Painful Period

Primary dysmenorrhea or painful period affects about 80% of young girls. The period pains can be severe enough to interfere with daily activities. Period pain or dysmenorrhea is characterized by severe cramps in the lower abdomen. There are two types: primary or secondary.

Primary dysmenorrhea

Primary dysmenorrhea usually starts around a year after the teenager has menstruation (menarche). There is no underlying medical problem. The exact cause of period pain is not certain. It has been postulated that once ovulation occurs, natural chemicals produced by the body called prostaglandins are made in the lining of the uterus (womb). Some prostaglandins cause the walls of the uterus to contract thus reducing the blood supply and resulting in severe cramps during the contractions. The pains tend to improve as women get older. Many women notice that their periods are less painful after they have had a baby.

Symptoms of painful periods: Cramping lower abdominal pains are the most common symptom. Pain can also spread to the lower back and the thighs. When severe, the pain can be accompanied by nausea or vomiting, diarrhea, constipation or feeling faint. Some women may also get headaches.

Secondary dysmenorrhoea

Secondary dysmenorrhoea affects older women and is caused by a disorder in the woman's reproductive organs. Pain from secondary dysmenorrhea usually begins earlier in the menstrual cycle and may last throughout the period. It is usually due to some medical conditions including the following:

• endometriosis
• pelvic inflammatory disease (PID) usually from STDs
• uterine fibroids
• Stenosis of the cervix, the narrowing of the lower part of the uterus (cervix), often caused by scarring

Symptoms of Dysmenorrhea

The following are the most common symptoms of dysmenorrhea. However, each individual may experience symptoms differently. Symptoms include:

• Aching pain in the lower abdomen (Pain can be severe at times.)
• low back pain
• pain radiating down the legs
• Feeling of pressure in the abdomen

When cramps are severe, symptoms may include:

• Nausea, vomiting, upset stomach
• Loose stools
• Fatigue, weakness
• Fainting
• headaches

Diagnosis

Diagnosis begins with a gynecologist evaluating a patient's medical history and a complete physical examination which may include a pelvic examination or rectal examination. A speculum (an instrument that lets the doctor see inside the vagina) may be inserted and vagina, cervix, and uterus examined. The doctor will feel for any lumps or changes, and a small sample of vaginal fluid may be taken for testing. Further tests may be required and may include the following

• Vaginal or pelvic ultrasound to detect any masses in the ovary or uterus
• Laparoscopy
• Hysteroscopy
• Magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

Treatment

To relieve mild menstrual cramps:

• Rest
• pain reliever, such as panadol
• Place a heating pad or hot water bottle on the lower back or abdomen
• Avoid foods that contain caffeine
• Avoid smoking and drinking alcohol
• Massage your lower back and abdomen
• Exercise regularly often reduces menstrual pain. To help prevent cramps, make exercise a part of your weekly routine

Specific treatment for dysmenorrhea will be determined based on:

• age, overall health, and medical history
• extent of the condition
• cause of the condition (primary or secondary)