Overview
Synopsis: Pain in period is normal, but “unbearable”? If you are experiencing severe menstrual pain, then it's time to take action because this pain can be dysmenorrhea. This article will help you understand what exactly it is, its causes, types, symptoms, diagnosis, and available treatment options.
Overview: What is Dysmenorrhea?
Dysmenorrhea is defined as painful period cramps that can vary widely from mild to debilitating pain in intensity. Cramping during periods is caused by uterine contractions that help shed the lining due to hormones. However, in the case of dysmenorrhea, levels of this hormone are quite high, leading to higher intensity pain.
From a medical standpoint, dysmenorrhea is classified under the International Classification of Diseases, tenth revision (ICD-10) in two codes, including:
- N94.4 – Primary dysmenorrhea
- N94.5 – Secondary dysmenorrhea
Although dysmenorrhea does not cause physical harm, it can impact a person's overall productivity, mood, and quality of life. Therefore, understanding everything about it is important.
Causes of Dysmenorrhea
Dysmenorrhea can arise from a series of biological and medical causes, depending on its type. Each cause is unique and helps choose the right treatment. These causes may include:
Hormonal Imbalances Causing Primary Dysmenorrhea:
- Primary dysmenorrhea is mainly caused by high levels of prostaglandins, a hormone-like chemical that triggers strong uterine contractions.
- Cramping is caused by a lack of blood flow to a specific area, which is what happens during dysmenorrhea.
- The strong contractions reduce blood flow to the uterus, leading to pain and cramping.
Underlying Medical Conditions Causing Secondary Dysmenorrhea:
Secondary dysmenorrhea is usually due to underlying conditions originating in the reproductive organs and/or pelvis, such as:
- Endometriosis
- Adenomyosis
- Uterine Fibroids
- Pelvic inflammatory disease (PID)
- Ovarian cysts
- Cervical stenosis
Secondary dysmenorrhea can worsen and be more prolonged than primary dysmenorrhea from an underlying condition. Therefore, addressing the underlying condition can actually treat dysmenorrhea itself.
Congestive Dysmenorrhea:
Dysmenorrhea can also be attributed to pelvic heaviness caused by water retention, hormonal fluctuations, and pelvic venous congestion prior to the menstruation. However, this cause is typically temporary as, again, congestion decreases.
Types of Dysmenorrhea
We mentioned the types of dysmenorrhea in earlier sections. Now, let’s explore and understand what these types actually are:
- Primary Dysmenorrhea : When the menstrual pain is caused without any underlying medical condition or pathology, it is termed primary dysmenorrhea. That is, it is connected with the uneven release of prostaglandins. This is a common type and begins with the first few menstrual cycles and eventually improves if no pelvic condition is observed.
- Secondary Dysmenorrhea : Secondary Dysmenorrhea refers to period cramps linked with different types of underlying reproductive or pelvic conditions. This pain often worsens with time and can be more painful and long-lasting than typical cramps.
Symptoms of Dysmenorrhea
Dysmenorrhea present itself with a range of visible and, of course, some uncomfortable symptoms, with some common ones as:
- Cramping in the lower abdomen
- Sharp, throbbing, or squeezing pelvic pain
- Pain radiating to the lower back, hips, or thighs
- Pelvic pressure or heaviness
Apart from these common symptoms, many signs are also associated with dysmenorrhea, which are not similar for everyone. These symptoms may include:
- Nausea
- Fatigue
- Headache
- Bloating
- Diarrhoea
- Dizziness
- Breast tenderness
Diagnosis of Dysmenorrhea
Diagnosis of dysmenorrhea is done with a mix of doctors’ expertise and the accuracy of medical instruments. The diagnosis generally begins with evaluating the type of dysmenorrhea, and here’s how your doctor does that by analysing:
- The timing and duration of pain
- Intensity of pain with time
- Patient’s response towards medications
- Presence of heavy bleeding or pain during sex.
- Family and personal history of reproductive conditions.
If the type of dysmenorrhea is found to be secondary, then further evaluation is recommended, with accurate tests and imaging, including:
- Pelvic Ultrasound to confirm fibroids, cysts, and adenomyosis
- MRI to get detailed images of pelvic tissues.
- Blood Tests to rule out the possibility of a hormonal imbalance.
- Laparoscopy to diagnose endometriosis.
Dysmenorrhea Treatment Options
Dysmenorrhea treatment options are many, but the right one depends on the type and severity of symptoms. Three approaches are generally used to tackle this condition, which are:
- Medications : Certain medicines can target prostaglandin production or help manage hormonal balance, ultimately helping treat dysmenorrhea. These medications may include
a. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs),
b. Hormonal pills or hormonal treatment,
c. Antispasmodics to relax the uterine muscles.
- Lifestyle Modifications : Some simple lifestyle changes can change the trajectory of your dysmenorrhea-related pain, such as:
a. Regular exercise or low-impact exercise
b. Yoga and stretching
c. Heat therapy in the lower abdomen
d. Balanced diet
e. Reduce caffeine or sugar intake
f. Stay hydrated and get good sleep
g. Meditation
- Advanced Treatments : If Dysmenorrhea reaches a level where the above two methods don’t work, which generally happens in secondary dysmenorrhea, then you may need an advanced option, such as:
a. Laparoscopic surgery in case of endometriosis
b. Fibroid removal
c. Adenomyosis management via hormonal therapy or minimally invasive procedures.
d. Managing ovarian cysts.
Conclusion
Finally, it can be concluded that although dysmenorrhea is very common, it can impact your daily life. Don’t compromise with period pain and understand the type of cramps to treat and transform your monthly experience. Because with timely intervention, and in most cases few lifestyle changes, you can get your comfort, balance, and command over your health back.
Common Questions Asked
How can I tell the difference between primary and secondary dysmenorrhea?
- Primary dysmenorrhea is characterised by cramps not associated with any pelvic pathology and usually starts in adolescence.
- Secondary dysmenorrhea is a result of other conditions, such as endometriosis or fibroids, and usually gets progressively worse over time.
What is the ICD-10 code for dysmenorrhea?
Primary Dysmenorrhea - N94.4
Secondary dysmenorrhea - N94.5
How common is dysmenorrhea?
While 60% of people complain of mild cramps, about 5% to 15% have severe contractions.
Is there another word for dysmenorrhea?
Dysmenorrhea is usually referred to as "menstrual cramps", "cramps", or "pain" associated with menstruation.
When do I need to see a doctor for period pain?
If the menstrual pain interferes with your daily life, is progressive in nature, or does not get better with over-the-counter medications, you should seek medical attention.
Are there any home remedies for dysmenorrhea?
Yes, heat, light exercise, hydration, herbal tea, or relaxation exercises can help alleviate dysmenorrhea symptoms.
Does dysmenorrhea affect fertility?
Primary dysmenorrhea does not impact fertility; any patient suffering from secondary dysmenorrhea, related to a condition impacting fertility, would have a concern.
Are there safe medications that relieve dysmenorrhea?
NSAIDs are commonly suggested as a treatment option for dysmenorrhea, but you should be evaluated by a medical physician to discuss what is appropriate for your specific needs or diagnosis.