Painful periods?

Painful periods?

What is Dysmenorrhea?

Dysmenorrhea is often referred to as “painful periods”. It’s basically pain that is linked to menstruation. It’s quite common, affecting more than half of women with a menstruation cycle. The pain or menstrual cramps typically lasts 1-2 days. There are two types of dysmenorrhea, primary and secondary. 

Primary Dysmenorrhea

What causes it?
According to ACOG, primary dysmenorrhea is caused by natural chemicals called prostaglandins. Prostaglandins are made in the lining of the uterus.

When does it occur during a menstrual cycle?
Pain usually occurs immediately prior to menstruation when prostaglandins increase in the uterine lining.

What ages are affected?
Girls and women of all ages from the first menstruation to the last can be affected by dysmenorrhea but the pain typically fades with aging. The beginning of a menstrual cycle is when the pain is typically the worst. 

 

Secondary Dysmenorrhea

What causes it?
According to ACOG, secondary dysmenorrhea is caused by a disorder in the reproductive system. It may begin later in life than primary dysmenorrhea. The pain tends to get worse, rather than better, over time.

When does it occur during a menstrual cycle?
Pain usually lasts longer than normal menstrual cramps.

What disorders can cause secondary dysmenorrhea?

A Quick Overview

Endometriosis

Endometriosis is a condition where endometrial tissue is found outside the uterus. It is ‘trapped’ in the pelvic area and lower tummy (abdomen) and, rarely, in other areas in the body. Endometriosis is usually confirmed by a laparoscopy.

Adenomyosis

Adenomyosis occurs when the tissue that normally lines the uterus (endometrial tissue) grows into the muscular wall of the uterus. The displaced tissue continues to act normally — thickening, breaking down and bleeding — during each menstrual cycle.

Fibroids

Fibroids are benign tumors that originate in the muscle part of the uterus called the myometrium. They are the most common solid benign growth within the reproductive tract. Fibroids are caused by a few things.

How is it diagnosed?

Your OB/GYN Specialist will review your medical history, including menstrual cycle symptoms. A pelvic exam, ultrasound or laparoscopy may be needed in order to diagnose dysmenorrhea.  

How is it treated?

Medications can be used to relieve pain from dysmenorrhea but other methods are recommended too like exercise, efficient sleep, and relaxation techniques.

NSAIDs are also used to target prostaglandins and reduce the amount produced to reduce the effects making cramps less painful. 

Dysmenorrhea and Birth Control

According to ACOG, If your symptoms or a laparoscopy point to endometriosis as the cause of your dysmenorrhea, birth control pills, the birth control implant, the injection, or the hormonal intrauterine device can be tried. Gonadotropin-releasing hormone agonists are another type of medication that may relieve endometriosis pain. These drugs may cause side effects, including bone loss, hot flashes, and vaginal dryness. They usually are given for a limited amount of time and are not recommended for teenagers.

Dysmenorrhea and Surgery

Uterine Artery Embolization is performed to treat dysmenorrhea if fibroids are causing the pain. Blood vessels that go to the uterus are blocked with small particles. This stops the flow of blood that usually allow fibroids to grow. This can be done as an outpatient procedure.

 

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