Although menstruation in women should be, and often painless. Many women suffer from the discomfort triggered by pain during their periods at some time during thier reproductory life. Dysmenorrhoea, also known as painful menstruation can be classified into
Two main types, namely
- Primary or Spasmodic dysmenorrhoea
- secondary or Congestive dysmenorrhoea.
Primary or spasmodic dysmenorrhoea:
Causes of Spasmodic dysmenorrhoea:
You should know that the pain is due to the spasm of the uterine muscle,() which is sufficient to cause ischaemia. The cause of the spasm is not certain but various factors have being discussed.
- Cervical obstruction.
- Hormonal imbalance.
- Prostaglandin{natural occurring lipids}
- Psychological factors
- Nerve pathways
Treatment:
- Correct any cause of emotional stress
- During attack, take a hot bath and then relax in bed with a hot water bottle.
- Analgestic drugs such as aspirin,codeine or dihydrocodeine should be prescribed but you should stay away habit forming drugs such as morphine, pethidine or alcohol. Anti spasmodic drugs such as atropine are usually ineffective.
- Suppress ovulation, the easiest way for these is to prescribe one of combined oral contraceptive preparations using pill containing 20 to 30 micro gram of oestrogen or an oral progestogen such as dydrogesterone(duphaston) will be helpful in the doses 10mg daily by mouth from days 5 to 25 of each cycle. Note: this is not suitable for someone who wishes to become pregnant.
- Drugs which inhibits the production of prostaglandins in the endometrium may diminish myometrial contractions{contraction of the smooth muscles forming the walls of the uterus} and therefore relieve dysmenorrhoea.
Secondary or congestive dysmenorrhoea:
Congestive dysmenorrhoea is mainly caused by a pelvic inflammatory disease and endometriosis {the mucus membrane that lines the uterus, the fertilized egg implants is implanted} it arises from an increased blood supply in the area caused by pelvic disease. .The pain is a dull ache in the lower abdomen and back, sometimes extending to the thigh.
An acute colicky pain may occur if a fibromyomatous {a benign uterine tumour} polyp is pushed or trusted out through the cervix, and in some women an intrauterine contraceptive device will cause colicky.
The treatment for congestive dysmenorrhoea is to treat the type of pelvic diseases that triggers the painful menstruation.
Types of pelvic diseases
- Menorrhagia
- Dyspareunia
- Infertility
Stay tuned!
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