Menstrual pain, a ‘woman thing’ known medically as ‘dysmenorrhea’ is described as painful cramps in the lower abdominal region that may occur a few days before the menstrual bleeding begins or just before the bleeding starts. The pain may be associated with normal, light, heavy or irregular bleeding. There are two main types:primary which begins at the onset of menstruation during puberty without any underlying cause; and secondary which begins at an older age, probably as a result of some underlying physical changes in the uteus or condition which will be discussed.

Menstrual pain often starts around the same period that the menstruation begins and often lasts for a few days (often times less than three). This pain is more pronounced in the pelvis and abdomen. In heightened cases, it can occur along with backaches, diarrhea, nausea and even vomiing. This pain can occur in women of all ages that have begun the period of menstruation. The pain could be mild, moderate or severe, though this can be subjective depending on your threshold for pain. For some ladies it can be so crippling as to prevent them from walking, going to school or work as well as prevent them carrying out their activity of daily living and this can be quite frustrating.

In ancient times, it was known that churches refused to give communion to menstruating women (some logic this was). And for the traditionalists, menstruating women were not allowed to serve their husbands food or sleep in the same place or allow them take sacrifices to the gods or even worship at the shrine. It is also rumored that menstrual cycles improved the development of awareness of time and lunar calendars in ancient Egypt, as royal stewards had to anticipate the queen’s temperament.

The problem of Dysmenorrhea is less common in females that exercise often and also in women that have children early in life.

Causes

Menstrual pain occurs as a result of production of a pro-inflammatory and pain hormone-like substance called prostaglandins which causes contraction of the walls of the uterus to help expel its lining during a period. This shed lining is what you see as blood during menstruation. For a lot of people it could be an uneventful but for a select few it is a very painful event. It is postulated that eating a lot of sweet things, excessive salt ingestion and caffeine intake around the time of your period seems to worsen the pain.

The cause of menstrual pain may be unknown or due to a number of factors.These include but not limited to:

1. Being less than 20 years old
2. Having a family history
3. Fibroids
4. Endometriosis
5. Fibrosis/Blood and tissue passing through a narrow cervix
6. Ovarian cysts
7. Not having a baby
8. Stress and anxiety
9. Pelvic inflammatory disease
10. Hormone imbalance
11. Use of copper intra uterine device (used for contraception)
12. In some unique cases, skeletal abnormalities may be a likely cause

Signs and symptoms

Majority of cases begin with severe pain in the lower abdomen or pelvic areas. This is common in young females as pain can also be transferred to the thigh regions and even the lower back. Symptoms that come with menstrual pain include nausea, diarrhea or constipation, bloating, headaches, low back pain, frequent urination, breast tenderness and vomiting. These symptoms often begin during the onset of the menstrual period and end with it. For secondary dysmenorrhea, there may be change in bowel moement, spotting of blood inbetween periods

Treatment options

Drug Therapies

First line of treatment should focus on relieving pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and naproxen may help relieve pain especially when taken a day or 2 before your period. Unfortunately, they can cause stomach upset, when taken on an empty stomach so take them with food. Remember, long-term use can increase the risk of stomach ulcers or bleeding.  Other forms of pain relief include but not limited to:

• Birth control pills and patches can help relieve pain especially if due to endometriosis.
• Intrauterine devices reduce menstrual bleeding and dysmenorrhea.
• Antibiotics for pain caused by pelvic inflammatory disease (PID)

The best form of treatment is tackling the root cause. Menstrual pain or cramps especially the pimary type, may improve with age, or child birth, it can be alleviated by a number of home remedies. Surgery can be a remedy for secondary dysmenorrhea caused by fibroids, endometriosis or fibrosis. Proper medication would provide relief from pain but do little to prevent the problem. Little knowledge exists to detect the people susceptible to this pain.

Home remedies

Alternative medication suggests that thiamine, omega 3, magnesium, calcium, Oil of evening primrose and vitamins A, D and E could be quite effective in providing relief from menstrual pain. For some women healthy eating, increasing water intake, mind-body techniques such as meditation, and exercises such as walking, yoga can also help relieve pain. Inhaling aromatic essential oils such as lavender and low back massage may also help relieve pain. Other treatments include:

1. Taking a warm bath or shower
2. Dinking hot/warm chamomile, cinammon or herbal tea
3. Using a hot water bottle on the tummy
4. Positive stress handling
5. Eating herbs and roots such as ginger, local yam,
6. Paw-paw
7. Proper sleep

Conclusions

Menstrual pain can affect women of all ages. A lot of home remedies can help make the pain more bearable. Lifestyle modifications such as exercise, healthy eating, positive stress handling and drinking sufficient water can help prevent and treat dysmenorrhea. Avoid caffeine, alcohol, and sugar before your period starts.

Thank you. Are there causes and remedies you know I didn’t add? Please don’t hesitate to share. Your comments are welcome.

Author: Dr. Nse

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