The excess pain a woman experiences during her menstrual cycle is called, “dysmenorrhoea”. As such the menstrual cycle of every woman is associated with some pain in the lower abdomen, cramps in the legs, backache and general discomfort. Given a chance majority of the women would like to stay back and rest during the 3 to 7 odd monthly days of menstruation.
But in dysmenorrhoea, there is severe pain incapacitating the lady. The pain can be sharp shooting or colicky or dull with sense of heaviness. There are invariably severe cramps in legs. Along with the pain, one may have associated sense of nausea, vomiting, sweating, giddiness, e.t.c.
The duration of pain is also variable. One may have pain during 1 or 2 days of the menstrual cycle or throughout the cycle till the vaginal bleeding lasts.
Actually under the influence of changes in the hormonal levels of progesterone and estrogen, the uterus is prepared each month for receiving the fertilized ovum released during ovulation. For this purpose blood vessels in wall of endometrium(inner layer of uterus) proliferate making it thick and soft. But when no fertilization occurs, this newly formed vasculature is shed. In fact, the term, :dysmenorrhoea”, is also described in some books as per the ancient meaning of the word-i.e. cry of the uterus for lack of a baby.
There is uterine contraction due to hormonal influence which contracts these blood vessels and also destroys the thickened endometrium. This causes release of prostaglandins and some other mediators of inflammation. All these factors contribute to the causation of severe pain during menses.
Dysmenorrhoea can be secondary to some problem in the uterus. Endometriosis, leiomyomas, other uterine tumors, pelvic congestion, pelvic inflammatory disease, intrauterine device ,e.t.c., are some of the causes for painful menstruation in women. In some cases there is no apparent cause for the pain. These cases are labeled as,”primary dysmenorrhoea”.
Primary dysmenorrhoea usually occurs in young girls about 15-16 years of age when the cycles become ovulatory. It may subside later in life with child bearing. But some women continue to have it even after delivering children.
Secondary dysmenorrhoea usually occurs later in life with an obvious underlying cause for the pain.
Diagnosis of dysmenorrhoea is fairly easy. Apart from the clinical examination, ultrasound of the pelvis helps in detecting or excluding certain conditions likely to cause that pain.
If there is an apparent cause for the painful menstruation, treatment of the cause cures it completely.
Primary dysmenorrhoea becomes a difficult condition for the sufferer. Since it is a monthly feature, a woman whether working outside or at home, cannot take off from her work. Many times, even family members tend to accuse her to be malingering.
Pain killers do provide relief, but taking pain relieving pills very frequently is not very good. They can cause gastritis and even kidney damage later on. Some women are given hormonal pills to help cure this condition but they are also associated with side effects.
Avoiding heavy food like fried things helps to avoid pre menstrual tension and also dysmenorrhoea. Taking adequate amount of fiber, iron and calcium in the diet helps a woman to overcome the pain of dysmenorrhoea to some extent. Acupressure, indigenous herbal preparations are also some of the non- pharmacological methods used to treat dysmenorrhoea.
Certain Yogic exercises are very helpful to make a woman get rid of dysmenorrhoea and make her feel comfortable through all days of the month.
Apart from all these measures, most important for a woman suffering from dysmenorrhoea is to, “accept”, the situation. She should be made to understand that she is made that way by nature and for few days every month she will suffer from pain and nothing much can be done about it. This acceptance will make her mentally care free and automatically the perception of pain will also reduce.
No woman should lag behind in any way due to dysmenorrhoea.