Dysmenorrhea is the medical term for painful or difficult periods also referred to as menstrual cramps. Dysmenorrhea literally means pain during the menstrual periods or menstruation. Some women also experience pain a few days before the periods along with the common period pain. Unfortunately, this is a very common condition expected to affect as many as 20-90% of the women in the reproductive age group. Typically, the menstrual pain begins within the first year since the woman’s first period.
Often times, dysmenorrhea isn’t a diagnosis by itself, but a symptom of some underlying gynecological disorder such as endometriosis, pelvic inflammatory disease, or something else. Even so, in most cases this condition occurs without the presence of any definite underlying cause. The presence or absence of an underlying cause is also the premise for the classification of dysmenorrhea into its two subtypes, primary and secondary dysmenorrhea. While dysmenorrhea with an underlying cause is known as secondary dysmenorrhea, dysmenorrhea without an underlying cause is known as primary dysmenorrhea.
As luck would have it, in women where the painful periods isn’t associated with any underlying cause, the pain is likely to reduce or disappear with age or after childbirth. Generally, underweight women, or those who had their first period before the age of 12, or women with irregular and/or heavy periods tend to suffer from painful periods.
Causes of Dysmenorrhea
In most women with dysmenorrhea, particularly primary dysmenorrhea there is no known cause linked to this condition. However, secondary dysmenorrhea may occur due to a variety of causes. Following is a list of the possible causes of painful periods.
- Endometriosis, a condition that results in the presence of the tissue lining the innermost layer of the uterus known as the endometrium in regions outside the uterine cavity is the commonest cause of dysmenorrhea. In fact, 70% of the adolescent girls with painful periods are estimated to be suffering from endometriosis.
- Uterine fibroids
- Cervical stenosis
- Polycystic Ovarian Syndrome or PCOS
- Skeletal deformities like unequal leg length, scoliosis, or spina bifida.
Symptoms of Dysmenorrhea
The most important symptom of dysmenorrhea is pain associated with the periods or menses. However, some women may also experience more than one or all of the following symptoms.
- Pain mainly in the pelvis during the periods that may radiate to the sides of the abdomen, lower back, or thighs. The pain generally lasts only for the initial phase of the menses, and rarely extends beyond the first 2 or 3 days of the menstrual period. However, in some women the pain may begin at the time of ovulation and continue until the end of the menstrual period.
- Nausea and vomiting
- Diarrhea or constipation
- Headaches with an increased sensitivity to light, smell, sound, or touch
How Is Dysmenorrhea Treated
The treatment of painful periods entirely depends on its underlying causative factor. The cause of secondary dysmenorrhea or the absence of a cause in cases of primary dysmenorrhea is determined through a detailed case history, pelvic examination, and further investigations such as, laboratory tests, gynecological ultrasonography, and sometimes a laparoscopy.
Depending on the cause and type of dysmenorrhea, an appropriate treatment regimen is followed to relieve the woman of her symptoms. Non-steroidal anti-inflammatory drugs are often prescribed for the pain. Some women may also feel better with appropriate hormonal birth control pills. However, when there’s an identifiable cause behind the pain it is first treated with suitable medications or surgery.