Causes, Types And Treatment Of Painful Menstruation(Dysmenorrhoea)

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Although menstruation in women should be, and often painless. Many women suffer from the discomfort triggered by pain during their periods at some time during thier reproductory life. Dysmenorrhoea, also known as painful menstruation can be classified into

 Two main types, namely

  •  Primary or Spasmodic dysmenorrhoea 
  • secondary or Congestive dysmenorrhoea.

 Primary or spasmodic dysmenorrhoea:
This is the commonest type of dysmenorrhoea and it usually occurs in girls or young women. The pain is spasmodic in nature(resembling a sudden contraction of the muscles). Usually starting on the first day of the period. It may last for several hours or continue through out the day and towards the next day. Sometimes the mentrual flow is scanty at first and the pain becomes lighter when the flow is properly established. The acute pain may be followed by a dull ache, nausea and vomitting and sometimes diarrhoea, headace and fainting may occur. The continuation of dysmenorrhoea to the age of 30 is more common in unmarried than married women.
 Causes of Spasmodic dysmenorrhoea:
 You should know that the pain is due to the spasm of the uterine muscle,() which is sufficient to cause ischaemia. The cause of the spasm is not certain but various factors have being discussed.

  1. Cervical obstruction.
  2.  Hormonal imbalance.
  3.  Prostaglandin{natural occurring lipids}
  4. Psychological factors 
  5. Nerve pathways 

Treatment:

  1.  Correct any cause of emotional stress
  2.  During attack, take a hot bath and then relax in bed with a hot water bottle.
  3.  Analgestic drugs such as aspirin,codeine or dihydrocodeine should be prescribed but you should stay away habit forming drugs such as morphine, pethidine or alcohol. Anti spasmodic drugs such as atropine are usually ineffective. 
  4. Suppress ovulation, the easiest way for these is  to prescribe one of combined oral contraceptive preparations using pill containing 20 to 30 micro gram of oestrogen or an oral progestogen such as dydrogesterone(duphaston) will be helpful in the doses 10mg daily by mouth from days 5 to 25 of each cycle. Note: this is not suitable for someone who wishes to become pregnant. 
  5. Drugs which inhibits the production of prostaglandins in the endometrium may diminish myometrial contractions{contraction of the smooth muscles forming the walls of the uterus} and therefore relieve dysmenorrhoea. 

Secondary or congestive dysmenorrhoea:
Congestive dysmenorrhoea is mainly caused by a pelvic inflammatory disease and endometriosis {the mucus membrane that lines the uterus, the fertilized egg implants is implanted} it  arises from an increased blood supply in the area caused by pelvic disease. .The pain is a dull ache in the lower abdomen and back, sometimes extending to the thigh.
  An acute colicky pain may occur if a fibromyomatous {a benign uterine tumour} polyp is pushed or trusted  out through the cervix, and in some women an intrauterine contraceptive device will cause colicky.

The treatment for congestive dysmenorrhoea is to treat the type of pelvic diseases that triggers the painful menstruation.
Types of pelvic diseases

  • Menorrhagia
  • Dyspareunia
  • Infertility

In subsequent posts i will be treating the types of pelvic diseases in details.
Stay tuned!

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