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Menstrual Cramps

No woman enjoys getting her monthly periods because of the accompanying menstrual cramps, bloating, headaches, and fatigue that make her feel miserable. It is common for you to have mild cramps during your periods because of uterine contractions. However, are the cramps severe and causing hinderances to your daily activities? Do you find no relief with pain killers and over the counter medications?
If yes, then don’t ignore what your body is telling you. There may be other reasons for your pain. But how do you know if you should be concerned? Read on to learn more about painful periods and what you should do if you have them.

Dysmenorrhea- Painful cramps during menstruation

Dysmenorrhea is the medical term for the severe and frequent menstrual cramps, and pain associated with menstruation. It is classified into primary and secondary dysmenorrhea based on the time of onset and underlying cause. You are probably suffering from primary dysmenorrhea, if you have been experiencing menstrual cramps from the time you first got your periods. This usually persists for life, and is because of severe and abnormal uterine contractions secondary to certain chemical imbalances in the body.

Dysmenorrhea that you experience in later life is caused by the presence of another medical condition in the body, and is termed as secondary dysmenorrhea. Few of the medical conditions that can cause secondary dysmenorrhea are endometriosis (a condition in the inner tissue of the uterus becomes implanted outside the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity often resulting in internal bleeding, infection, and pelvic pain), pelvic inflammatory disease (PID), uterine fibroids, abnormal pregnancy (i.e., miscarriage, ectopic), infections, tumors, ovarian cysts (fluid filled sacs in the ovary) or polyps in the pelvic cavity.

At risk

As your uterus contracts more strongly during menstruation, it presses against the nearby blood vessels and cuts off the supply of oxygen to the uterine muscle tissue. Brief loss of oxygen to the muscle results in pain. Menstrual cramps are seen to affect over 50% of women with about 15% of them experiencing severe cramps. It is more common in adolescent girls affecting upto 90% of them.

You are at increased risk of suffering from painful menstrual cramps if you started menstruating before the age of 11, your age is below 20 years, you experience heavy bleeding during your periods, are overweight, have never delivered a baby, if you smoke/ drink, or suffer from depression.

Clinical picture

If you suffer from dysmenorrhea, then you may experience symptoms of cramping and pain in the lower abdomen radiating down the legs, nausea, vomiting, fatigue, weakness, fainting, and headaches. The pain you experience may be crampy and sharp that comes and goes or could be a dull constant ache. You may experience it 1 to 3 days before or during the menstrual period with a peak at 24 hours that later subsides after 2 to 3 days.

Time to seek help

You need to seek an appointment with your doctor if the cramps and discomfort are not relieved by over the counter medicines or lifestyle modifications. Maintaining a record of your periods and symptom tracker for 2 to 3 months can help your doctor figure out the best treatment option for you. You doctor may want to check if you have cysts in your ovary or you may have to undergo a minor surgical procedure called as laparoscopy ( involves making a small cut in your abdomen to look inside your pelvis)

If you have started experiencing painful periods later in life, if there is pain at times other than the first two days of your period, or pain during sex, then you need to see your doctor. Also if the pain is not relieved by medicines and is accompanied by unusual vaginal bleeding or discharges it is safer for you to consult your doctor to rule out any serious problem.

Your evaluation at the doctor’s clinic will cover a detailed history, complete physical examination including pelvic examination. Your physician will arrive at a diagnosis of dysmenorrhea after ruling out other menstrual disorders, medical conditions, or medications causing or aggravating the condition. Your doctor may order for certain diagnostic procedures such as blood tests, urine analysis, ultrasound imaging of the pelvis, MRI, laparoscopy, or hysteroscopy for confirming the diagnosis.

Managing menstrual cramps

Few measures that can help you in managing your dysmenorrhea are regular exercise, increased protein intake, cutting down on sugar and caffeine, taking a hot water bath or shower, using a heating pad across the abdomen, or getting an abdominal massage done. Eating healthy foods, drinking lots of fluids and getting plenty of rest is necessary during the menstrual cycle.

Over the counter medications called as anti-prostaglandins may help in relieving your pain and discomfort, making the flow lighter, and causing the uterus to cramp less. Also medicines containing ibuprofen, acetaminophen, or naproxen sodium can help. You need to take these medicines about 4 to 6 hours with food before the pain starts.

Your doctor may also prescribe oral contraceptive pills as a treatment option. You may also find relief by intake of vitamin supplements of vitamin B1 or vitamin E. You may want to try acupuncture as an alternative treatment for the management of the pain and discomfort. Few other treatment options include magnesium supplements, fish oils, and use of magnets.

You may need to undergo surgical intervention if your menstrual cramps are being caused by endometriosis or fibroids in which the abnormal tissue needs to be removed to reduce your symptoms.

Time to stop suffering!!!

Dysmenorrhea is caused either due to chemical imbalances in your body or may be secondary to some underlying medical condition that is causing the pain. Few measures such as regular exercise, intake of protein rich foods, taking a hot water bath or shower, using a heating pad across the abdomen, and getting plenty of rest may help majority of the women. Also over the counter medications called as anti-prostaglandins and medicines containing ibuprofen, acetaminophen, or naproxen sodium may help in relieving your pain and discomfort, making the flow lighter, and causing the uterus to cramp less. However in some of you the pain may be severe and may not be relieved by over the counter medicines causing interference in your daily activities. It is then necessary for you to seek an appointment with your doctor to undergo detailed evaluation to exclude any underlying medical condition that needs attention.

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