Dysmenorrhea - Menstrual Cramps
Not many women can say that they do not experience any unpleasant and troublesome sensations during their periods. For the rest of them this natural monthly process is associated with weakness, lack of appetite, headaches, abdominal pains and cramps and other more or less severe symptoms and about 10% of them are incapacitated for several days each month. Almost every woman at least once in her life has searched for the ways to reduce menstrual cramps. The condition when a woman experiences severe pain or other emotional and vegetative symptoms during menstruation is called dysmenorrhea and it’s not a disease.
The mechanism of dysmenorrhea is complex and is not fully understood yet. As of today, there are several opinions explaining this process and the most common one links the development of dysmenorrhea with the secretion or hormone-like substances called prostaglandins. Prostaglandins increase uterine activity and enhance its spasmodic contraction resulting in the stimulation of the nerve endings and their increased sensitivity.
Primary and secondary dysmenorrhea
There are two types of dysmenorrhea – primary and secondary one. Primary dysmenorrhea is not associated with any changes in the internal organs and it manifests itself with the beginning of menstruation in puberty. As for secondary dysmenorrhea, it is caused by organic changes of the pelvic organs, endometriosis, pelvic inflammatory diseases, etc. and usually occurs at the age of about 30 years.
Dysmenorrhea treatment should be aimed at the elimination of not only menstrual cramps (by pain relievers, for example), but also the very cause of dysmenorrhea. The symptoms of primary dysmenorrhea can be relieved with:
- Gestagens - hormones that promote renewal of the uterine lining and relax uterine muscles;
- Combined oral contraceptives containing hormones that prevent ovulation and reduce menstrual cramps;
- NSAIDs – they are administered in patients who cannot take gestagens or oral contraceptives due to some reasons. These medications work by suppressing the action of prostaglandins;
- Antispasmodics that reduce muscle tone and thus relieve menstrual cramps.
The treatment of secondary dysmenorrhea is always focused on the treatment of the underlying disease. Surgical methods are used in the case of uterine fibroids or acute endometriosis and only if other treatment options have been unsuccessful.
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