Mini Review

Dysmenorrhea Decoded: Unveiling The Mysteries of Painful Periods

Vijayasri R, Preetha S, Abitha P, Anushya D and Bhuvaneshwari V*

Department of Biotechnology, PSGR Krishnammal College for Women, India

Submission: November 01, 2023;Published: November 06, 2023

*Corresponding author: Bhuvaneshwari V, Department of Biotechnology, PSGR Krishnammal College for Women, India

How to cite this article: Vijayasri R, Preetha S, Abitha P, Anushya D, Bhuvaneshwari V. Dysmenorrhea Decoded: Unveiling The Mysteries of Painful Periods. J Gynecol Women’s Health 2023: 26(2): 556183. DOI: 10.19080/JGWH.2023.26.556183

Mini Review

Dysmenorrhea, commonly known as painful menstrual periods or menstrual cramps, is a condition that affects many individuals with a uterus. Dysmenorrhea is a prevalent and often underestimated gynecological condition that affects a significant portion of the female population during their reproductive years. Characterized by painful cramps and discomfort in the lower abdomen and pelvis, dysmenorrhea is a recurring challenge that can significantly impact the quality of life and daily activities of those who experience it [1].

During this time, the uterus contracts to shed its lining, leading to varying degrees of discomfort and pain. This comprehensive article aims to provide in-depth insights into dysmenorrhea, its types, causes, symptoms, diagnosis, management, and prevention.

Overview

What is Dysmenorrhea?

“Dysmenorrhea” is the medical term for painful menstrual periods. It occurs due to uterine contractions that help shed the uterine lining. The pain typically begins just before your period and subsides after a few days. Dysmenorrhea can present with various symptoms, including nausea, fatigue, and diarrhea. For most individuals, these symptoms alleviate within two or three days.

Normal vs. Dysmenorrhea

Mild to moderate menstrual cramping is considered normal, affecting approximately 60% of individuals with a uterus. However, around 5% to 15% of people experience such severe pain during their periods that it disrupts their daily lives. It’s important to note that the percentage of affected individuals may be higher due to underreporting. Painful periods tend to improve with age and may also lessen after giving birth.

Types of Dysmenorrhea

Primary Dysmenorrhea

Primary dysmenorrhea refers to recurring menstrual cramps that have no identifiable underlying medical cause. The pain typically starts one or two days before the period or when bleeding begins. Pain can range from mild to severe and usually subsides within two to three days. Primary dysmenorrhea is more common. It typically begins within a few days of the menstrual cycle and is associated with the release of prostaglandins, hormone-like compounds that cause the uterus to contract. These contractions can result in cramping pain that ranges from mild to severe [2].

The release of prostaglandins during the menstrual cycle is a key factor in the development of primary dysmenorrhea. These lipid compounds, produced in the uterine lining, trigger uterine contractions, leading to pain and discomfort. Fluctuations in hormone levels, particularly elevated prostaglandins and changes in estrogen and progesterone, can influence the severity of menstrual cramps. While primary dysmenorrhea is not directly linked to any underlying medical condition, it can still significantly impact a person’s daily life and well-being.

Secondary Dysmenorrhea

Secondary dysmenorrhea occurs when painful periods are linked to an underlying medical condition or infection affecting the reproductive organs. Pain from secondary dysmenorrhea often starts earlier in the menstrual cycle and lasts longer than typical menstrual cramps. Conditions like endometriosis, fibroids, and pelvic inflammatory disease can lead to more severe and prolonged menstrual pain. Secondary dysmenorrhea is characterized by menstrual pain that is linked to an underlying medical condition, such as endometriosis, fibroids, or pelvic inflammatory disease [3-5]. In this form of dysmenorrhea, the pain is often more intense and may not begin until later in the menstrual cycle.

Unlike primary dysmenorrhea, secondary dysmenorrhea is associated with specific underlying medical conditions that contribute to the severity of menstrual pain. Conditions such as endometriosis, uterine fibroids, adenomyosis, or pelvic inflammatory disease can lead to more severe and enduring menstrual pain. Inflammatory processes in the pelvic area can contribute to pain during menstruation, which may be associated with various conditions, including infections and autoimmune disorders.

