Dysmenorrhea- means the menstrual cramps, painful periods. These cramps usually occur just before or during periods. In some cases, this can cause discomfort that is merely annoying, while in other cases menstrual cramps are severe enough to interfere with day today activities for a few days in each month.
Menstrual cramps typically caused by uterine contractions.
Conditions such as adenomyosis, endometriosis, or uterine fibroids can lead to menstrual cramps also. The pain can be reduced by treating the cause. Menstrual cramps that are not caused by another conditions tends to reduce with age and often lessen after giving birth.
There are two categories of dysmenorrhea:
In primary dysmenorrhea there is no pelvic pathology involved. The menstrual cramps or pain are at highest level on first two days of menstrual cycle.
Primary Dysmenorrhea can be caused by increased prostaglandin production by the endometrium in an ovulatory cycle which causes contractions of uterine muscles.
Primary dysmenorrhea starts from 12-24 hours prior to the onset of menses.
The abdominal pain can be accompanied by nausea, diarrhea, fatigue, dizziness, or headache.
In secondary dysmenorrhea there is involvement of pelvic or uterine pathology.
The causes of secondary dysmenorrhea include:
Common symptoms of dysmenorrhea include:
Secondary dysmenorrhea commonly occurs after the woman has experienced problem free periods for some time.
The other symptoms of secondary dysmenorrhea include:
Assessment and Diagnosis
Primary dysmenorrhea- Cramping pain with menstruation and physical examination is absolutely normal.
If the signs and symptoms are findings then further evaluation should do, this usually include:
Non-invasive diagnostic procedures:
Invasive diagnostic procedures:
The treatment options for dysmenorrhea includes:
Life style changes such as
Treatment for secondary dysmenorrhea include:
Management of secondary dysmenorrhea is directed at diagnosis and treatment of underlying cause (e.g. endometriosis or PID- pelvic inflammatory disease).