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Menstrual pain
Menstrual pain: Menstrual pain consists of the abdominal cramplike aching (with possible
nausea, headache, backache, weakness, irritability, and depression) that accompanies
menstruation in a woman. It normally occurs at the approximate monthly intervals of
menstruation.
Its scientific name is dysmenorrhea (dis-MEN-uh-ree-uh). Two main types are recognized.
Primary dysmenorrhea is a natural process that is a normal part of menstruation.
Secondary dysmenorrhea has an additional underlying cause due to disease or other
malfunction.
Cause The exact cause of menstrual pain remains unknown. The primary type is thought to
result mainly from contractions of the uterus similar to but weaker than those that
occur during childbirth. Such contractions are triggered by a hormonelike chemical,
prostaglandin, that is produced with menstruation.
Secondary dysmenorrhea appears during the menstrual cycle but is caused in most cases
by infection, inflammation, or other disorder of the woman's reproductive organs.
Incidence Only women develop the menstrual pain of primary dysmenorrhea. All women are
subject to it during menstruation, but its effects are slight for some. On the other
hand, for an estimated one woman in every ten, the effects are so severe that they
require cutting back on regular activities to some extent. Those effects can be avoided
entirely by the taking of oral contraceptives.
Normally most women start experiencing menstrual pain in the early teenage years, about
two years or more after their periods have begun. Regular recurrence may begin when the
cycle of ovulation becomes well established. It may lessen spontaneously starting in
about the mid-twenties. Few women experience it after the birth of a first child. Cases
of menstrual pain representing secondary dysmenorrhea are comparatively uncommon.
Symptoms you are likely to notice Many women who get only mild onslaughts of primary
dysmenorrhea typically feel headachy and have a tinge of nausea with vague discomfort
and a sense of overfullness of the abdomen. Other women go through moderate to severe
attacks. Symptoms of these may include pain as if from cramping in the abdomen that
varies from noticeable to very sharp; aching in the lower back; an upset stomach with
vomiting; headache; frequent voiding of urine and feces; a feeling of faintness and
perhaps actual fainting; and emotional depression. These reactions generally start right
before or with menstruation and dissipate in the first day or two of menstruation.
Secondary dysmenorrhea typically differs in duration. It tends to start a few days
before menstruation and goes on all through menstruation. Its major symptom is a not
very sharp but heavy ache that feels lodged far down in the abdomen.
Symptoms your physician may observe In cases of secondary dysmenorrhea doctors look for
evidence of a disorder of the reproductive organs or other organs in the pelvic area.
mong these may be an inflammation or infection of the uterus, Fallopian tubes, or
intestines. Such a disorder might also include a cyst or benign tumor. An intrauterine
device or IUD that had been inserted into the uterus as a contraceptive may also lead
to secondary dysmenorrhea.
Treatment At least some relief of menstrual pain can be realized simply by reducing
stress, exertion, and irritation. Helpful measures include getting increased rest,
exercising in moderation, and putting an electric heating pad or hot-water bottle on the
stomach. Also helpful for relief is the taking of common pain relievers such as
ibuprofen, sometimes in prescription-strength doses.
Difficult cases of primary dysmenorrhea have been found to be relieved for some nine of
every ten women by medicines that inhibit the production of prostaglandins. These must
be prescribed by a physician and seem to prove most effective when the physician also
guides the woman in their use.
Treatment of secondary dysmenorrhea often requires the help of a specialist to diagnose
and correct the disorder that is its specific contributing cause.
Prevention Attacks of menstrual pain tend to be heightened in their intensity if a woman
is unusually fatigued or stressed. Making efforts to be as well-rested and stress-free
as possible by the expected time of menstruation may hence reduce the customary severity
of an attack.
Oral contraceptives or birth control pills suppress ovulation and menstruation. Taking
them therefore leaves a woman free of menstrual pain while they are active in her system.
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