"Dysmenorrhoea" means painful menses. Almost all women notice some discomfort during periods, but if pain is severe and the woman has to stay in bed, away from work or school, it is called dysmenorrhoea.
There are two types of dysmenorrhoea - primary or spamodic and secondary or congestive dysmenorrhoea. Primary dysmenorrhoea is common, affecting more than 50% of women. In 5 - 15% it is severe enough to affect daily activities. It starts in teenage and becomes less severe with age and after having a baby.
In spasmodic dysmenorrhoea there is usually no underlying abnormality in the pelvis and uterus, and exact cause is unknown. The pain only occurs at the completion of an "ovulatory cycle: ie one during which an egg was released. It does not occur after an anovulatory cycle. Besides in ovulatory cycles, there may be an increased build up of Prostaglandins which causes excessive uterine contractions and pains.
The pain begins a few hours before or at the onset of menstruation and disappears after 48 hours. The pain is confined to the lower abdomen and may extend into lower back and thighs. Often it may be associated with other symptoms like nausea, headache, fatigue and diarrhoea.
Listening, understanding and reassurance would be helpful in relieving concern and aids in coping with pain. Relaxation techniques, yoga, acupuncture may have an added role to play. Use of hot water bottle and Paracetamol are often simple first hand measures to relieve pain.
The use of anti inflammatory medicines has been found to be the most effective therapy. The use of Brufen and Mefenamic acid has been found to be very successful. Treatment needs to be commenced on the first day of periods or at the onset of pain. Adverse effects of short course therapy is uncommon, although one has to be aware that gastric upset may occur. If one fails to respond to the NSAIDs, one may often be advised to commence the oral contraceptive pill. OC pills minimize local prostaglandins, suppresses ovulation, and relieves period pains.
Continuing dysmenorrhoea that is refractory to above treatments, merits a gynaecological consultation to exclude any underlying problems.
Almost all women suffer from dysmenorrhoea, and a supportive and empathetic approach makes an important contribution to pain relief.
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