Dysmenorrhea: Painful Periods

Dr. Claude Allouche, Gynecologist Dysmenorhhee engl
Ahuza Clinic, Raanana
058 726 02 64

Pain during menstruation is called dysmenorrhea. Primary dysmenorrhea begins with a girl's first periods during adolescence and is usually harmless. It is considered secondary when it appears later in a young woman after puberty, in which case, an underlying condition is often investigated.

WHAT IS DYSMENORRHEA OR PAINFUL PERIODS?

Dysmenorrhea refers to abdominopelvic pain that precedes or accompanies menstruation (menstrual cramps).

  • These pains generally last one to three days.
  • They start with bleeding and are most intense when the bleeding is heaviest.
  • Pain may be felt just before the period starts and may sometimes continue slightly afterward.
  • These are cyclical pains, returning with each menstruation.
  • Menstrual cramps are usually felt in the lower abdomen (pelvis) but can also radiate to the back and thighs.

The intensity of the pain varies:

  • Some may feel mild discomfort, while others experience moderate or severe cramping, or spasms in the lower abdomen, making daily activities difficult.

Premenstrual Syndrome (PMS):
Period pain may be preceded by PMS, which starts a few days before menstruation and may include:

  • Breast swelling and tenderness,Douleur
  • Abdominal bloating,
  • Swelling of the extremities,
  • Irritability or anxiety,
  • Headaches.

ASSOCIATED SYMPTOMS WITH DYSMENORRHEA:

  • Nausea, vomiting,
  • Migraine,
  • Diarrhea,
  • Fatigue,
  • Dizziness.

AN URGENT CASE: TOXIC SHOCK SYNDROME DURING PERIODS

The use of internal menstrual products (tampons or menstrual cups) can cause toxic shock syndrome, a serious toxico-infectious condition.
Symptoms include:

  • High fever,
  • Abdominal pain,
  • Digestive issues (vomiting, diarrhea),
  • Weakness and muscle pain.

This requires immediate medical attention.

CAUSES OF MENSTRUAL PAIN

Menstrual pain (associated with periods) may:

  • Appear during adolescence (primary dysmenorrhea) and generally be harmless.
  • Occur later, in adulthood (secondary dysmenorrhea), and may be linked to an underlying condition.

PRIMARY DYSMENORRHEA (PAINFUL PERIODS FROM ADOLESCENCE)

Primary dysmenorrhea appears during adolescence, within a few months after the onset of menstruation. It is very common and usually not serious.

  • It is caused by an excess of prostaglandins produced by the uterine lining (endometrium) during menstruation. Prostaglandins trigger uterine contractions to expel the lining.
  • An excess of prostaglandins causes abnormal uterine contractions, depriving the uterine muscle of oxygen (hypoxia), leading to pain.

Contributing factors to primary dysmenorrhea include:

  • Early onset of menstruation,
  • Family history of dysmenorrhea,
  • Nulliparity (having no previous pregnancies),
  • Smoking, which may worsen the condition.

DYSMENORRHEA: A COMMON PROBLEM FOR YOUNG WOMEN

  • 50-70% of teenage girls experience painful periods either regularly or occasionally.
  • Dysmenorrhea decreases after age 18.
  • Period pain is the leading cause of school absenteeism among adolescents and professional absenteeism among young women.

In most cases, menstrual pain improves or disappears after a few years or following a first pregnancy. However, if the pain worsens over time, an underlying cause may be suspected, such as:

  • Vaginal or uterine malformations,
  • Endometriosis in adolescence.

It is important to talk to your doctor about menstrual pain during regular adolescent health check-ups.

SECONDARY DYSMENORRHEA IN ADULT WOMEN

Secondary dysmenorrhea appears later in life, in women who previously had little to no menstrual pain. The pain may be accompanied by other symptoms, such as:

  • Bleeding between periods,
  • Abnormally heavy periods,
  • Pain during intercourse.

In such cases, an underlying cause is immediately investigated. Possible causes include:

  • Endometriosis,
  • Adenomyosis (presence of uterine lining tissue within the muscle of the uterus),
  • Uterine fibroids,
  • Endometrial polyps,
  • A displaced copper IUD,
  • A change in hormonal contraception.

Source : https://www.ameli.fr