Dysmenorrhea
What Is Dysmenorrhea?
Dysmenorrhea is the medical term for painful menstrual periods. Symptoms may include menstrual cramps, low back pain, leg pain, nausea, vomiting, diarrhea, headaches and fainting. Primary dysmenorrheal begins with the onset of periods in early teens. Secondary dysmenorrhea begins at a later age and/or refers to symptoms which are getting progressively worse each month.
What Causes Dysmenorrhea?
Primary dysmenorrhea is thought to be caused by the release of a hormone from the endometrium (lining of the uterus) as it breaks down for menstruation. This hormone is called prostaglandin and causes contraction of smooth muscle in the uterus, intestines, and blood vessels. Secondary dysmenorrhea may also be caused by prostaglandin release, but may be a sign of a more serious disorder such as endometriosis, pelvic scarring or adhesions, ovarian cysts or tumors, or even ovarian cancer. Dysmenorrhea which is severe and not improved by medical therapy, or which is getting progressively worse, requires further tests for more serious causes.
Is There Any Treatment For Dysmenorrhea?
There are many treatments for dysmenorrhea. Aspirin or Tylenol are sometimes used. Birth control pills will usually relieve dysmenorrhea and will also provide contraception if needed. A group of drugs which act as prostaglandin inhibitors (NSAIDS) are available for specific treatment of dysmenorrhea and may be very valuable for this condition. Ovarian cysts, pelvic adhesions, or severe endometriosis may require laparoscopic surgery or more complicated therapy.
What Are These Prostaglandin Inhibitor Drugs (NSAIDS)?
This group of medications is related to aspirin and was originally developed to treat arthritis patients. They are considered very safe when used for 3-4 days per month with menstrual periods. Ibuprofen (Advil, Motrin, Nuprin and others), Aleve, and Orudis are available at the pharmacy without a prescription. Several others (Anaprox, Naprosyn, Meclomen, Ansaid, and others) require a doctor's prescription and may be more successful if ibuprofen does not work well for you. These medications act by inhibiting the synthesis and release of prostaglandins, which are local hormones that cause the cramps and pain of dysmenorrhea. It is very important to start these medications as soon as you know your menstrual period is starting (preferably 12-24 hours before symptoms usually start) and also to take the pills regularly until your symptoms would normally have resolved. They will not work as well if taken only when needed like pain pills. Rare side effects include diarrhea, abdominal cramps, ringing in the ears, headaches and nausea. Women who are allergic to or have problems with Aspirin should avoid these medications unless instructed by your doctor.
