This is the term given to menstrual cramps - the pain experienced by women at the time of their periods. More than half of all menstruating women experience such cramps, and these are severe in 10-15 per cent of these. These pains are different from the symptoms experienced during pre-menstrual tension.
The medical profession divide dysmenorrhoea into two types - primary and secondary. In primary dysmenorrhoea cases, this type of cramp usually begins when periods first start, and there is no underlying gynaecological problem. In secondary dysmenorrhoea, there is often an underlying gynaecological problem.
What Causes Dysmenorrhoea?
Normal periods involve the lining of the womb, or uterus, being shed each month if fertilisation of an egg has not occurred. When this occurs, chemicals called prostoglandins are released which cause the uterine muscles to contract. Women who have high levels of prostoglandins released have more intense and painful periods than women with lower levels. This is because the muscles of the uterus contract more severely, making the discomfort worse - such discomfort is often described as being similar to 'early labour pains'.
What Are The Signs And Symptoms Of Dysmenorrhoea?
The main sign is pain. This is felt in the lower abdomen, or 'belly', and the pelvis, and can spread round to the back or down the legs. This pain can be intermittent or continuous, and usually begins about 24-48 hours before a period begins. It lasts 1-3 days and then subsides over another day or two. It may be accompanied by nausea or vomiting in some cases, and constipation or diarrhoea can also occur - this is due to the prostoglandins that are released also affecting the smooth muscles of the bowel.
Will I Have Any Tests Or Investigations?
The diagnosis is usually made without any tests being necessary but if there is very heavy blood loss or an associated anaemia, blood tests and an ultrasound scan of the pelvis are sometimes arranged to check for fibroids or other pathology such as endometriosis, adhesions or pelvic inflammatory disease.
What Treatment Might I Need?
Apart from simple ways in which a sufferer of dysmenorrhoea is able to help herself (see below), the main way to treat this pain is with non-steroidal anti-inflammatory drugs (NSAIDs). Examples of these are Nurofen, Ibuprofen (both available over the counter without prescription) and Ponstan or Naproxen from your GP. These should be taken 1 to 2 days before a period is due to start, rather than when the pain begins, and continued for 2 to 3 days.
If such treatment is still inadequate, another possibility involves taking the contraceptive pill which not only regulates the timing of a period but reduces its discomfort and blood loss by reducing the level of prostoglandins being released.
Surgery is performed far less frequently than it was in the past, when hysterectomy was not uncommon - dysmenorrhoea is far more likely to be treated medically now, and if surgery is contemplated then it will probably be of the form of an endometrial ablation where the uterus is kept intact, but the lining removed with a heat-generating instrument under general anaesthetic.
What Course Will The Illness Follow?
Most women with dysmenorrhoea do not experience their symptoms getting any worse as they age - in fact, the opposite usually occurs with primary dysmenorrhoea. If secondary dysmenorrhoea is a problem, the course depends on the underlying reason.
Can I Do Anything To Help Myself?
Many women find that rest and sleep is a great help, along with regular exercise during the day - especially walking. Warmth in the form of a heating pad or a hot water bottle wrapped in a towel and put on the painful area often helps, and some women also find sexual activity reduces their pain - this is obviously highly individual to each sufferer. Although often difficult, finding ways to reduce stress at the time of the dysmenorrhoea undoubtedly helps many women as well.
Tell Your Doctor
1. Are your periods regular?
2. Have you always suffered from painful periods?
3. How long do your periods usually last?
4. Has your blood loss become heavier recently?
5. Does your pain prevent you from working or carrying out your normal life?
Ask Your Doctor
1. Am I able to have the coil fitted for contraception if I want one?
2. What are the side effects of any drug treatment?
3. Will having a baby have any effect on my dysmenorrhoea afterwards?
4. How much exercise should I be doing to help myself?
5. Will being sterilized make my dysmenorrhoea worse?
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