Painful Menstruation

On this page:

• Definition
• Types
• Causes
• Implications
• What You Can Do

Definition

Dysmenorrhea is sharp, intermittent or dull aching pain in the lower abdomen or pelvis during menstrual periods. This pain may actually start 2-3 days before the start of menstrual periods.

The hormone prostaglandin which is produced by the uterine cells, is thought to be responsible a factor in primary dysmenorrhea. This hormone causes contraction of the uterus. The levels of prostaglandins tend to be much higher in women with severe menstrual pain than in women who experience mild or no menstrual pain.

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Types

• Primary Dysmenorrhea - This refers to menstrual pain that may occur in the absence of any uterine or pelvic problem in otherwise healthy women. This pain may be mild or severe, usually more intense on the first 2 days of starting a period.
• Secondary Dysmenorrhea - Refers to menstrual pain that can be attributed to some underlying disease process or structural abnormality either in the uterus or in the pelvic organs.

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Causes

• Endometriosis
• Premenstrual syndrome (PMS)
• Ovarian cysts
• Stress and anxiety
• Uterine fibroids
• Uterine polyps
• Pelvic inflammatory disease
• Multiple sexual partners
• History of sexual or physical abuse
• Intrauterine Device
• Using tampons

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Implications

Almost all women are affected by some degree of pain and discomfort during their menstrual periods. For a some, the discomfort may be serious enough to make it impossible to perform normal household chores, go to work or school especially for the first 2 days. The pain may begin several days before or just at the start of your period and it generally subsides as menstrual bleeding tapers off. Although some pain during menstruation is considered to be part of the normal menstrual period, excessive pain certainly needs to be evaluated by your physician. Secondary dysmenorrhea due to endometriosis can scar your fallopian tubes and lead to infertility. Scarring of the fallopian tubes due to secondary infertility can result in ectopic pregnancy.

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What You Can Do

• Medications
  • Over-the-counter nonsteroidal anti-inflammatory drug (NSAID) like aspirin, ibuprofen (Advil, Motrin) or naproxen (Aleve, Anaprox).
  • Cox-2 inhibitors such as celecoxib (Celebrex), rofecoxib (Vioxx) and valdecoxib (Bextra)
  • Antibiotics to treat pelvic inflammatory diseases.
  • Birth control pills (oral contraceptives) to suppress ovulation.

• Vitamins
  • Take vitamin B6, calcium and magnesium supplements

• Home Remedies
  • Apply a heating pad to your lower abdomen.
  • Do light circular massage with your fingertips around your lower abdomen.
  • Elevate your legs by placing 2-3 pillows under your legs or lie lie on your side with your knees bent.
  • Take warm showers or baths.
  • Drink plenty of fluids especially warm beverages.
  • Get enough rest and sleep
  • Walk or exercise regularly.
  • Eat a well balanced diet rich in complex carbohydrates, fruits and vegetables
  • Decrease your intake of salt, sugar, alcohol and caffeine.
  • Eat small frequent meals.
  • Practice relaxation techniques like meditation or yoga.

• Consult your Physician if:
  • There is foul smelling vaginal discharge that has increased in amount recently
  • You are passing blood clots
  • You have a fever
  • The pain continues after your period is over

• Surgery
  • Surgical procedures may include removal of cysts, polyps, adhesions, fibroids or complete hysterectomy in cases of extreme endometriosis.

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