Painful Periods (Dysmenorrhea)
What is dysmenorrhea?
When the periods are painful, it is called dysmenorrhea. It can be of two types- primary and secondary
How common is it?
Dysmenorrhea is the most common complaint related to periods. More than one half of women who menstruate have some pain for 1–2 days each month.
What are the features of primary and secondary dysmenorrhea?
Primary: Presents early in life (since menarche) and with no underlying disease. Pain starts with start of periods and decreases with time, lasting for a few days.
Secondary: Presents later in life and is associated with some underlying diseases. The pain starts before the onset of periods and tends to worsen over time and may last even after the menses is over.
What are the conditions associated with secondary dysmenorrhea?
- Endometriosis
- Adenomyosis
- Fibroids
- Polyps
- PID
What diagnostic tests are required to find the cause of dysmenorrhea?
- Pelvic Examination
- Ultrasound Examination
- Diagnostic Hysteroscopy
- Diagnostic Laparoscopy
What is the treatment for dysmenorrhoea?
- Lifestyle modifications- exercise, enough sleep, and relaxation techniques.
- Nonsteroidal anti-inflammatory drugs (NSAIDs
- Tranexamic acid
- Oral Contraceptive Pills
- GnRH analogues
Surgical management is required when medical treatment fails. It includes surgery directed at removal of the pathology.
- Fibroid- Laparoscopic Myomectomy
- Endometriosis- Excision of lesion
- Polyp- Hysteroscopic polypectomy
- Adenomyosis- Wedge Resection
- Hysterectomy- it is the last resort when dysmenorrhea is severe and all other measures have failed.
Dr. Mayuri Kothiwala
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