Dysmenorrhea

Definition

Dysmenorrhea is painful menstruation that are associated with ovulation. It's the most common gynecologic complaint and it may also  lead to the  cause of absenteeism. The incidence peaks in women in their early 20s and then slowly decreases. It may also occur as a primary disorder or secondary to an underlying disease. Because primary dysmenorrhea is self-limiting, the prognosis is generally good. The prognosis for secondary dysmenorrhea depends on the underlying disease.

Causes of dysmenorrhea

• Hormonal imbalance
• Psychogenic factors
• Endometriosis
• Pelvic tumors
• Cervical stenosis
• Uterine leiomyomas
• Pelvic inflammatory disease

The pain of dysmenorrhea probably occur from increased prostaglandin secretion in menstrual blood which intensifies normal uterine contractions. Prostaglandins intensify myometrial smooth muscle contraction and uterine blood vessel constriction thereby worsening the uterine hypoxia normally associated with menstruation. This combination of intense muscle contractions and hypoxia may causes the intense pain of dysmenorrhea. Prostaglandins and their metabolites may also cause GI disturbances such as headache and syncope.

Symptoms of dysmenorrhea

• Sharp
• Intermittent
• Cramping
• Lower abdominal pain
• Groin and vulva
• Urinary frequency
• Nausea
• Vomiting
• Diarrhea
• Headache

Dysmenorrhea may also be associated with signs and symptoms that suggest premenstrual syndrome such as:

• Backache
• Chills
• Abdominal bloating
• Painful breasts
• Depression
• Irritability

Treatment of dysmenorrhea

• For the treatment of this disease, you can use initial treatment and its aims to treat pain and may also include analgesics such as nonsteroidal anti-inflammatory drugs, for mild to moderate pain - especially effective due to inhibition of prostaglandin synthesis through inhibition of the enzyme cyclooxygenase
• You can also used another treatment such as cyclooxygenase (COX)- 2-specific inhibitors, which is used to relieve the pain of dysmenorrheal.
• You can also applied heat to the lower abdomen, used cautiously in young adolescents because appendicitis may mimic dysmenorrhea.
• You can also use opioids for severe pain, prostaglandin inhibitors to treat pain by decreasing the severity of uterine contractions.
• If you have primary dysmenorrhea, then effective alternative to treatment with antiprostaglandins or analgesics, such as hormonal contraceptives, to treat pain by suppressing ovulation and inhibiting endometrial prostaglandin synthesis.
• For the treatment of secondary dysmenorrhea is designed to identify and correct the underlying cause and may include surgical treatment of underlying disorders, such as endometriosis or uterine leiomyomas.
• For the treatment of this disease, you should provide the complete information including explanation of normal female anatomy and physiology as well as the nature of dysmenorrhea.
• Take female hormones that prevent ovulation, such as oral contraceptives.
• Encourage the patient to keep a detailed record of her menstrual cycle and symptoms and to seek medical care if symptoms persist.
• You can also use vitamin-B supplements to treat this disease. Because these help to treat symptoms in some persons.