Dysmenorrhea: Causes, Symptoms, Diagnosis, and Treatment

What is dysmenorrhea? Menstrual pain or dysmenorrhea is pain or cramps in the lower abdomen. This is the most common condition that occurs before or during menstruation. In fact, many women experience it routinely. Therefore, it helps you recognize the symptoms, causes, and treatments.

Type of Dysmenorrhea

There are two types of dysmenorrhea, namely:

1. Primary dysmenorrhea

Primary dysmenorrhea is another name for menstrual pain that is common. pain or cramps usually occur one or two days before women get menstruation.

Pain usually feels in the lower abdomen or back, can be mild to severe pain. Menstrual cramps usually begin just before or at the beginning of menstruation and continue for one to three days. Pain will decrease with a woman’s age and can stop completely after having her first baby.

2. Secondary dysmenorrhea

Secondary dysmenorrhea is pain caused by abnormalities in the female reproductive organs. These disorders include, adenomyosis, endometriosis, uterine fibroids, or infection.

This type of menstrual pain usually starts earlier in the menstrual cycle and lasts longer than menstrual cramps. Pain is often not accompanied by nausea, vomiting, fatigue, or diarrhea.

Causes of Dysmenorrhea

Dysmenorrhea is caused by muscle contractions in the uterus. If uterine contractions are too strong, this condition can compress nearby blood vessels, inhibiting the supply of oxygen to uterine muscle tissue. During the menstrual period, the uterine wall produces a hormone called prostaglandin. This hormone causes the uterus to contract and often causes pain.

Women with more than normal amounts of prostaglandins can experience cramps. Menstrual pain occurs when part of the muscle loses oxygen supply for some time. Over time, when the hormonal condition is stabilizing, menstrual cramps will stop.

While the cause of secondary dysmenorrhea is disease in the female reproductive organs. Diseases that can cause secondary dysmenorrhea include:

1. Endometriosis

It is a painful medical condition when cells from the lining of the uterus grow in other parts of the body, usually in the fallopian tubes, ovaries, or tissues that line the pelvis.

2. Fibroids in the Womb

Fibroids are non-cancerous tumors that can compress the uterus or cause unusual menstruation and pain, although this condition often causes no symptoms.

3. Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is an infection of the uterus, fallopian tubes, or ovaries that is often caused by sexually transmitted bacteria that cause dysmenorrhea.

4. Adenomyosis

It is a rare condition where the lining of the uterus grows in the uterine muscle wall, which causes inflammation, pressure, and pain. This condition can also cause longer or heavier periods.

5. Cervical Stenosis

The next cause of dysmenorrhea is cervical stenosis or cervical stenosis, a condition that is also rare where the cervix is ​​very small or narrow so that it can inhibit menstrual flow, causing increased pressure in the uterus which results in pain.

Risk Factors for Dysmenorrhea

Every woman can develop menstrual pain or dysmenorrhea, but here are some habits and conditions that might be at higher risk:

  • Women who smoke
  • Women who drink alcohol during periods (alcohol tends to prolong menstrual pain)
  • Women who are overweight (obese)
  • Women who start menstruation before age 11 years
  • Women who have never been pregnant

Dysmenorrhea Symptoms

Menstrual pain symptoms are divided into two categories, namely symptoms of primary and secondary dysmenorrhea:

1. Primary dysmenorrhea

Primary dysmenorrhea symptoms include:

  • Menstrual pain immediately after menarche or first menstruation (? 6 months)
  • Common pain for 48-72 hours (often starts several hours before or after menstrual flow)
  • Cramps or labor pain
  • Background of constant lower abdominal pain, radiating to the back or thigh
  • Unusual pelvic examination findings (including rectal)

2. Secondary dysmenorrhea

The following are symptoms of secondary dysmenorrhea:

  • It starts in their 20s or 30s, after a relatively painless previous cycle
  • Heavy menstrual flow or irregular bleeding
  • Occurs during the first or second cycle after menarche
  • Pelvic abnormalities
  • Not responding to nonsteroidal anti-inflammatory drugs (NSAIDs) or oral contraceptives (OC)
  • Infertility
  • Dyspareunia (persistent vaginal pain)

Diagnosis of Dysmenorrhea

In order to diagnose dysmenorrhea, the doctor will evaluate your medical history and do a complete physical and pelvic examination. Here are some other tests that might be done, including:

1. Ultrasonography (USG)

This test uses high frequency sound waves to describe internal organs.

2. Magnetic resonance imaging (MRI)

MRI tests use large magnets, radio frequencies, and computers to make detailed images of organs and structures in the body.

3. Laparoscopy

This minor procedure, using a laparoscope, is a thin tube with a lens and light attached. This tool is inserted into the incision in the abdominal wall. Laparoscopes are used to look into the pelvic and abdominal regions, and doctors can usually detect abnormal growths.

4. Hysteroscopy

Is a visual examination of the cervical canal and the inside of the uterus. Doctors use a hysteroscope (an observer) that is inserted through the vagina.

Natural Dysmenorrhea Treatment

How to deal with dysmenorrhea naturally by making lifestyle changes and home remedies, including:

1. Exercise regularly

The first way to overcome dysmenorrhea is physical activity, even sex, to help ease menstrual cramps for some women.

2. Using heat

How to treat dysmenorrhea easily enough by soaking in hot water or using a heating pad, a hot water bottle or a hot compress cloth on the lower abdomen can relieve cramps.

3. Food Supplements

Some supplements such as vitamin E, omega-3 fatty acids, vitamin B-1 (thiamine), vitamin B-6, and magnesium supplements can reduce menstrual pain.

4. Reducing Stress

Psychological stress can increase the risk of menstrual cramps and their severity. Therefore, reduce your stress to relieve it.

Medical Dysmenorrhea Treatment

If the natural way to overcome dysmenorrhea is not effective, to relieve menstrual cramps can be done according to the following doctor’s recommendations:

1. Painkillers

Over-the-counter pain relievers, such as ibuprofen or naproxen sodium, with regular doses starting the day before menstruation starts can help control pain. In addition, nonsteroidal anti-inflammatory drugs that are prescribed are also available.

Take painkillers at the beginning of menstruation, or immediately after feeling the symptoms, and continue to take prescribed medication for two to three days, or until the symptoms disappear.

2. Birth control pills

Birth control pills contain hormones that can prevent ovulation and reduce the severity of cramps. These hormones can also be used in several forms, such as injections, skin patches, implants placed under the skin of the arms, flexible rings inserted into the vagina, or intrauterine devices.

3. Operation

If menstrual pain is caused by an abnormality such as endometriosis or fibroids, surgery to correct the problem can help reduce symptoms.

Uterus removal surgery can also be an option if other procedures fail to relieve symptoms and if you don’t plan to have children.

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