Living with Dysmenorrhoea
(Menstrual Pain)

What is dysmenorrhoea?

Dysmenorrhoea is just the medical term for menstrual cramps, or the abdominal pain you experience during or just before your period (menstruation).

 

For some women, the discomfort of menstruation is merely annoying, but for others it can be severe enough to interfere with their everyday activities.

 

Conditions such as uterine fibroids and endometriosis are some of the reproductive health conditions that can cause dysmenorrhoea – in which case, treating the cause will relieve and treat the pain.
However, most menstrual cramps are not caused by any underlying condition and tend to lessen with age.

Dysmenorrhoea is classified by:

  • A throbbing or cramping pain in your lower abdomen, usually on the left or right side, or in pelvic region (hips).
  • The pain can be intense and can radiate to your lower back or upper thighs.
  • The pain may start 1-3 days before your period, while it generally peaks 24 hours after menstrual onset and tends to subside in 2-3 days.

Some women may also experience

  • Nausea
  • Vomiting or diarrhoea
  • Headache
  • Fatigue and pallor
  • Dizziness or fainting.

What causes dysmenorrhoea?

During your period, your uterus (where the baby develops during pregnancy) becomes inflamed and contracts to help expel its outer lining (the endometrium).

Hormone-like substances called prostaglandins trigger the uterine muscle to contract and cause the resulting pain and inflammation.
Higher levels of prostaglandins are associated with more severe period pain.

 

Dysmenorrhoea is classified as either primary, if there is no underlying cause, or secondary if there is an underlying reproductive system disorder, such as:

  • Uterine fibroids: These are benign (non-cancerous) growths in the wall of the uterus.
  • Endometriosis: This is a condition where uterine tissue becomes implanted outside of your uterus, most commonly in your ovarian tubes (also known as the fallopian tubes), ovaries or the pelvic cavity.
  • Adenomyosis: This is a disorder where the tissue that lines the outside of your uterus (the endometrium) begins to grow into the muscular wall (myometrium) beneath.
  • Pelvic inflammatory disease (PID): This is a sexually transmitted infection (STI) of the female reproductive system caused by the bacteria, gonorrhoea and chlamydia.
  • Cervical stenosis: This is an abnormal narrowing of the opening of the uterus (the cervix) that can impede your menstrual flow.

You may be at increased risk of experiencing primary dysmenorrhoea if you:

  • Are younger than 30 years old
  • Started puberty early, (age 11 years or younger)
  • Experience menorrhagia (heavy menstrual bleeding) or metrorrhagia (irregular bleeding between periods)
  • Have a family history of dysmenorrhoea
  • Are overweight or obese
  • Engage in smoking.

Living and managing

You can manage menstrual pain through some of these lifestyle tips:

  • Exercise regularly: Physical activity helps ease period pain and helps you to manage your weight.
  • Use heat: Using a heating pad, hot water bottle or soaking in a hot bath might help ease your menstrual cramps.
  • Try dietary supplements: Studies indicate that vitamin E, omega-3 fatty acids, vitamin B1 (thiamine), vitamin B6 and magnesium supplements might help reduce menstrual cramps.
    Also make sure you eat a healthy diet. See Cooking from the Heart for healthy and delicious meal ideas.
  • Get enough sleep and reduce stress: Stress might increase both your risk of experiencing menstrual cramps and how severe your menstrual pain is.
  • Avoid cigarette smoke, alcohol and caffeine: If you smoke, you can talk to your doctor about ways to quit.

 

How can you treat period pain?

To ease your menstrual cramps, your doctor might recommend:

  • Pain relievers: Over-the-counter pain relievers, in the form of nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen, can help relieve primary and secondary dysmenorrhoea. Your doctor can also prescribe higher strength NSAIDs if you have severe pain.
    It is recommended that you start taking pain relief medication at the beginning of your period, or as soon as you start to experience pain, and continue taking the medicine as directed for two to three days, or until your symptoms are gone.
  • Hormonal birth control/ “the pill”: Oral birth control tablets contain hormones that prevent ovulation (the release of an unfertilised egg from the uterus), thereby preventing pregnancy. These medications can also reduce the severity of period pain.
    These hormones can be delivered in other contraceptive forms, such as an injection, skin patch, implant placed under the skin of your arm, a flexible ring that you insert into your vagina or by an intrauterine device (IUD).
  • Surgery: If you have secondary dysmenorrhoea caused by endometriosis or fibroids, you might need surgery to correct the problem and relieve your symptoms.
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