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Dr Eccles: Dysmenorrhoea
- Period Pain
What Happens When I have a Period?
A period occurs when an egg is produced but not fertilised after ovulation, and the body produces a hormone-like substance called prostaglandin to make the muscles in the uterus contract and expel the womb lining from the body as it no longer required. Most women have some menstrual cramps for the first two days of their period because of these contractions and this is perfectly normal.
What is dysmenorrhoea?
Dysmenorrhoea is the medical term for severe period pain or menstrual cramps and affects up to 50% of menstruating women, making normal everyday activities very difficult. There are two types of dysmenorrhoea: Primary dysmenorrhoea: It is thought that women with primary dysmenorrhoea produce more prostaglandins in their body, causing more severe uterine contractions, and therefore more pain. Primary dysmennorrhoea normally affects adolescent women and there is not usually an underlying gynaecological problem.
Secondary Dysmennorrhoea The pain of secondary dysmennorrhoea is similar to that of primary dysmennorrhoea, but there is usually an underlying gynaecological problem and it tends to affect older women.
What are the Symptoms of dysmennorrhoea?
Apart from severe stomach cramps, the pain can also extend into the lower back or into the thighs. It can be intermittent, or continuous, lasting for 1-3 days, and then subsiding over the next one or two days. The cramps and pain can be accompanied by nausea and vomiting, and the release of prostaglandins can also cause constipation and/or diarrhoea because of their effect on the smooth muscles of the bowel.
What are the Causes of dysmennorrhoea?
Over-production of prostaglandins is a known cause of primary dysmennorrhoea. However, sometimes it can have no recognisable underlying reason. Secondary dysmennorrhoea is usually a symptom of a gynaecological problem, the most common being endometriosis. Pelvic inflammatory disease (PID), ovarian cysts and fibroids can also be causes.
What treatments are available?
There are many treatments available including natural remedies, over the counter medication and prescribed medications: Some women prefer pain relief the natural way using a magnet treatment such asLadyCare, which had a 93% success rate in a recent user trial. Herbal medicines, acupuncture or chiropractic have also been tried by others. Painkillers/analgesics are the most common choice of pain relief and can be bought over the counter from pharmacies. If stronger painkillers are required, your doctor may prescribe them. Sometimes the contraceptive pill may also be prescribed which actually stops ovulation.
The Evidence for LadyCare?
Since 1977 there have been numerous (12 or more) double blind placebo-controlled trials of static magnets, as used in LadyCare, in the treatment of pain, many of which have reported significant success rates. Results from a scientific trial (randomised double-blind crossover study conducted by Reading Scientific Services Ltd) on LadyCare amongst 100 period pain sufferers revealed that 76% of participants experienced significant pain relief and that 66% took significantly less medication when wearing LadyCare. Another recent survey revealed that over 90% of respondents reported a high level of satisfaction with their LadyCare and a notable trial amongst Women Police Officers showed a 93% success rate.
How Can My Doctor Help?
As explained above, your doctor may recommend or prescribe painkillers or the contraceptive pill. However, he may also suggest an internal examination or a laparoscopy (a pelvic examination with fibre-optics) to check whether there are any underlying gynaecological problems that need further investigation. You should monitor your symptoms in a diary for a couple or months so that you can give a detailed description of the pain. Tell your doctor: how regular your periods are and when pain occurs how long you have suffered from painful periods and what type of pain it is how long your periods usually last whether the blood loss has become heavier recently whether or not blood loss includes clotting in the flow whether the pain prevents you carrying out everyday activities.
How Can I Help Myself?
Easier said than done but reducing stress levels can really be of help as it relaxes your muscles. If you find it difficult to relax, take up yoga or a similar discipline - not only will you learn how to relax, but you will also get some gentle exercise in between periods, which can also be beneficial in reducing the pain of dysmennorrhoea. Old favourites include hot water bottles on the tummy, whilst some women find that a gentle walk can help relieve their pain. Reduce your caffeine levels and substitute tea and coffee with herbal drinks - this will also contribute to improving your overall health as caffeine can increase blood pressure.
Will I always suffer from dysmennorrhoea?
Not necessarily. Primary dysmennorrhoea usually occurs during adolescence and the pain tends to lessen with age. With secondary dysmennorrhoea, if the underlying cause is identified and successfully treated, the symptoms, such as secondary dysmennorrhoea, should disappear. In the meantime, the pain of dysmennorrhoea can be controlled.
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Article ©2004-2007 Dr.Nyjon Eccles - reproduced with kind permission
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