Knowing its Causes and Treatment
Dysmenorrhea or pain during menstruation is one of the most common afflictions that affect women. For some it may only be a mild discomfort. However, for others, it can be a disabling condition. Pain in dysmenorrhea is often described as dull and cramping in the lower abdomen, particularly in the pelvic area and happens right before or during menstruation. The pain may be limited to the abdominal area or may radiate to other parts of the body particularly the lower back and thighs. Dysmenorrhea disappears in the latter of part of the menses or after taking analgesics such as NSAIDs.
Dysmenorrhea is caused by the contraction of the uterus during menstruation. The uterus is composed of three layers: the endometrium, the myometrium, and the perimetrium. During the menstrual cycle, the endometrium, the innermost layer, thickens and becomes highly vascularized in response to different hormones. Eventually, this layer gets sloughed off during menstruation. The myometrium, which is primarily made up of smooth muscles, contracts to help shed off the thickened layer. Sometimes the contractions are too strong, causing the pain associated with menstrual pain.
Abdominal pain is the most prominent symptom of dysmenorrhea. Often it is described as dull and aching; however some women also experience a crushing or stabbing pain. In many cases, this may be the only discomfort felt. However, in women with moderate to severe pain, nausea, vomiting and diarrhea may also happen. Pallor, clammy skin, and dizziness also occur, particularly in those who experience severe menstrual cramping. In a few cases, dehydration may also set in, causing weakness, dry lips, and thirst.
Causes of dysmenorrhea are varied. One of the most common causes includes hormonal imbalance and endometriosis, or the growth endometrial tissue outside the uterus. Fibroid growths, an over thickened endometrium, or the presence of contraceptive objects inside the uterus can also cause pain during menstruation. In a significant number of women, particularly adolescents, no exact cause for dysmenorrhea can be pinpointed. In many cases, pain during menstruation disappears once they enter their twenties or after giving birth. Dysmenorrhea is more likely to occur in women who have a family history of dysmenorrhea, those who have never been pregnant, those who smoke, and those who started menstruating at an early age. Dysmenorrhea at an older age is relatively uncommon and should be investigated for possible gynecological problems.
Dysmenorrhea can be easily managed at home. NSAIDS such as mefenamic acid are effective in controlling the pain. Rest, lower back massages, and warm compress have also been effective home remedies. Antispasmodics to relax the uterine muscles may also be administered alone or together with pain medications. In addition, oral contraceptive pills are often prescribed for those who suffer heavy and painful bleeding due to hormonal imbalance. These pills prevent ovulation and the oversecretion of certain hormones. For those who frequently experience severe unrelenting pain or have associated heavy menstrual bleeding, an ultrasound of the pelvic area is often requested to rule out any abnormal growths. Aside from medicines, surgery may be indicated for women who have uterine growths.