Dysmenorrhea Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Dysmenorrhea is a term used to describe complaints of painful cramps that generally appear during menstruation or menstruation. Dysmenorrhea is one of the most common problems related to menstruation.
More than half of women who are menstruating will complain of menstrual pain. This condition usually lasts 1–2 days.
Reason
There are two types of dysmenorrhea, namely primary and secondary.
Primary dysmenorrhea is not caused by problems with the reproductive organs. This condition is generally caused by an increase in prostaglandins, which are produced in the lining of the uterus. The increase in prostaglandins triggers contractions of the uterus or uterus. Naturally, the uterus tends to have stronger contractions during menstruation. These uterine contractions can cause complaints of pain.
In addition, uterine contractions that are too strong can compress the surrounding blood vessels and cause a lack of blood flow to the muscle tissue of the uterus. If this muscle tissue experiences a lack of oxygen due to a lack of blood supply, complaints of pain can arise.
The second type, namely secondary dysmenorrhea, is caused by pathologies in the reproductive organs. Various conditions that can cause complaints of secondary dysmenorrhea are:
- endometriosis
- Pelvic Inflammatory Disease (PID) / pelvic inflammatory disease
- Cysts or tumors on the ovaries
- Stenosis or blockage of the cervix
- Adenomyosis
- Fibroids
- Uterine polyps
- Adhesions on the inside of the uterus
- Congenital malformations ( bicornuate uterus, Septate Uterus, etc.)
- Use of an intrauterine device (IUD)
- Transverse vaginal septum
- Pelvic congestion syndrome
- Allen-Master syndrome
Symptom
The symptoms of dysmenorrhea that arise depend on the type of dysmenorrhea itself, namely primary and secondary dysmenorrhea. In primary dysmenorrhea, the symptoms that appear are generally as follows:
- Pain appears adjacent to the first menstruation/menarche (usually in the first 6 months).
- 48–72 hours in duration (often occurring a few hours before menstruation or just after menstruation begins).
- Pain like cramps or labor pains.
- Pain in the lower abdomen can radiate to the back or thighs.
- May be accompanied by complaints of nausea, fatigue, and bloating.
- Often complaints decrease with age, or after giving birth.
- Examination results are normal.
While the symptoms of secondary dysmenorrhea are usually:
- Generally, complaints appear in the 20s or 30s, where the previous menstrual cycle was not accompanied by complaints of pain.
- Menstrual pain gets worse and lasts longer than normal menstrual pain.
- Menstruation that is heavier than usual, or cycles that are irregular.
- There is infertility.
- Dyspareunia (pain during intercourse)
- Abnormal vaginal discharge.
- Examination results are not normal.
Diagnosis
To determine the diagnosis of dysmenorrhea, a detailed medical interview is required. Generally, the doctor will ask questions related to the age of the first menstrual period, menstrual history, other complaints, history of menstrual pain, triggering factors for menstrual pain, progress of menstrual pain complaints, sexual history, and childbirth, effects of menstrual pain complaints on daily life, and others.
In addition, usually a physical examination will also be carried out, especially a pelvic examination. Supporting examinations can also be considered, for example, ultrasound examination, laparoscopy, and so on.
Treatment
In primary dysmenorrhea, complaints of pain often improve with the administration of NSAIDs (non-steroidal anti-inflammatory drugs). Examples are diclofenac, ibuprofen, ketoprofen, mefenamic acid, and others. In addition, hormonal therapy can also be given, for example with hormonal contraception (eg birth control pills).
Oftentimes, lifestyle changes can also help with complaints. For example by exercising regularly, ensuring adequate sleep time, and avoiding smoking and alcohol consumption. Relaxation techniques, warm compresses on the painful abdominal area, and back and stomach massages can also help.
Treatment of secondary dysmenorrhea is adjusted to the disease that causes this complaint. Therefore, it is important that the cause of secondary dysmenorrhea is evaluated.