Hi ,
I have to face very severe pain in the first day of my period and in second day also it pains but less than first day . My periods are regular . Could you suggest why does it happen and what can I do to lessen it.
Answers (1)
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DYSMENORRHEA (painful periods/ menstrual cramps) one of the most common gynaecological SYMPTOM that affect the quality of life of women. the term dysmenorrhea is derived from greek words dys - painful/ abnormal; meno - month and rrhea - to flow.
PRIMARY DYSMENORRHEA
Dysmenorrhea is primary when it occurs in the absence of co-existent pelvic pathology. It is due to excessive levels of prostaglandins (hormone ) which stimulates uterine contractions and vasoconstriction (the constriction/narrowing of the blood vessels) which potentiate myometrial (the middle layer of the uterus) ischemia (inadequate blood supply) causing pain.
Age at onset : 16–25 yrs
Onset of pain (spasmodic) is just prior to menstruation.
usually self-limited.
SECONDARY DYSMENORRHEA
Dysmenorrhea is secondary when there is an identifiable anatomic or macroscopic pelvic pathological condition. There may be associated vaginal discharge, dysperiunia (painful sexual intercourse), menorrhagia (heavy bleeding at menstruation).
Age at onset : 30- 45 yrs
Onset of pain : Pain (congestive) increases through the luteal phase (before period starts) peaking at onset of menstruation.
Secondary dysmenorrhea may arise from a number of underlying pathological conditions.
COMMON CAUSES
EndometriosisPelvic Inflammatory Disease ( Infections)AdenomyosisIntrauterine polypsSubmucosal fibroidsIUCDs
LESS COMMON
- Congenital uterine abnormalities
- Cervical stenosis
- Asherman syndrom
- Chronic ectopic pregnancy
- Pelvic congestion syndrome
- Ovarian cysts or neoplasms
RISK FACTORS FOR DYSMENORRHEA
Young age, early menarche, heavy menstrual flow, nulliparity (state in which a woman has never carried a pregnancy), smoking, depression, anxiety, stress.
MANAGEMENT
Treatment of dysmenorrhea is aimed at providing symptomatic relief as well as inhibiting the underlying processes that causes symptoms.
Primary dysmenorrhea respond to
NSAIDs (nonsteroidal anti-inflammatory drugs, blocking production of prostaglandins) that provide analgesic (pain-killing) and anti-inflammatory effects eg: aspirin, ibuprofen and naproxen. Should be offered as first line treatment for pain relief.COCs (combined oral contraceptives) are commonly used as a second line therapy when NSAIDs are ineffective, poorly tolerated or contraindicated. COCs inhibit ovulation and endometrial tissue growth, thereby decreasing prostaglandin release. Contraception is the additional benefit of COCs.
Treatment of Secondary dysmenorrhea must address the underlying disease ( cyst removal/ removal of submucosal fibroids/polyps etc ). Secondary dysmenorrhea may be resistant to NSAIDs and COCs.
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
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