Dysmenorrhea Pain Associated with Menses
Menstrual cycles represent one important part of the health female’s body’s preparation for pregnancy. Starting with menarche and the onset of menstrual periods, most young women will experience the onset of sexual changes to their body. Breasts will form and grow, the body will take on the characteristic feminine appearance, pubic hair will grow and menstrual periods will start.
Depending on state of health, climate, nutrition and genetics, most women will start to menstruate between the ages of 11 and 16 years of age. By 55 years of age most women will stop menstruating and enter into the menopause.
Dysmenorrhea is painful menstruation often referred to as menstrual cramps or “cramping.” It is one of the most common of all gynecologic complaints dealt with by women and their medical doctors. It is a leading cause of absenteeism of women from work, school, and other activities. In addition to identifiable pathological causes, number of constitutional factors may lower pain threshold thus appearing as worsening dysmenorrhea. Common factors include anemia, obesity, chronic illness, overwork, stress in general, diabetes, and poor nutrition.
There Are Two Types of Dysmenorrhea
- Primary dysmenorrhea: Primary dysmenorrhea generally occurs within the first few of menstruation. It usually begins when the first ovulatory cycles beginning, in most cases this is before the age of 20. Primary dysmenorrhea is often associated with nausea (in about 50% of patients), vomiting (in 25% of patients) and associated with increased frequency of bowel movements (in 35% of patients). Of these women, some 10% have severe enough dysmenorrhea to end up greatly limiting their activities for one to three days each month.
The pain occurs low over the abdomen within the midline of the abdomen. It is characteristically recognized by cramps that come and go not lasting more than a few minutes at a time. This pain is generally believed to be caused by contractions of the woman’s uterus. Menstrual pain usually occurs a few hours before the onset of menstrual bleeding and reaches its peak intensity within a few hours. It can last through the entire menstrual cycle or only for a few hours and usually for 1-2 days. It is relieved by the onset of good menstrual flow and is not related to any definable pelvic lesion or pathologies. Dysmenorrhea tends to decrease with age and often resolves immediately after childbirth.
- Secondary dysmenorrhea: Secondary dysmenorrhea related to the presence of another condition or pelvic pathology such as endometriosis, salpingitis and PID (pelvic inflammatory disease), post surgical adhesions, which actually causes the pain. Secondary dysmenorrhea often begins as early as a few days before the onset of the monthly menstrual period and can last for several days or more after the onset of the menstrual flow. Frequently, it is localized to one side or the other, but can involve the center of the pelvis or the entire pelvis. Characteristically, it does not peak nor diminish as early or quickly as primary dysmenorrhea. It generally starts later in life and most commonly in women who did not previously suffer from primary dysmenorrhea. Dysmenorrhea caused by a pathologic process can be superimposed over a pre-existing case of primary dysmenorrhea. IUD’s often cause similar pains and problems.
What Are the Symptoms?
Besides pelvic and/or abdominal pain, dysmenorrhea is often associates with a complex of symptoms such as abdominal bloating, frequent and intense cramps, pain below the waistline, or a dull ache that may radiate into the lower back or legs. Additional symptoms often included are: headache, nausea, diarrhea or constipation, frequent urination, and, occasionally, vomiting. As stated above, these symptoms generally occur just before or even during the menstrual period.
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