Excessive painful menstrual periods or dysmenorrhoea can cause much discomfort and days off from school and work for many young adults and women. Fortunately, there are many treatment options available to bring some relief for those individuals with dysmenorrhoea.
What are painful menstrual periods?
Menstruation is a monthly occurrence for women in which the body sheds the lining of the uterus (womb) which is then passed through the cervix and out through the vaginal canal.
Some pain, cramping and discomfort during menstrual periods is normal. However, excessive pain that causes a woman to regularly miss work or school is not.
Primary dysmenorrhea occurs in women who experience pain just before and during menstruation, but who are otherwise healthy. Women who have had normal periods that later become painful may have secondary dysmenorrhoea. This condition is usually accompanied by a problem affecting the uterus or other pelvic organs.
Menstrual cramps that are not caused by an underlying condition tend to lessen with age. Contrary to what many think, having a baby does not mean severe dysmenorrhoea will disappear.
What are some causes of dysmenorrhoea?
In many cases of primary dysmennorhoea no identifiable cause is found. In some cases it is associated with increased prostaglandins levels. These hormone-like substances might trigger muscle contractions to help the uterus expel its lining each month. These contractions can cause pain and inflammation. Women with higher levels of prostaglandins may experience more severe menstrual cramping and pain.
In some cases, such as with secondary dysmenorrhea, painful menstrual periods can be the result of an underlying medical condition such as:
• endometriosis (a painful medical condition in which cells from the lining of the uterus grow in other parts of the body)
• fibroids in the uterus
• pelvic inflammatory disease, an infection of the uterus, fallopian tubes or ovaries often caused by sexually transmitted infections
• sexually transmitted infections (STIs)
• adenomyosis, a rare condition in which the uterine lining grows into the muscular wall of the uterus
• cervical stenosis, a rare condition in which the cervix is so small it slows menstrual flow
When to seek medical attention
If menstrual pain is interfering with your ability to perform basic tasks each month, it may be time to talk to see your gyanecologist about your symptoms. Talk to your doctor if you experience any of the following:
• painful menstrual periods that have lasted longer than three months
• passing blood clots
• cramping accompanied by diarrhoea and nausea
• pelvic pain when not menstruating
Treatment
Your doctor might suggest some home treatments if your dysmenorrhoea is not very severe – and there is no underlying medical condition. Some home treatments include the following:
• using a heating pad on your pelvic area or back
• massaging the abdomen
• taking a warm bath
• regular physical exercise
• eating light, nutritious meals
• practicing relaxation techniques or yoga
• taking an anti-inflammatory medication such as ibuprofen several days before your expected period
Medical treatment
If home treatment is not successful in relieving your menstrual pain, there are a number of medical treatment options. Treatment will depend on the severity and underlying cause of your cramps. If there is an underlying condition this must be dealt with. There are many medications available for treating dysmenorrhoea.
Surgery is an option if your pain is caused by endometriosis or uterine fibroids and other treatment options have not been successful.
In very rare cases a hysterectomy (surgical removal of the uterus) is also an option if other treatments have not worked and pain is severe.
Conclusion
Many women experience abdominal and pelvic pain just before and during their menstrual periods. In some women the pain is minimal but for others the pain is very severe and can interfere with everyday activities for a few days every month. These women should seek medical advice as there is treatment available for severe menstrual cramps.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB, BS, DGO, MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