Moreover, emotional and psychological factors can exacerbate the perception of pain, making it feel more intense. Stress and anxiety are known to have a significant impact on the experience of dysmenorrhea. Lifestyle choices, including smoking and excessive alcohol consumption, can contribute to menstrual pain. Lack of physical activity and obesity may also play a role. Diet and nutritional deficiencies can influence menstrual pain as well. For example, a lack of omega-3 fatty acids or excess consumption of caffeine and sugar may exacerbate cramps [5].

Symptoms and Causes

Main Causes of Painful Periods

Menstrual cramps are primarily caused by prostaglandins, which trigger uterine contractions during menstruation. Prostaglandin levels increase before menstruation, leading to stronger contractions and the associated cramping. While the exact reasons behind varying levels of menstrual pain remain unclear, higher prostaglandin levels are associated with more severe cramps [6].

Why Are Period Cramps Painful?

Pain during menstruation is a result of the uterus contracting to shed the uterine lining. The muscles contract and relax, leading to discomfort and pain. In some cases, individuals experience more intense pain due to higher prostaglandin levels or individual variations in sensitivity.

Symptoms of Painful Menstrual Cramps

Typical symptoms of dysmenorrhea include:

Aching, throbbing pain in the lower abdomen

Pain typically commences 1 to 3 days before the onset of menstruation, reaches its peak approximately 24 hours after the period begins, and gradually diminishes within 2 to 3 days.

Feeling of pressure in the abdomen

Radiating pain extending to the lower back and thighs.

Additional symptoms like nausea, dizziness, loose stools, and headaches

How Secondary Dysmenorrhea Causes Menstrual Cramps

Secondary dysmenorrhea results from various medical conditions affecting reproductive organs, including:

Endometriosis

Adenomyosis

Uterine fibroids

Pelvic inflammatory disease (PID)

Cervical stenosis

Congenital conditions

These conditions can cause pain, swelling, scarring, and abnormal bleeding during menstruation.

Risk Factors for Dysmenorrhea

Certain factors may increase the likelihood of experiencing dysmenorrhea:

Early onset of menstruation (before age 12)

Younger age (under 20)

Heavy or prolonged periods (lasting more than seven days)

Smoking

Family history of dysmenorrhea

Potential Causes of Dysmenorrhea

Dysmenorrhea may be attributed to various causes, which can vary from person to person. Prostaglandins play a central role in primary dysmenorrhea, while secondary dysmenorrhea is often associated with medical conditions. Here are some potential causes of dysmenorrhea:

Prostaglandins: In primary dysmenorrhea, the release of prostaglandins from the uterine lining triggers uterine contractions, leading to pain and discomfort. Elevated prostaglandin levels and fluctuations in estrogen and progesterone can influence the severity of menstrual cramps.

Medical Conditions: Secondary dysmenorrhea is often linked to underlying medical conditions such as endometriosis, uterine fibroids, adenomyosis, or pelvic inflammatory disease. These conditions can lead to more severe and enduring menstrual pain.

Inflammation: Inflammatory processes in the pelvic area can contribute to pain during menstruation and may be linked to various conditions, including infections and autoimmune disorders.

Emotional and Psychological Factors: Stress and anxiety can exacerbate the perception of pain, making it feel more intense.

Lifestyle Choices: Smoking, excessive alcohol consumption, lack of physical activity, and obesity can contribute to menstrual pain.

Diet and Nutritional Deficiencies: Nutritional factors, such as a lack of omega-3 fatty acids or excessive consumption of caffeine and sugar, can influence the severity of dysmenorrhea.

Understanding the types and potential causes of dysmenorrhea is crucial for healthcare professionals to provide effective treatment and management strategies. It is also essential for individuals experiencing dysmenorrhea to be aware of these factors and seek appropriate medical advice for their specific condition.

Complications of Painful Periods

While menstrual cramps themselves usually don’t lead to complications, underlying medical conditions can. Conditions like endometriosis or pelvic inflammatory disease can result in infertility or ectopic pregnancy. It’s essential to consult a healthcare provider to rule out underlying causes for severe period pain.

Diagnosis and Tests

Recognizing Dysmenorrhea

If there is severe or prolonged menstrual cramps, or if they interfere with daily activities, contacting a healthcare provider is essential. Both primary and secondary menstrual cramps are treatable, so seeking medical advice is crucial. A healthcare provider will conduct a thorough evaluation, including questions about the symptoms, menstrual cycles, and a pelvic exam. If no apparent cause is found, primary dysmenorrhea is diagnosed. Additional tests, such as ultrasound, hysteroscopy, or laparoscopy, may be recommended if secondary dysmenorrhea is suspected.

