patch can be used to treat dysmenorrhea effectively. Birth control methods that have progestin-only, like the birth control implant and the injection, may be effective in reducing menstrual pain. Also, the hormonal intrauterine device (IUD) can be used to treat dysmenorrhea effectively.
Is there any medication used to treat dysmenorrhea caused by endometriosis?
If your symptoms or a laparoscopy detect endometriosis as the cause of your dysmenorrhea, birth control pills, the birth control implant, the hormonal intrauterine device, or injection can be used. You may be given gonadotropin-releasing hormone agonists which are also a medication taken to relieve endometriosis pain.
However, these drugs have several side effects like bone loss, vaginal dryness, and hot flashes. But they’re usually given for a short period of time. They are suitable for adults except in severe cases when other treatments are not effective, a teenager can be administered the drugs.
What other treatment methods help alleviate menstrual cramps/pains?
Certain treatment methods like taking vitamin B1 or magnesium supplements may help ease dysmenorrhea. Although adequate researches are needed to ascertain the effectiveness of these supplements to the treatment of dysmenorrhea, acupuncture has been found to be helpful in relieving menstrual cramps.
When can UAE (uterine artery embolization) be done in the treatment of dysmenorrhea?
If a fibroid is the cause of your dysmenorrhea, uterine artery embolization (UAE) may be needed for its successful treatment.
How is UAE (uterine artery embolization) carried out?
Here, the blood vessels to the uterus are shielded with small particles, stopping the flow of blood that allows fibroids to grow. Some women may prefer to undergo uterine artery embolization (UAE) as an outpatient.
Are there any complications associated with uterine artery embolization (UAE)?
Yes, there are as some women experiences pains, infections, and bleedings.
When is surgery needed in the treatment of dysmenorrhea?
Surgery is only needed when other treatments do not work effectively in relieving menstrual cramps. Your surgery type may depend on the cause of your pain.
If the pains are as a result of fibroids, they can be removed with surgery. Endometriosis tissue can also be removed during surgery. Although endometriosis tissue may resurface after the surgery, removing it can reduce the pain in a short while. However, taking hormonal birth control or other medications after surgery may delay or prevent the return of pain in the body.
Consequently, if the disease-causing the dysmenorrhea is severe and other treatments seem not to work effectively, hysterectomy may be carried out. This procedure is usually the last method employed by most doctors.
Having known the symptoms, causes, and treatments for dysmenorrhea, try to avoid unhealthy lifestyles like smoking and drinking of alcohol so as not to increase your menstrual cramps or pains. If you have further questions, visit your obstetrician-gynecologist.