Menstrual Cramps (Dysmenorrhea): Causes, Symptoms, and Treatments
Although it’s very common for women to experience mild pain during their periods, some women have severe cramps that are hard to tame.
If you can’t relieve the pain with a help of the over-the-counter pain medicine and you’re unable to do anything the first three days of your menstruation, you may suffer from the condition called dysmenorrhea.
Despite being a complicated term, dysmenorrhea has a simple meaning – it’s a difficult monthly flow that features severe cramps and other health issues related to it.
It’s crucially important to learn as more information about dysmenorrhea as possible to treat the condition correctly. Today, we’re on our journey to learning why menstrual cramps happen and how you can treat them in a natural way.
What are the types of dysmenorrhea?
Women suffer from primary dysmenorrhea or secondary dysmenorrhea, which are both considered menstrual disorders. While the first type is the most common one and doesn’t possess serious health risks, the second type can require serious medical treatment, including surgery.
- Primary dysmenorrhea. It’s a painful menstruation that has no underlying pelvic pathology. Despite the severe pains, primary dysmenorrhea is considered a safe process of menstruation. The cramps in the lower abdomen can begin a day or two before menstruation and can last 2 to 4 days. Primary dysmenorrhea affects up to 50% of women, especially girls during adolescence and women in their 20s.
- Secondary dysmenorrhea. It’s an alarming sig you need to see a gynecologist as soon as possible. Secondary dysmenorrhea is often related to any gynecologic disorder you might have. Endometriosis is one of the medical problems that reveals itself in the form of cramps particularly during menstruation. It happens when the tissue similar to the uterus lining is outside its normal location. Apart from having cramps, you may also have heavy periods and suffer from infertility. Even though secondary dysmenorrhea is more common among women in the middle adulthood, every woman can have this condition.
What are the major causes of both types of dysmenorrhea?
Primary dysmenorrhea. When your uterus relaxes and tightens, letting the blood leave the uterus, cramps may occur. The uterus lining releases special chemicals, prostaglandins, which increase the strength of the uterine contractions, particularly during the first two days of menstruation.
The excessive levels of prostaglandins are often the major cause of primary dysmenorrhea. Other causes include retroverted uterus (a uterus that’s tilted posteriorly), stress, sedentary lifestyle, obesity, smoking, alcohol, and poor eating habits.
Secondary dysmenorrhea. This condition is more serious and thus is caused by highly serious factors, such as pelvic inflammatory disease (an infection of the fallopian tubes), endometriosis, adenomyosis, fibroids, an ovarian cyst or tumor, sexually transmitted infections, and the use of birth control methods like an intrauterine device (IUD), among the others.
Secondary dysmenorrhea gets worse with each cycle and the cramps occur long before the onset of the menstrual flow and continue up to 5 days after it ends.
What are the major symptoms of dysmenorrhea?
Dysmenorrhea cramps may be congestive (dull and deep pain) and spasmodic (a sharp pelvic pain at the beginning of menstrual flow). They’re are obviously easy to spot, but here are the most common symptoms of dysmenorrhea that you might experience:
- Severe cramping or throbbing pains in the lower abdomen;
- Nagging pain throughout the entire body;
- Lower back pain that radiates to the thighs;
- Nausea and vomiting;
- Headaches similar to migraine attacks;
- Bloating and diarrhea;
- Low energy;
- Sleep disturbance.
Is it possible to diagnose dysmenorrhea?
There are no specific tests to diagnose primary dysmenorrhea – women do it themselves with a help of a menstruation journal. If you think you might be suffering from secondary dysmenorrhea, you may need to do a blood test (either a differential count (DC) or a total count (TC), or both) to figure out if any infectious process is happening in your pelvic organ.
Then, you may need to do bacteriological tests to find out if you have a pelvic inflammatory disease (PID) or sexually transmitted diseases (STD). In some cases, doctors use urinalysis, transvaginal or abdominal ultrasound, and a diagnostic laparoscopy.
Making the Diagnosis
If you experience painful periods, check with your doctor to see whether you might have an underlying disorder that is causing secondary dysmenorrhea. You may be given a pelvic examination, and your blood and urine may be tested.
A doctor may also wish to use ultrasound to get a picture of your internal organs or even use the technique of laparoscopy for a direct look into your uterus.
Treatment and Prevention
Your doctor may prescribe medications or other remedies depending on the cause of the dysmenorrhea.
Primary dysmenorrhea is usually treated by medication such as an analgesic medication. Many women find relief with nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen.*
Some doctors may prescribe hormone medications. Oral contraceptives also may also help reduce the severity of the symptoms. Nausea and vomiting may be relieved with an antinausea (antiemetic) medication, but these symptoms usually disappear without treatment as cramps subside. Implantable contraception and progesterone IUDs, which release low levels of the hormone progesterone, have also been found to be very helpful in decreasing pain.
Women who do not respond after three months of treatment with NSAIDs and hormonal contraceptives may have secondary dysmenorrhea. Treatment for secondary dysmenorrhea will vary with the underlying cause. Diagnostic laparoscopy, other hormonal treatments, or trial of transcutaneous electrical nerve stimulation (TENS) are potential next steps. Surgery can be done to remove fibroids or to widen the cervical canal if it is too narrow.
In addition to the above, other non-medicinal treatments for the pain of dysmenorrhea include:
- holding a heating pad or hot water bottle on your abdomen or lower back
- taking a warm bath
- doing mild exercises like stretching, walking, or biking – exercise may improve blood flow and reduce pelvic pain
- getting plenty of rest and avoiding stressful situations as your period approaches
You may also wish to consider alternative therapies such as hypnosis, herbal medications, or acupuncture. Be cautious with herbal medications. They may be “natural,” but they are not necessarily safe or free of side effects. They can also interact with other medications you may be taking. Check with your doctor or pharmacist before trying any herbal medications.