| Basic Information |
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| Description |
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Severe, painful cramps during menstruation. Primary dysmenorrhea means
pain has recurred regularly or within a year or two of the first
period (puberty). Secondary dysmenorrhea means pain began years after
periods started. Women with dysmenorrhea are generally fertile.
Severity of symptoms varies greatly from woman to woman, and from
one time to the next in the same woman. Dysmenorrhea usually is less
severe after a woman has had a baby.
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| Frequent Signs and Symptoms |
- Cramping and sometimes sharp pains in the lower abdomen,
lower back and thighs. The pain starts at onset of menses and lasts
for hours to days.
- Nausea and vomiting (sometimes).
- Diarrhea(occasionally).
- Sweating
- Lack of energy.
- Urinary frequency.
- Irritability, nervousness, depression.
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| Causes |
- Strong or prolonged contractions of the muscular wall of the
uterus. These may be caused by concentration of prostaglandins
(hormones found in the cervix and uterus). Research shows that
women with dysmenorrhea produce and excrete more
prostaglandins than those who don't have as much discomfort.
- Dilation (stretching) of the cervix to allow passage of blood
dots from the uterus to the vagina in cases where the cervix is
narrowed or constricted
- Other causes include:
- Pelvic infections.
- Endometriosis, especially if dysmenorrhea begins after age 20.
- Adenomyosis (an abnormal benign growth of the endometrium).
- Fibroids or other benign tumors of the uterus.
- Use of intrauterine device (IUD).
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| Risk Increases With |
- Use of caffeine or nicotine.
- Stress. The degree of dysmenorrhea may vary according to
general health or mental state. While emotional or psychological
factors don't cause the pain, they can worsen it or cause some
women to be less responsive to treatment.
- Family history of dysmenorrhea.
- Lack of exercise; poor diet.
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| Preventive Measure |
- Take female hormones that prevent ovulation, such as oral
contraceptives.
- Treatment of the underlying cause.
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| Expected Outcome |
- Symptoms can be controlled with treatment.
- Symptoms improve with age and with childbirth. Symptoms are
rare in postmenopausal women.
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| Possible Complications |
- Severe pain that regularly interferes with normal activity.
- Infertility from underlying cause.
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| Treatment/Post Procedure Care |
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| General Measures |
- Pelvic exam and a patient history may help suggest the
cause of dysmenorrhea.
- Initial treatment aims are to relieve pain. Long term goals of
treatment involve treating any underlying cause with medication,
counseling or possibly surgery.
- Heat helps relieve pain. Use a heating pad or hot-water bottle on
the abdomen or back, or take hot baths. Sit in a tub of hot water
for 10 to 15 minutes as often as necessary.
- Transcutaneous electrical nerve stimulator (TENS) treatment
may help relieve pain.
- Psychotherapy or counseling, if dysmenorrhea is stress related
- Hypnosis therapy may help.
- Treatment as required, for the cause for the secondary dysmenorrhea.
- Surgery may be recommended for women whose pain cannot
be controlled by medications.
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| Medication |
- For minor discomfort, use nonsteroidal anti-inflammatory drugs
(NSAIDs) such as aspirin, ibuprofen or naproxen.
- Other medications that may be prescribed are antiprostaglandins
(for painful menstrual periods) and oral contraceptives, which
prohibit ovulation.
- In severe cases, hormones (e.g., gonadotropin-releasing
hormone ([Gn-RH]) can stop ovary function and relieve pain.
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| Activity |
- No restrictions. When resting in bed, elevate your feet or bend
your knees and lie on your side.
- Regular, vigorous exercise reduces discomfort of future periods.
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| Diet |
- Reduce or discontinue consumption of any caffeine containing
beverages or foods.
- You may be prescribed vitamin-B supplements. These help
relieve symptoms in some persons.
- Herbal teas may help reduce symptoms of dysmenorrhea for
some women.
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| Notify Your Healthcare Provider If |
- You or a family member has symptoms of dysmenorrhea that
cannot be controlled.
- Bleeding becomes excessive (you saturate a pad or tampon
more frequently than once each hour).
- Signs of infection develop, such as fever, a general ill feeling,
headache, dizziness or muscle aches.
- New, unexplained symptoms develop. Drugs used in treatment
may produce side effects.
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