Dysmenorrhea - Common menstrual problem in women


Dysmenorrhea- Common menstrual problem in women

Dysmenorrhea means the painful menstruation which is characterized by menstrual cramps or painful periods, affects nearly every woman at some point in her life.  It is the most common reproductive problem in women. There are two types: primary and secondary.

Primary or normal cramps affects up to 90% of all women.  This usually occurs in women about three years after they start menstruating and continues through their mid-twenties or until they have a child. Backache, dizziness, headache, nausea, vomiting, diarrhea and tenseness may accompany the condition.  Symptoms typically start a day or two before menstruation, usually ending when menstruation actually begins.  Secondary dysmenorrhea has an underlying physical cause and primarily affects older women, although it may also occur immediately after a woman begins menstruation.

Causes and symptoms:

Primary dysmenorrhea is related to the production of prostaglandins, natural chemicals the body makes that cause an inflammatory reaction.  They also cause the muscles of the uterus to contract, thus helping the uterus shed the lining built up during the first part of a woman's cycle.  Women with severe menstrual pain have higher levels of prostaglandin in their menstrual blood than women who do not have such pain. In some women, prostaglandins can cause some of the smooth muscles in the gastrointestinal tract to contract, resulting in the nausea, vomiting and diarrhea some women experience.  Prostaglandins also cause the arteries and veins to expand, so that blood collects in them rather than flowing freely through them, causing pain and heaviness. Yet another reason for severe cramps, particularly in women who have not yet had a baby, is that the flow of the blood and clots through the tiny cervical opening is painful.  After a woman has a baby, however, the cervix opening is larger.

Secondary dysmenorrhea is more serious and is related to some underlying cause. The pain may feel like regular menstrual cramps, but may last longer than normal and occur throughout the month.  It may be stronger on one side of the body than the other. Possible causes include:

  • A tipped uterus
  • Endometriosis, a condition in which the same type of tissue found in the lining of the uterus occurs outside the uterus, usually elsewhere in the pelvic cavity
  • Adenomyosis, a condition in which the endometrial lining grows into the muscle of the uterus
  • Fibroids
  • Pelvic inflammatory disease (PID)
  • An IUD
  • A uterine, ovarian, bowel or bladder tumor
  • Uterine polyps
  • Inflammatory bowel disease
  • Scarring or adhesions from earlier surgery


Primary dysmenorrhea is typically treated with non-steroidal, anti-inflammatory medications like ibuprofen and naproxen, which studies show help 64 to 100% of women. Birth control pills relieve pain and symptoms in about 90% of women by suppressing ovulation and reducing the amount of menstrual blood.  It may take up to three cycles before a woman feels relief.  Heat from a heating pad or hot bath, can also help relieve pain.  Treatment for secondary dysmenorrhea depends on the underlying cause of the condition.

Alternative therapy:

Numerous alternative treatments may help relieve the menstrual pain. These include:

  • Transcutaneous electrical nerve stimulation (TENS), which several studies found, relieved pain in 42-60% of participants, working faster than naproxen in one study.
  • Acupuncture: One study of 43 patients followed for a year found that 90% of those who had acupuncture once a week for three menstrual cycles had less pain, and 43% used less pain medication.
  • Omega-3 fatty acids: Often sold as fish oil supplements, omega 3 fatty acids are anti-inflammatory and work against the effects of prostaglandins. Studies found that women with low amounts of omega-3 fatty acids in their diets were more likely to have menstrual cramps; those who took supplements had less pain.
  • Vitamin B-1: One large study found that symptoms disappeared in 87% of women who took 100 mg a day for 90 days.
  • Magnesium supplements: One study of 30 women who took 4.5 milligrams of oral magnesium three times daily for part of the month decreased their symptoms up to 84%.



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