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Identifying the causes and treatment of Primary and secondary dysmenorrhea

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Considered one of the most common gynaecological problems for women, dysmenorrhea is the medical term for distressing menstrual cramps caused by uterine contractions. The degree of pain varies from woman to woman. Still, it can be severe enough to restrict daily activities, cause absence from school or work and substantially affect the quality of life and general wellbeing. 

Based on the pathophysiology or cause, dysmenorrhea is of 2 types:

  • Primary dysmenorrhoea 
  • Secondary dysmenorrhoea

To put it simply, primary dysmenorrhea is the recurrent menstrual pain that occurs every month but is without any organic disease while secondary dysmenorrhoea is menstrual pain that is the result of reproductive system disorders.

What causes primary and secondary dysmenorrhea? 

Primary dysmenorrhea occurs during menstrual bleeding and is associated with the overproduction of prostaglandins (a group of lipids ) or vasopressin (a type of hormone). When menstruation begins, the endometrial cells release prostaglandins that stimulate muscular contractions and restrict blood supply. Every woman releases different prostaglandins levels; and the more prostaglandins released, the more severe dysmenorrhoea gets. That is why every woman experiences varying levels of pain during menstruation.

On the other hand, secondary dysmenorrhoea is caused by a disorder or infection in the reproductive organs such as fibroids, endometriosis, endometrial polyps, ovarian cysts, pelvic inflammatory disease, adenomyosis, etc. 

Symptoms of Primary & Secondary Dysmenorrhea

Primary DysmenorrheaSecondary Dysmenorrhea
Begins with menarche (first period) or within 6 to 12 months after menarche, with the onset of ovulatory cyclesCan begin at any age and arise as a new symptom when a woman is in her 30s or 40s
Recurrent and occurs in every cycleMay or may not occur in every cycle
Pain occurs in the lower abdomen or pelvis regionPain can occur anywhere in the abdominal region
Pain is usually associated with the onset of menstrual flow, can occur 1-2 days before menstrual flow, and last for around 8-72 hoursCan occur any time, and often there is a change in duration and intensity of pain in every menstrual cycle
Can also include other associated symptoms like pain in the back and thighs, nausea and vomiting, diarrhea, and headacheDepending on the causative disease, other symptoms like dyspareunia (pain during sexual intercourse), menorrhagia (heavy bleeding), etc. may be present
There are no abnormal findings observed on examination, laboratory testing, or ultrasoundPelvic abnormality or diseased reproductive organs are observed on physical examination and confirmed by ultrasound

Treating primary and secondary dysmenorrhea

Though most women experience some form of discomfort during menstrual bleeding, it is important to look out for abnormal signs during the menstrual cycle for effective management.

Diagnosis of both primary and secondary dysmenorrhea requires a thorough physical examination and an ultrasound of the patient. These are usually enough to conclude primary dysmenorrhea, but further tests are required to determine the causative disorder if secondary dysmenorrhea is suspected. 

Treatment aims to relieve the pain of the patient or treat the physiological mechanisms behind menstrual pain (i.e., prostaglandin production) with paracetamol, aspirin, Non-steroidal anti-inflammatory drugs (NSAIDs), and oral contraceptives. Although effective in managing the patient’s symptoms, these medications do not cure the cause and are also associated with side effects such as acid reflux, stomach inflammation, and elevated risk of heart attacks.

An alternative approach 

In such situations, a natural and more long-term alternative to manage dysmenorrhea effectively would be Ayurveda. An Ayurvedic expert can help uncover the underlying causes of dysmenorrhea and manage it without altering normal body functioning. If you are looking for a viable solution to deal with excessive period pain in a more sustainable manner and without side effects, visit Hempstreet to know more. Here you can reach out to expert consultants who can guide you with better management and treatment of painful menstrual cycles. 

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459624/ 

https://pubmed.ncbi.nlm.nih.gov/2178834/ 

https://www.thesun.co.uk/fabulous/6006411/period-pain-painkillers-bad-idea-ease-cramps/

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