Dysmenorrhoea
is a pain associated with the periods in menstruating women.
There are two types. Primary dysmenorrhoea and secondary dysmenorrhoea
(“primary” means there is no other factor involved, “ secondary” means the condition results from another, or second, condition). Primary dysmenorrhoea is usually found in the younger age groups who have had no children. The pain starts, usually, just before the menstrual bleeding, is of a cramping nature and felt in the lower abdomen. The worst of it is usually over in the first 24 hours. In some cases, however, it can be severe, prolonged and associated with nausea, vomiting, backache, headache and faintness. It is thought to be due to the presence of excess prostaglandin. Secondary dysmenorrhoea, usually affects older women, may start some days before the menstrual bleeding and often lasts beyond it. The pain is typically an aching lower abdominal pain, sometimes associated with cramping, and often with dyspareunia (pain on intercourse). Causes for secondary dysmenorrhoea include pelvic inflammatory disease, endometriosis and fibroids, and sometimes the presence of an IUCD (intra-uterine contraceptive device, the “coil”).
Most girls, at some stage in growing up, experience primary dysmenorrhoea. If it is mild it will respond to simple over-the-counter pain relievers. If it is more troublesome a doctor should be consulted. He may prescribe one of the NSAIDS (non-steroidal anti-inflammatory drugs) such as mefenamic acid, anti-spasmodics, progesterone or the mixed oral contraceptive pill which will reduce the pain by stopping ovulation. All cases of secondary dysmenorrhoea should be seen by a doctor and the cause determined. Untreated, some conditions may lead to chronic ill health and infertility. The doctor will most likely carry out an internal examination, remove any IUCD, take a bacterial swab from the cervix for examination, and refer for an ultrasound etc. He may also seek a gynaecological opinion. Various medications might be prescribed, from antibiotics for pelvic infection, danazol for endometriosis, and for the pain, often NSAIDS. |
