Dysmenorrhea: Mechanism and Treatment
Dysmenorrhea is a common and often debilitating condition affecting women. It refers to uterine pain during menstruation. While most women experience minor pain during menstruation, dysmenorrhea is diagnosed when the pain is so severe as to limit normal activities, or require medication.
The pain of dysmenorrhea may present different in different women. It may present as sharp shooting pain localised to lower abdomen or vagian, or it may present as a dull throbbing pain over lower back. It may precede menstruation by many days and it usually subsides as menstruation tapers off. Dysmenorrhea may also co-exist with excess vaginal bleeding as seen in DUB and fibroids.
Dysmenorrhea is classified as either primary or secondary.
Secondary dysmenorrhea is diagnosed when symptoms are attributable to an underlying disease, disorder, or structural abnormality either within or outside the uterus. The most common cause of secondary dysmenorrhea is endometriosis. Other causes include fibroids, ovarian cysts and pelvic congestion due to pelvic inflammatory disease. The presence of a copper intra uterine devices can also cause dysmenorrhea Primary dysmenorrhea is diagnosed when none of these is detected.
Signs and Symptoms
The main symptom of dysmenorrhea is pain concentrated in the lower abdomen,the umbilical region or just above the pubis. It may go to the thighs and lower back.Other symptoms include nausea, vomiting, constipation, headache, dizziness, fainting and fatigue. Symptoms of dysmenorrhea often begin immediately following ovulation and can last until the end of menstruation. This is because dysmenorrhea is often associated with changes in hormonal levels in the body that occur with ovulation. The use of certain types of birth control pills can prevent the symptoms of dysmenorrhea, because the birth control pills stop ovulation from occurring.
Diagnosis
This condition is normally diagnosed by the history you provide. There is not so much of an ambiguity in diagnosis of this disorder. In some cases a pelvic ultrasound may reveal diseases of the genital tract and pelvis which may help classify dysmenorrhea as secondary. Other than this there is no role for any specific investigation in the diagnosis of dysmenorrhea.
Treatments
Nutritional
Several nutritional supplements have been indicated as effective in treating dysmenorrhea, includingOmega-3-fatty acids, magnesium, Vitamin E, Zinc, and Thiamine (vitamin B1).
Several studies have indicated that intake of omega-3 fatty acids can reverse the symptoms of dysmenorrhea. The richest dietary source of omega-3 fatty acids is flax oil.
Painkillers
Non-steroidal anti inflammatory drugs (NSAIDs) are effective in relieving the pain of primary dysmenorrhea. NSAIDs can have including nausea, ulcers and burning in stomach and diarrhoea.
Hormonal contraceptives
Although use of hormonal contraceptives can improve or relieve symptoms of primary dysmenorrhea, recent studies have contested the efficacy of this claim. IUD’s with hormones embedded on them are shown to be effective in relieving pain of primary dysmenorrhea.
Non-drug therapies
Several non-drug therapies for dysmenorrhea have been studied, including behavioral, acupuncture acupressure and the use of a TENS unit.
Behavioral therapies assume that the physiological process underlying dysmenorrhea is influenced by environmental and psychological factors, and that dysmenorrhea can be effectively treated by physical and cognitive procedures that focus on coping strategies for the symptoms rather than on changes to the underlying processes.
Acupuncture and acupressure are used to treat dysmenorrhea. Recent research has stated that the treatments appear "promising" for dysmenorrhea, and that the researchers considered further studies to be justified.
Treatment with a transcutaneous electrical nerve stimulation (TENS) unit is often used for chronic pain. An alternative to this is a hot water bottle on the affected area. The heat relaxes the muscles in the area and provides a temporary relief to the pain experienced.
Other medications and herbal therapies Other medications and herbal therapies have been studied in the treatment of dysmenorrhea. These include Chinese and Japanese herbal medicines and guava leaf extract. However none of these treatments have been backed up by hard scientific evidence.
Dysmenorrhea is one of the commonest causes of absenteeism and lost work days amongst women. Knowledge of this disorder will help you face it and also help you to find treatments for this debilitating disease.