
What is Dysmenorrhea?
Dysmenorrhea is a cramping type of pain during menses.
Types of dysmenorrhea :
It can be of two types. Primary or Secondary
Primary dysmenorrhea: This is mainly because of the excessive or imbalanced amount of prostanoids secreted from the endometrium (uterine lining) during menstruation. The prostanoids result in increased uterine contractions in a dysrhythmic pattern. Uterine hypercontractility, decreased uterine blood flow and increased peripheral nerve hypersensitivity contribute to pain.
Secondary dysmenorrhea: This is the cyclic menstrual pain that occurs in association with underlying pelvic pathology.
Causes: endometriosis
adenomyosis
subacute endometritis
pelvic inflammatory disease
ovarian cysts
congenital uterine or vaginal malformation
Intrauterine devices
Diagnosis:
To diagnose the cause of pain, the following tests are done:
– Complete blood count & ESR to rule out infection
– Urine microscopy to rule out urinary tract infection
-Cervical culture
– Abdominal or transvaginal ultrasound
-laparoscopy
-Hysteroscopy
Management:
– Hot fomentation: applying heat to the lower abdomen and back
-weight loss
– doing exercises daily for 45 mins at least 5 days a week
-Avoid stress
– Adequate sleep
-NSAIDS & Hormonal pills
– For secondary dysmenorrhea, the underlying cause needs to be identified and treated