PAINFUL PERIODS (DYSMENORRHEA)

More than 50% of women have some level of pain during their periods. Pain typically lasts for a few days and in most cases it's defined as mild pain. Sometimes, pain can be moderate to severe, preventing normal daily activities, which is called dysmenorrhea. Dysmenorrhea is relatively common and results in missed days of school and work.

Uterus has a strong muscular layer which contracts and relaxes. Whereas this happens throughout the menstrual cycle, during the period it happens more strongly. Typically, these contractions are a result of prostaglandins (PG) that increase prior to the period and decrease towards the end of menstruation. This is one of the reasons why pain eases towards the end of the period. There are two types of dysmenorrhea that include primary and secondary depending on whether the pain is just due to the period itself or another cause.

Primary Dysmenorrhea:

Primary dysmenorrhea presents with a wide variety of symptoms such as pain or cramps in the lower back and abdomen or pelvis, dizziness, nausea, vomiting, headaches, diarrhea and shooting pains to the thighs and legs as well as the back. Primary dysmenorrhea is a result of pain caused by the menstrual changes and the release of prostaglandins. It typically begins following the first period (menarche) and over time pain becomes less and more tolerable. After having a baby, the pain may also improve, but is some cases it continues through the reproductive years. It's also common to have some cycles more painful than others.

Secondary Dysmenorrhea:

Secondary dysmenorrhea is having painful periods due to another cause in addition to menstruation. It may present with more severe pain that primary dysmenorrhea and in most cases lasts longer as well. Some of the common causes of secondary dysmenorrhea include the following:

Endometriosis:

Endometriosis is a relatively common gynecological condition that results in the presence of endometrial cells in certain areas of the pelvis, other than the inside of the uterus. Endometriotic lesions can be found on or inside the ovary, fallopian tubes, outside of the uterus, intestines, bladder and on the peritoneum (membrane that wraps abdominal organs). Endometrial tissue outside of the uterus responds to monthly hormonal changes the same way it does inside the uterus. It creates an inflammatory reaction in the pelvis because it swells, breaks and bleeds. Endometrios