Pain experienced during the menstrual cycle is referred to as dysmenorrhea. It is a common symptom wherein there is usually a sharp pain in the lower abdominal area that may radiate to the thighs as well. It normally starts on day 1, and peaks as the flow becomes heaviest during days 2 or 3.

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Dr Ila Jalote, consultant obstetrician and gynecologist, Manipal Hospital, Gurugram, explains that there are two types of dysmenorrhea, which are:

1. Primary dysmenorrhea: Common menstrual cramps that are not due to any other diseases, ranging from mild to very severe. Pain can also be accompanied by nausea, vomiting, feeling tired, and even loose motions. Common menstrual cramps can get better with age and after giving birth.

2. Secondary dysmenorrhea: If painful periods are because of a reproductive organ disorder or an infection. The pain of secondary dysmenorrhea usually begins earlier and lasts longer than common menstrual cramps. Other complaints of nausea and vomiting are usually not there.

Primary dysmenorrhea — causes and risk factors

Dr Jalote says painful menstrual cramps occur due to a chemical called prostaglandin which causes the uterus to contract. “During menstruation, if the uterus contracts too strongly, it can press against nearby blood vessels cutting off the oxygen supply to muscle tissue, causing pain,” she adds.

Primary dysmenorrhea is influenced by many factors:

– Age less than 20 years
– Never having given birth
– Heavy menstrual flow
– Belonging to higher socioeconomic status
– Severe dieting
– Being underweight or obese
– Smoking
– Alcohol consumption
– Social isolation
– Depression and anxiety

Secondary dysmenorrhea — causes and risk factors

According to the doctor, menstrual cramps due to other problems of reproductive organs can include:

* Endometriosis: A condition in which the inner lining of the uterus is found outside of it, most commonly forming a cyst in the ovary. This lining bleeds during menses causing swelling, scarring and pain.
* Adenomyosis: A condition in which the lining of the uterus grows into the muscle of the uterus causing the uterine size to increase and leading to heavy period flow and pain.
* Infection or pelvic inflammatory disease: A bacterial infection which starts in vagina and uterus and spreads causing inflammation and pain. It is often accompanied by vaginal discharge and pain during intercourse.
* Fibroids: Benign tumors of the muscles of the uterus which can cause painful periods, heavy flow and even difficulty in conception.

Using a heating pad on lower back or abdomen can provide relief. (Photo: Getty/Thinkstock)

When should you consult a gynecologist?

“If you have severe or unusual menstrual cramps that last for more than 2-3 days, you should consult a gynecologist. Both primary and secondary dysmenorrhea can be treated. After initial examination, if secondary dysmenorrhea is suspected, the patient may be prescribed additional tests like an ultrasound. If a problem is detected, there will be targeted treatment,” the doctor says.

Keep in mind

Primary dysmenorrhea can be treated by:

– Taking rest when needed
– Using a heating pad on lower back or abdomen
– Back massage
– Avoiding smoking and alcohol
– Regular exercise
– Eating a balanced diet
– Relaxation and breathing exercises
– Painkillers belonging to the NSAIDs group after consulting your gynecologist

For cases not relieved by above points, a higher dose of painkillers or oral contraceptive pills might be prescribed, Dr Jalote concludes.

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