Introduction – Menstruation or commonly known as a period is a bodily cycle seen in women where shedding of the uterus lining occurs every month. A regular cycle is a good thing to have. The shedding partly consists of tissue and blood. This process is driven by hormones which are chemical messengers in your body and organs like the pituitary gland in the brain and the ovaries play a major role in menstruation. A cross sectional study conducted in India revealed that 50 to 87.8% of women reported dysmenorrhoea. Among this range, 70% of females in the adolescent age group – suffered the most pain. 

How Does Healthy Menstruation Happen?

This cyclical occurrence is under the tight control of hormones – especially from the pituitary and ovaries, which influence the uterus into initiating the process of menstruation. The process of menstruation happens in 4 phases namely the menses, follicular phase, ovulation and the luteal phase.

Hormones like oestrogen, progesterone, follicular stimulating hormone and prostaglandins are responsible for the process of a smooth cycle. Any irregularities in these hormones can cause various symptoms ranging from painful menses to infertility.

What Is Painful Menses Or Dysmenorrhoea?

Dysmennorhoea is pain caused in the lower abdomen and back during the process of menstruation. It is classified into 2 types: primary and secondary. 

• Primary dysmenorrhoea is the most common type seen in adolescent and young adult women. Hormones like prostaglandins are released in increased amounts leading to the cut off of blood flow to the uterus, causing ischemia and severe pain. Early menarche, irregular oestrogen production, smoking, stress and obesity, and family history are some contributing factors for the high prostaglandin levels.
• Secondary dysmenorrhoea: This type of menstrual cramps or pain is seen due to underlying pelvic conditions like endometriosis, fibroids, adenomyosis or PID (Pelvic inflammatory disease), polyps, cervical diseases, congenital abnormalities, ovarian cysts and Intra uterine device (IUD) complications. Any of these factors can cause the pelvic organs like the uterus and ovaries to produce high levels of prostaglandins, causing extreme pain during menses. Symptoms can range from extreme pain in the lower abdomen, thighs, a feeling of pressure, bloating, nausea, vomiting, dizziness and headaches respectively. 

Dysmenorrhea must be diagnosed and treated in a timely fashion. If it is primary dysmenorrhea, then, there is no need to worry too much. But, if other medical conditions are causing severe pain, it is important to deal with them, to prevent any complications from occurring later on. Untreated PID or endometriosis can lead to infertility in severe cases. Diagnosis is usually done by a gynaecologist- using a pelvic exam. A speculum will also be inserted, so that the doctor gets a better look at your vagina and cervix. If results remain inconclusive and you still have painful symptoms, then you may need a hysteroscopy, ultrasound or a laparoscopy. 

Management of Dysmenorrhoea Symptoms- 

Relieving period cramps depends on severity and underlying pathologies. If there are no underlying diseases, pain killers, ample rest with hot bag application are advised. If the pain is extremely severe affecting your daily life, your gynaecologist may provide hormonal medications. In secondary dysmenorrhoea pains, the underlying uterine or ovarian problems must be treated first and the body recovers by itself. 

Conclusion – Menstruation is a natural process like digestion and respiration. Any pain in such a natural process is an area of concern and should be addressed at the earliest. Visit your nearest gynaecologist if you are affected by it. Informing your complete medical history helps the gynaecologist to suggest a plan according to your condition. Since dysmenorrhoea may be hormonal in nature, you will need holistic care. Feminova Women’s Clinic has some of the best gynaecologists, including the Top PCOS Specialist in Hyderabad – who are well experienced in addressing your suffering by providing appropriate measures and requisite advice.

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