What is Painful Menstruation (Dysmenorrhea) ?
Dysmenorrhea is a painful menstrual bleeding that interferes with daily life in women. It is normal for a woman to experience pain complaints during the menstrual period. However, these pains can become very severe depending on some disorders. Painful menstruation is considered a gynecological disease in women.
The pain experienced in the case of dysmenorrhea occurs intermittently and manifests itself in the form of cramps. In addition, this pain is more intense in the suprapubic region. Painful menstruation is accompanied by complaints such as nausea, vomiting and diarrhea. This intense pain can last up to 48 hours. It is normal to feel pain due to uterine contractions during the menstrual period. However, in some cases, the severity of these pains can increase significantly.
What are the types of dysmenorrhea ?
Dysmenorrhea can be expressed as a medical term for menstrual bleeding. There are two different types of dysmenorrhea;
It is the pain caused by menstrual cramps due to the contraction in the uterus during the menstrual period in women. Primary dysmenorrhea pains are intensely felt in the lower abdomen. In women experiencing menstrual bleeding, cramps may be seen in the uterine region due to some substances secreted by the body.
Pain related to this can be seen before the menstrual period or may occur during the menstrual period. This pain is felt more severely during menstruation and usually lasts for 1-2 days. Complaints of primary dysmenorrhea appear at the age of the first menstruation and decrease in severity with advancing age. The recovery rate for this pain is very high in women who have given birth.
Menstrual pain is caused by a disease of the female reproductive organ. Secondary dysmenorrhea is a condition that tends to get worse rather than better over time.
It lasts longer than the pain experienced due to menstrual cramps. Generally, even if the menstrual bleeding ends in women, this pain tends to continue. It occurs in later ages due to some health problems. Pain intensity increases over time. Pain usually begins before the menstrual period, continues during the period of menstrual bleeding and continues after the completion of menstruation.
What are the symptoms of dysmenorrhea ?
Dysmenorrhea usually occurs with various symptoms. When these symptoms are combined with other conditions, it can be understood that painful menstruation is experienced.
Dysmenorrhea symptoms are as follows;
-Digestive system problems such as diarrhea, constipation, and vomiting
-Loss of appetite
-Pain or cramping in the lower abdomen
-Increase in headache complaints
While these symptoms may occur in every patient, they may not be seen in some patients. When secondary dysmenorrhea is usually evaluated together with other symptoms, the underlying cause can be revealed by specialists.
What are the causes of dysmenorrhea ?
The causes of dysmenorrhea should first be examined according to its type. The primary causes of dysmenorrhea are usually pelvic pain that occurs due to the natural production of the hormone progtaglandins. It occurs due to the contraction of a chemical called prostaglandin, which causes menstrual cramps. The uterus, where the baby grows, narrows during the menstrual cycle. During the menstrual period, the uterus contracts more strongly.
When the uterus contracts too strongly, it puts pressure on the surrounding blood vessels and the oxygen supply to the uterine muscle tissue is cut off. As a result, pain occurs.
Secondary desmenorrhea is a more serious condition. Therefore, the underlying causes should be examined in detail. The causes of second desmenorrhea are as follows;
-Painful menstrual period and groin pain may occur due to the chocolate cyst, which occurs when the endometrium tissue on the inner wall of the uterus comes out of the uterus.
-Due to adenomyosis disease, which is characterized as the endometrium, which is located in the inner wall of the uterus, in the muscle layer of the uterus, the menstrual period is more painful and more bleeding.
-Fibroids, which can be defined as benign lumps that appear in the uterus, can also lead to painful menstrual periods.
How is dysmenorrhea diagnosed ?
Dysmenorrhea is usually primarily examined for symptoms depending on the disease and the history of painful menstrual bleeding during the menstrual period. Specialists undergo a gynecological examination. After the pelvic examination, if necessary, a smear can be applied by taking a swab from the cervix.
Specialists may also order an ultrasound examination and different laboratory tests if necessary to make a diagnosis. In addition, a surgical procedure called laparoscopy may be required. During this procedure, the cause of dysmenorrhea can be determined by making a very small incision in the navel.
How is dysmenorrhea treated ?
Different methods can be used for the treatment of dysmenorrhea. Depending on the patient's condition, hormone therapy or drug therapy can be applied. In addition, in some procedures, surgery can also be performed.
The main purpose during drug therapy is to reduce the severity of cramps by suppressing prostaglandin production. Medicines can also eliminate the complaints of vomiting and nausea in women. Drug treatment is not recommended in patients with bleeding disorders, liver disorders, stomach disease.
Hormonal methods such as birth control pills, skin patches or vaginal ring are also effective in reducing painful menstrual complaints. Specialists may request the use of hormonal intrauterine devices in certain cases. Hormones reduce the level of prostaglandin produced in the body. As a result, there is a regression in the development of bleeding, pain, uterine fibroids and chocolate cysts. When hormone therapy is discontinued, regrowth may occur.
In case of fibroid pain and chocolate cyst, a surgical procedure called laparoscopy can be performed. In very severe cases, removal of the uterus will be the last treatment option for women.