Management and Treatment

Girls used numerous non-pharmacologic remedies as well as medications for pain but infrequently accessed formal medical care [7,8].

Pain Relief Methods

Various methods can help alleviate painful periods:

NSAIDs and other pain relievers: Nonsteroidal antiinflammatory drugs (NSAIDs) like ibuprofen can reduce prostaglandin levels and relieve pain. If over-the-counter options are insufficient, prescription medications may be recommended.

Hormonal medications: Hormonal birth control methods, such as pills, patches, or vaginal rings, can reduce menstrual pain.

Additional approaches to alleviate menstrual cramps include:

a) Applying a heating pad or hot water bottle to your lower back or abdomen during cramps.

b) Prioritizing extra rest during your menstrual period.

c) Steering clear of caffeinated foods and beverages.

d) Refraining from smoking and alcohol consumption.

e) Engaging in gentle massages of your lower back and abdomen.

f) Maintaining a regular exercise routine; individuals who exercise often experience reduced menstrual pain.

Alternative Therapies

Natural methods for managing period pain include:

a) Yoga

b) Acupuncture and acupressure

c) Relaxation and breathing exercises

d) Diet adjustments, such as consuming anti-inflammatory foods

e) Supplements like vitamin D or magnesium

Individuals with secondary dysmenorrhea will receive treatment for the underlying condition, which may involve oral contraceptives, other medications, or surgery.

Prevention

Can Dysmenorrhea Be Prevented?

Dysmenorrhea cannot be entirely prevented. However, maintaining a balanced diet and engaging in regular exercise may help reduce the intensity of cramps.

Living with Dysmenorrhea

If painful periods significantly occur, it’s essential to contact a healthcare provider. Mild cramps are normal, but severe cramping that hinders your ability to work or attend school may require treatment. Keeping track of the symptoms and discussing them with the healthcare provider is a helpful way to address your concerns.

In summary, dysmenorrhea is a common gynecological condition that can cause significant discomfort and pain during menstruation. Understanding its types, causes, symptoms, and treatment options is essential for managing this condition effectively and improving your quality of life. In conclusion, dysmenorrhea is a complex condition with primary and secondary forms, each associated with specific causes and factors that influence the severity of menstrual pain. The impact of dysmenorrhea extends beyond physical discomfort and can affect the overall well-being and quality of life for those who experience it. By understanding the different types and potential causes of dysmenorrhea, healthcare providers can better diagnose and treat this condition, ultimately improving the lives of those affected by it. It is important for further research and clinical studies to continue advancing our knowledge of dysmenorrhea and its management.

Acknowledgement

The authors thank the management of PSGR Krishnammal College for Women, DBT Builder, DST FIST, UGC, Department of Biotechnology for providing infrastructure facilities and support for the work.

References

1. Nagy H, Khan MA (2022) Dysmenorrhea. StatPearls Publishing.
2. Bernardi M, Lazzeri L, Perelli F, Reis FM, Petraglia F, et al. (2017) Dysmenorrhea and related disorders. F1000Res 6: 1645.
3. Harel Z (2002) A contemporary approach to dysmenorrhea in adolescents. Pediatr Drugs 4(12): 797-805.
4. Omidvar S, Bakouei F, Amiri FN, Begum K (2016) Primary dysmenorrhea and menstrual symptoms in Indian female students: prevalence, impact and management. Glob J Health Sci 8(8): 53632.
5. Itani R, Soubra L, Karout S, Rahme D, Karout L, et al. (2022) Primary dysmenorrhea: pathophysiology, diagnosis, and treatment updates. Korean J Fam Med 43(2): 101-108.
6. French L (2008) Dysmenorrhea in adolescents: diagnosis and treatment. Pediatr Drugs 10(1): 1-7.
7. O'Connell K, Davis AR, Westhoff C (2006) Self-treatment patterns among adolescent girls with dysmenorrhea J Pediatr Adolesc Gynecol 19(4): 285-289.
8. Wong P (2011) Attitudes towards dysmenorrhoea, impact and treatment seeking among adolescent girls: A rural school‐based survey. Aust J Rural Health 19(4): 218-223.