Dysmenorrhea, or painful menstruation, is a medical condition experienced by many women at some point during their lives. The condition is characterized by extremely painful and unpleasant cramps which occur over the course of a menstrual period. These cramps can be so intense that a woman is unable to function because of the strength and duration of the cramping. While dysmenorrhea is not usually regarded as life threatening, it can be extremely frustrating, and there are some options to treat it which should be considered by women who struggle with painful menstruation.
The menstrual period is used to shed the lining of the uterus if an egg is not fertilized. The process is triggered by the production of prostaglandins, compounds which encourage the uterus to contract. This cuts off the blood supply to the lining, causing it to die, while also expelling the dead tissue. After the period is over, the lining will regrow to prepare for the possibility of pregnancy. Prostaglandin production does appear to be linked with painful periods, since high levels seem to be associated with more cramping, but it's not the only cause.
In secondary dysmenorrhea, the condition is caused by an underlying medical problem, which could include a congenital abnormality in the reproductive tract, or a condition such as endometriosis. The condition usually appears later in life, as a woman's body changes and these changes cause a problem. In these situations, addressing the underlying condition can often clear up the dysmenorrhea. Primary dysmenorrhea has no underlying cause, and usually onset occurs early in life.
Women who are active tend to be less prone to painful periods, as are women who eat a balanced diet and avoid smoking. The size of the uterus seems to be a factor in some women. When women experience painful menstruation, they sometimes find that changing physical position helps to address the cramps, and it is also possible to take drugs to manage the pain and inflammation which are associated with severe cramping.
If dysmenorrhea is experienced, a doctor should be consulted to determine whether it is primary or secondary. In the case of primary dysmenorrhea, lifestyle changes can sometimes resolve the problem. A gynecologist can provide support and information as well as testing to explore possible causes for painful periods.
A medical history and pelvic exam alone may provide enough information for the doctor to determine whether the cramps are caused by primary dysmenorrhea. In primary dysmenorrhea, the pelvic exam is normal between menses. Examination during menses may produce discomfort but no abnormal findings.
In secondary dysmenorrhea, there may be findings on physical exam. Additional tests may include radiologic studies (including ultrasound) and laparoscopy (involves inserting a tiny, flexible lighted tube through a small incision just below the navel to view the internal abdominal and pelvic organs).
Symptoms of menstrual cramps include:
Dull, throbbing or cramping pain in your lower abdomen
Pain that radiates to your lower back and thighs
Some women also experience:
Nausea and vomiting
Loose stools
Sweating
Dizziness
Diet changes and supplements: Eating vegetables, fruits, fish, and foods high in fiber may help decrease your pain. Choosing foods that are low in fat may also help. Supplements that may help decrease your pain include magnesium, and vitamins B and E. Omega-3 fatty acids (fish oil) and certain herbs may also help.
Avoid drinks that contain alcohol.
Keep a pain diary. It may be easier to answer your caregiver's questions by making a pain diary or book. A pain diary will help you remember what happened each day because it is all written down. Write down when your periods start and stop. Write down all the words that come to you about your pain and other symptoms.
Exercise: Stay active. Getting regular exercise often can decrease the pain. Exercise increases body chemicals that may help ease pain and make you feel better. Talk to your caregiver before you start exercising. Together you can plan the best exercise program for you.
Manage your stress. Stress may make dysmenorrhea worse. Find ways to help your mind and body relax, such as deep breathing. Stay away from people or things that make you feel upset. Talk to someone about things that upset you.
Stop smoking and avoid people who smoke. Ask caregivers for information on how to stop smoking if you are having trouble quitting.