Dysmenorrhea is caused by contractions in the uterus as it sheds the endometrial lining that’s naturally created each month in preparation for egg fertilization and pregnancy; if a woman hasn’t gotten pregnant that month, the lining breaks down, separates from the uterus and flows out through the cervix and vagina over the course of 3-7 days. If you suffer from regular menstrual cramps that are not related to any other physical condition, that’s primary dysmenorrhea.
Primary Dysmenorrhea
Primary dysmenorrhea develops within a year of the onset of menstruation and generally becomes less intense over time, with symptoms often disappearing after pregnancy. Women suffering from primary dysmenorrhea frequently have higher levels of prostaglandins, hormone-like substances that generate monthly uterine contractions.
Secondary Dysmenorrhea
Secondary dysmenorrhea is the result of an underlying medical condition, typically involving the female reproductive system. Symptoms of secondary dysmenorrhea can be relieved once the condition is successfully treated. Among the circumstances that can cause secondary dysmenorrhea are endometriosis, pelvic inflammatory disease (PID), uterine fibroids or polyps, use of an intrauterine device (IUD), a tipped uterus (also called tilted or retroverted), sexually transmitted diseases (STDs) or ovarian cysts. Secondary dysmenorrhea can start any time after a woman begins menstruating but most often develops several years later.
Do I have Dysmenorrhea?
While most women suffer from menstrual cramps from time to time, primary and secondary dysmenorrhea can be uncomfortable or painful enough to disrupt someone’s regular daily routine. Menstrual cramps are felt as dull, throbbing pain in the abdominal and pelvic regions, sometimes radiating to the lower back and thighs. Some women also experience dizziness, sweating and constipation or loose bowel movements. In more severe cases, you may feel nausea or even vomit as a result of dysmenorrhea. Cramps can be intermittent or continual. They usually start shortly before menstrual flow begins, peak in about a day and then subside in 1-2 days.
Treatment Options: Exercise, Rest and NSAIDS
Most women learn to manage menstrual cramps on their own. In the past, it was common for women lie down and rest to alleviate symptoms of dysmenorrhea, which gave rise to the false notion that women were somehow “unwell” when they had their period. Rest is still a good way to give cramps a chance to subside, but exercise, especially walking, can be just as effective in relieving dysmenorrhea symptoms. If you’re taking it easy, lie on your side with your knees bent or keep your legs elevated. A hot bath or placing a heating pad on your lower stomach might also help, and think about giving meditation or yoga a try.
Over-the-counter medications are available for treating primary dysmenorrhea: acetaminophen (Tylenol) or acetaminophen plus a diuretic (Midol, Pamprin, Premsyn and other formulations specifically for women) can be useful, along with nonsteroidal anti-inflammatory drugs (NSAIDs). The most common NSAIDs are ibuprofen (e.g., Advil, Motrin, Midol IB, Nuprin) and naproxen sodium (Aleve, Anaprox). If these don’t relieve your cramps, a doctor might prescribe stronger pain killers or low dose oral contraceptives (birth control pills), which prevent ovulation and reduce production of the prostaglandins that trigger uterine contractions. Women with secondary dysmenorrhea may also respond well to these treatments, but in some instances, depending on the underlying cause, antibiotics might be prescribed; in more serious cases, a surgical procedure might be necessary (for example, removing fibroid tumors to treat endometriosis).
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