dysmenorrhea · menstrual health · painful periods ·Nov 29, 2021

Dysmenorrhea: All You Need to Know

What is dysmenorrhea?

Painful menstrual cramps are medically termed dysmenorrhea and affect more than half of menstruators, with some experiencing severe pain.

The pain is usually mild, but in some cases, it can be severe enough to interfere with daily activities.

What are the types of dysmenorrhea?

Two types of dysmenorrhea can affect menstruating people:

Primary dysmenorrhea

In this type, the pain results from menstruation alone without the interference of an underlying condition. It has been linked to hormone-like fatty acids called prostaglandins which are responsible for causing uterine contractions and controlling inflammation.

As progesterone levels drop at the beginning of a period, the body releases more prostaglandins. The amount of these substances produced is usually interlinked with the intensity of the pain experienced. It’s generally seen that people with primary dysmenorrhea experience longer periods with heavier bleeding.

Certain risk factors can also contribute to primary dysmenorrhea:

Anxiety or depression
A history of painful periods in the family
Obesity
Stress
Smoking
Early menarche
Never having conceived

Secondary dysmenorrhea

This type usually starts later in life and is caused by an underlying medical condition like:

Endometriosis - In this condition, the uterine tissues lining the wall grow outside the uterus instead of inside. Endometriosis causes severe menstrual cramping and many other symptoms.

Adenomyosis - In adenomyosis, the lining of the uterus breaks through the muscle wall of the womb and cause symptoms like cramping and bloating before and during periods.

Uterine growths - These can range from anything between polyps, fibroids and cysts, causing uterine cramps during or outside of periods. It can also cause symptoms like bloating, lower back pain and constipation.

Using an intrauterine device (IUD) - Using an IUD as a contraceptive is sometimes linked to more painful periods and an increased risk of pelvic inflammatory disease (PID).

Pelvic inflammatory disease (PID) - Sometimes an infection caused by sex or otherwise can cause severe inflammation in the uterus or other pelvic organs, causing a life-threatening disease called PID. It can cause severe cramps during periods and should be treated immediately.

Structural abnormalities - Some people possess structural deformities in the uterus that can lead to more painful periods.

What are the usual symptoms?

Different symptoms are experienced by different menstruators, but they usually range from:

Painful cramps in the lower abdomen
Pain in the lower back and legs
Nausea and vomiting
Diarrhoea
Fatigue and weakness
Headaches
Dizziness

How is dysmenorrhea diagnosed?

Apart from medical history evaluation, your doctor may run a few tests to diagnose dysmenorrhea which can include:

Ultrasound - Using high-frequency sound waves, an image of your internal organs are created to determine an underlying cause.

Magnetic resonance imaging (MRI) - Large magnets, radio frequencies and a computer are used to create detailed images of the internal organs and bodily structure.

Hysteroscopy - A viewing instrument called a hysteroscope is inserted into the vagina to visually examine the cervix and the uterus to search for abnormalities.

Laparoscopy - A laparoscope is a thin tube with a lens and a light that is inserted into the abdominal wall by making a small incision. The doctor uses this device to examine if there are any abnormal growths.

Are there any treatment options?

A number of things can get the pain under control or take care of dysmenorrhea altogether:

Use heat - Heat is generally used to treat any kind of pain in different parts of the body. You can use a heating pad, a hot water bag or a heating patch like the Carmesi Cramp Relief Patch for hassle-free pain management on the go.

Try OTC pain medication - You can buy OTC painkillers to treat your cramps. These usually work by lowering down the body’s inflammation levels.

Try orgasming - Orgasms from sex or masturbation can help with abdominal cramps as they release hormones like endorphins, which are known to relieve pain.

Exercise - Some studies have shown that exercising for 30 mins regularly can help reduce dysmenorrhea symptoms. Aerobics or yoga is especially helpful for cramps.

Hormonal birth control - Pills, patches, injections, hormonal IUDs or contraceptive implants are all examples of hormonal birth control which work by thinning the uterine lining, thereby decreasing the production of prostaglandins. This can contribute to decreased bleeding and cramping.

Surgical options - There are two surgical procedures that control dysmenorrhea. They involve cutting or destroying the uterine nerves, thus preventing the transmission of pain signals. However, this does not provide long-term effects as the nerves grow back and the procedures can be complicated in nature. So, always speak extensively to your doctor before opting for any surgery.

What are the barriers to treatment?

Dysmenorrhea is a common condition that makes so many women miss work or school and who are left in no condition to perform daily activities. But despite this, people can face difficulty in seeking out medical help for the condition.

The reason ranges from a common disregard of period pain as something that is not serious to seek out treatment to a lot of underlying sexism and gender bias. Even some doctors dismiss period pain as ‘normal’ and there is still an existing taboo against menstruation that prevents women from discussing their pain or even using it as a valid reason for skipping work or school.

These barriers need to be addressed before we can advance as a society and start taking dysmenorrhea seriously and giving people a fair chance to get treated without the fear of dismissal.