What exactly are the effects of dysmenorrhea?
Primary dysmenorrhea, or non-pelvic pathological menstrual pain, is a very common obstetrical and gynecological condition that affects 45% to 95% of women who suffer from it. Even with such a high prevalence, dysmenorrhea often goes untreated appropriately and can even go unnoticed, and it may not only be health professionals, pain researchers, or even the women themselves who are suffering from dysmenorrhea who ignore this.
Whether menstruating or not, women with dysmenorrhea are more sensitive to pain than women without dysmenorrhea. What’s more, even when women are not suffering from pain? menstruation, pain sensitivity is also increased, thus demonstrating that pain has a long-term effect on dysmenorrhea and is more likely to develop certain chronic diseases, such as dysmenorrhea as a high risk factor for fibromyalgia.
In addition, dysmenorrhea can have many negative effects on quality of life for at least a few days each month. Women with primary dysmenorrhea have a reduced quality of life during their periods, their moods become worse, and their sleep quality decreases. The current first line of medication for dysmenorrhea remains NSAIDs, which can significantly reduce pain during the day and night.
What is dysmenorrhea?
The pain associated with menstruation is called dysmenorrhea.
Is dysmenorrhea common?
The most common menstrual disorder reported is dysmenorrhea. More than half of all women experience pain for 1 to 2 days each month when they have their period.
What are the types of dysmenorrhea?
There are two types of dysmenorrhea: primary dysmenorrhea and secondary dysmenorrhea.
What is primary dysmenorrhea?
Primary dysmenorrhea is pain caused by the onset of menstruation or cramps during menstruation.
What causes primary dysmenorrhea?
Primary dysmenorrhea is usually caused by physiological prostaglandins. Prostaglandins are released by the lining of the uterus.
At what time does primary dysmenorrhea pain occur?
The pain usually occurs just before the start of menstruation, when prostaglandin levels in the endometrium are elevated. On the first day of menstruation, prostaglandin levels are high. As the period continues and the endometrium sheds, prostaglandin levels decrease. The pain usually decreases as the prostaglandin level decreases.
At what age does dysmenorrhea start?
Usually, primary dysmenorrhea occurs shortly after a woman’s first period. Many women who have primary dysmenorrhea have periods that become less painful as they get older. This type of dysmenorrhea also tends to improve after having children.
The table shows the factors associated with dysmenorrhea, both known (solid line) and unproven (dashed line), and the interrelationship of these factors. Women with dysmenorrhea tend to have decreased sleep quality, quality of life, and physical activity, worse moods when pain occurs, and increased prevalence of chronic pelvic pain.
After multiple menstrual cycles, dysmenorrheic women have increased sensitivity to painful stimuli; however, it remains unknown whether increased pain sensitivity is the cause of recurrent menstrual pain or the chronic effects it brings. Unknown genetic or environmental factors and some underlying differences in the progression of central nervous system pain may play a role in pain sensitivity and eventually lead to recurrent dysmenorrhea.
What is secondary dysmenorrhea?
Secondary dysmenorrhea is caused by a disease of the reproductive system. It may appear later than primary dysmenorrhea. The pain can become more severe over time rather than less severe.
At what time does secondary dysmenorrhea occur?
Pain due to secondary dysmenorrhea usually lasts longer than a normal period. For example, it may have started a few days before your period, the pain may become more intense as the period continues, and it may remain painful after your period is over.
What are the diseases that cause secondary dysmenorrhea?
Some of the following conditions can cause secondary dysmenorrhea: Endometriosis: tissue from the endometrium appears on the ovaries, fallopian tubes, back of the uterus and bladder. With hormonal changes, these endometriotic tissues break down and bleed, and these bleeds can lead to pain, which is more pronounced during menstruation. Bleeding can lead to pelvic adhesions, and chronic pelvic adhesions can lead to pain.
Adenomyosis: normal endometrial tissue grows in the myometrium of the uterine wall.
Fibroids: fibroids located in the uterine wall can cause pain.
How to find the cause of menstrual pain?
Your doctor will review your medical history, including symptoms and menstrual cycle, and will also do a gynecological exam. An ultrasound may also be done. In some cases, a laparoscopy will also be done. This is a procedure that allows the doctor to see the pelvic area.
How is dysmenorrhea treated?
Your doctor may recommend taking medication first to see if the pain is relieved. Medications usually include painkillers or hormones, such as birth control pills. Some lifestyle changes may also be effective, such as exercise, getting enough sleep, and relaxation.
If medications don’t work, treatment will focus on finding and removing the cause of the dysmenorrhea, which may require surgery. In some cases a combination of treatments may work better.
What are the medications used to treat dysmenorrhea?
Some? Prostaglandin-specific pain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs). They reduce the amount of prostaglandins produced by the body to relieve pain.
AIDs work best when they are started at the time when there are signs of menstruation and when there are signs of pain. They are usually taken for only 1 to 2 days. Women with bleeding disorders, asthma, aspirin allergy, liver damage, stomach disorders or ulcers should not take NASIDs.
Which birth control can help control menstrual cramps?
Birth control methods that contain both estrogen and progestin, such as the pill, the patch, and the vaginal contraceptive ring can be used to treat dysmenorrhea. Progestin-only birth control methods such as birth control implants and injectables can also be effective in reducing dysmenorrhea. Hormonal IUDs can also be used to treat dysmenorrhea.
Which medication is used to treat dysmenorrhea due to endometriosis?
If symptoms or laparoscopy indicate that endometriosis is the cause of dysmenorrhea, birth control pills, birth control implants, injectable preparations, and hormonal IUDs can be tried. Gonadotropin-releasing hormone agonists (GnRH-a) are another medication that can relieve the pain of endometriosis. These medications may have some side effects, such as osteoporosis, hot flashes, and vaginal dryness. They are usually taken for a limited time. They are generally not recommended for adolescents, except in severe cases where other treatments have not worked.
What alternatives can help relieve dysmenorrhea?
Some alternatives may be able to help relieve menstrual cramps. Vitamin B1 or magnesium supplements may be effective, but there are not enough studies to show that they are an effective treatment for dysmenorrhea. Acupuncture has been shown to be helpful in relieving dysmenorrhea.
What conditions are treated with uterine artery embolization (UAE) to treat dysmenorrhea?
If the dysmenorrhea is caused by a fibroid UAE may be helpful.
What is UAE?
In this procedure, the blood vessels to the uterus are blocked by small particles that stop the blood supply to the blood vessels supplying the growth of the fibroids. Some women may have UAE as an outpatient procedure.
What are the complications of UAE?
Complications include infection, pain and bleeding.
What is the right time to treat dysmenorrhea?
If other treatments do not relieve the dysmenorrhea, surgery needs to be considered. The type of surgery depends on the cause of the pain.
If the pain is caused by a fibroid, surgery can sometimes remove it. Endometriotic tissue can be removed surgically, but it may recur after surgery, although surgical removal can provide short-term pain relief. Taking hormonal contraceptives or other medications after surgery can delay or prevent the pain from returning.
If other methods do not work and the dysmenorrhea is severe, a hysterectomy may be performed. Hysterectomy is usually the last resort.