Period Pain or Dysmenorrhoea
“My period started some four months ago. I had no problems, apart from the anxiety of expecting it, and learning to adjust to this new experience.
Bang! From the blues came this agonizing lower abdominal pain, month in month out, two days before my period.
I am not able to go to school each time the pain come on. It leaves me so exhausted for three days.
Our family doctor announced to us that it is not an illness in it self, but it is called dysmenorrhoea or menstrual pain.” – Jessica, Colorado USA
Millions of women world wide, like Jessica, suffer from severe menstrual or period pain.
It is suprisingly a cause of acute hospital attendence. It needs to be identified as a cause of lower abdominal pain in women of child bearing age(11 - 45 yrs of age).
This is usually straight forward in most teenagers. The difficulty arises in girls having their first menses who do not know what menstrual pain is like.
For some, it leaves them totally incapacitated for two to four days every month, resulting in considerable time loss from work or school.
It also means that within that time, this could impact on their enjoyment of day to day activities. But what is Period or menstrual pain?
What is Menstrual Pain?
Period pain, also called dysmenorrhoea or mentrual pain refers to cramping lower abdominal pain occurring a day or two before menstruation and continuing for another one or two days after the onset of menses.
About four out of every five woman do experience some degree of pain during menstruation, and this is normal.
In the remaining one out of five, they experience very severe pain during their period.
There are two types of menstrual pain. These are Primary dysmenorrhoea and secondary dysmenorrhoea. The difference between the two types relates mainly on the cause of the menstrual pain.
This is period pain not due to any disease or abnormality in the womb or female reproductive tract.
It is as a result of excessive or high sensitivity to normal hormones produced after ovulation. This hormone called prostaglandins reach their highest level just before menstruation starts.
This causes the uterus to contract, which in a way, help to expel the menses. When the amount of hormone is more than need, or the uterus is over sensitive to a normal amount, the woman could come up with severe pain.
Excessive contraction of the uterus from the action of the prostaglandins cause the pressure in the uterus to rise above normal blood pressure, so blood flow to the uterus is reduced.
It is the kind of menstrual or period pain found in younger woman.
So, if there is no ovulation, there can be no period pain of this kind.
Primary dysmenorrhoea in it self is thus not an illness. Things that can predispose a woman to having this kind of pain include
• Similar pain in mother or sister
This is period pain commonly found in older women above 30 years of age. It is less common than primary dysmenorrhoea.
It is usually caused by some disorder in the reproductive tract of the woman which could in fact combine with excessive prostaglandin production too.
Common causes of secondary dysmenorrhoea include:
Symptoms of Period Pain
Primary dysmenorrhoea as said, is occurs mostly in young women of child bearing age, usually in their early teens.
It usually follows after a few menses, though it could occur with the first menses rarely. This is because, as explained above, dysmenorrhoea only occurs after ovulation.
If no egg is released, no period pain. The first few menses in most women do not result in the release of eggs.
This explains why oral contraceptive pills are effective in treating period pain, as they prevent the release of eggs or ovulation.
The pain begins as a lower abdominal pain, cramping, 4 to 12 months after the onset of menstruation and continuing till after child birth or birth of second or third child.
The pain typically starts a day or two before the period, and may continue for another day or two.
There may be associated headache, back ache, diarrhoea, constipation feeling like vomiting, or actually vomiting. A few women may have such severe pain that they may actually pass out (faint)!
Temperature is expected to be normal as well as heart rate. The pain should respond to medications if given before the onset, a few days before menses begin.
Secondary dysmenorrhoea is seen in women who may have had normal periods without pain for most of their life time.
It commonly occurs after the age of thirty. It may start as lower abdominal pain, a few days or weeks before their menses. They may be showing some signs of some illness, reflecting the underlying disorder.
Before a woman is dismissed as having secondary dysmenorrhoea, it is important that all possible causes of lower abdominal pain in a woman have been ruled out, as some may be sinister!
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