Women's Health


​​​What is dysmenorrhea?

Dysmenorrhea, also known as menstrual cramps or period pain, is a pain occurring in the lower abdomen. It is one of the most common conditions among women. Most women suffer dysmenorrhea during teenage and may last for four or five years after the first menstrual period (menarche). Dysmenorrhea may affect the daily activities of some women for several days every month.

  • Primary dysmenorrhea: Repetitive menstrual cramps that occur on a monthly basis, but are not considered a medical condition. Period pain usually occurs on the day of menstruation, or one or two days earlier. Occurring in the lower abdomen, back or hips, period pain is usually mild to severe, lasts for 12-72 hours, and may be associated with nausea, vomiting, fatigue, and diarrhea. 
  • Secondary dysmenorrhea: This type of dysmenorrhea is usually caused by a disorder in a woman’s reproductive organs. Some of these conditions include endometritis endometriosis, fibroids, cysts or infection. The pain usually starts earlier in the menstrual cycle and lasts longer than primary dysmenorrhea. It is not usually associated with vomiting, nausea, fatigue or diarrhea.
Dysmenorrhea occurs due to cramps (contractions) in the uterus, due to prostaglandins—a substance the uterus makes.  If it contracts too strongly during your menstrual cycle, it can press against nearby blood vessels. This briefly cuts off the supply of oxygen to the uterus. It’s this lack of oxygen that causes your pain and cramping. Dysmenorrhea can also be attributed to the following medical conditions:
  • Endometriosis: It refers to the abnormal growth of endometrial cells (the lining of the uterus) into the two fallopian tubes, ovaries or the lining tissue of the pelvis.
  • Uterine fibroids: Benign (non-cancerous) growths in the womb may be a source of pain.
  • Pelvic inflammatory disease: Caused by inflammation in the woman’s reproductive organs, owing to sexually transmitted infection (STI).
  • Cervical stenosis: The cervical opening in some women is too narrow to allow the menstrual discharge to get out of the body, and hence causes a painful increase of pressure on the uterine wall.
  • Pain and/or cramps in the lower abdomen (sometimes, the pain is acute). The pain usually starts at the beginning of, or prior to, menstruation. It may also occur 24 after the onset of menstruation, and lasts for 2-3 days.
  • Pain in the thighs, lower back, and hips
  • Nausea
  • Headache
  • Dizziness
  • Diarrhea
Your doctor will review your medical history and perform a physical exam, including a pelvic exam. During the pelvic exam, your doctor will check for abnormalities in your reproductive organs and look for signs of infection. If your doctor suspects that a disorder is causing your menstrual cramps, he or she may recommend other tests (e.g. ultrasound) to create an image of your uterus, cervix, fallopian tubes and ovaries.

To ease your menstrual cramps, your doctor might recommend:
  • Pain relievers: Pain relievers, such as ibuprofen, at regular doses, help control the pain of cramps. Such pain relievers are usually administered over-the-counter.  Start taking the pain reliever at the beginning of your period, or as soon as you feel symptoms, and continue taking the medicine as directed for two to three days, or until your symptoms are gone.
  • Hormonal birth control:
  • Hormonal intrauterine device (IUD), or oral birth control pills, contain hormones that prevent ovulation and reduce the severity of menstrual cramps—especially the cramps associated with primary dysmenorrhea. The doctor may prescribe medical treatment if the need arises. 
  • Surgery: 
  • If your menstrual cramps are caused by a disorder such as endometriosis or fibroids, surgery to correct the problem might help your symptoms. Surgical removal of the uterus also might be an option if other approaches fail to ease your symptoms and if you're not planning to have children.
Guidelines for women with dysmenorrhea:
To help relieve menstrual pain, it is recommended to: 
  • Apply warm compresses to the lower abdomen;
  • Exercise;
  • Take a warm bath;
  • Do relaxation activities (e.g. yoga, meditation, etc);
  • Take over-the-counter pain relievers;
  • Get sufficient rest;
  • Avoid smoking (both positive and negative);
  • Avoid stress—it can increase and worsen the menstrual pain;
  • Consume less caffeine as it causes stress.
It is also advisable to keep a record of menstruation dates and the accompanying symptoms to help diagnose problems when they arise.

Clinical Education General Department
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Last Update : 05 August 2021 04:11 PM
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