Most women experience pain, discomfort, mood changes, and other symptoms associated with the menstrual cycle. But did you know that these symptoms may reach a point that requires treatment? A medical term used to describe this condition is “dysmenorrhea.” You may have heard this term before, or perhaps this is the first time you are learning about it. If so, let us in Dalili Medical share with you some information about it, how to deal with it, and how you can distinguish between normal menstrual cramps and dysmenorrhea. So, continue reading the article.

**Is dysmenorrhea a normal condition?**

It is normal to feel some pain during your period. About 60% of women experience mild cramps during this period. While between 5% and 15% of women suffer from pain severe enough to affect their daily activities. The number is likely higher, as doctors believe that many women do not report menstrual pain. In most cases, menstrual pain tends to ease with age, and may also improve after childbirth.

**How ​​long does dysmenorrhea last?**

If a girl is at the beginning of puberty, she may feel severe pain several days before her period. If she is older or has children, she may feel less pain before her period begins.

**How ​​can you be sure that you are suffering from dysmenorrhea?**

There are many symptoms that may appear during this period. If you are experiencing the following symptoms, you probably have dysmenorrhea:

- Severe and persistent pain in the lower abdomen, which is one of the most prominent signs of dysmenorrhea.

- A feeling of pressure in the same area, in addition to pain in other areas such as the thighs, lower back, and hip.

- Persistent nausea and the desire to vomit, in addition to diarrhea in some cases.

**What is the main cause of painful menstrual periods?**

Menstrual cramps are caused by a chemical called prostaglandin, which causes the uterus to contract. Prostaglandin levels are higher during the menstrual cycle, causing the uterus to contract more forcefully. These contractions help shed the lining of the uterus, which is the blood and tissue that comes out of the vagina during the menstrual cycle. Prostaglandin levels rise just before bleeding begins, then decrease during menstruation, leading to relief of cramps after a few days.

**Why are menstrual cramps so painful?**

What you feel are uterine contractions. The uterine muscles contract to shed the uterine lining. Although experts are not entirely sure why some women experience more severe pain, they believe it may be related to higher levels of prostaglandins. There may not be a clear explanation, as each person's body is different.

**What is the best treatment for dysmenorrhea?**

The optimal treatment for dysmenorrhea depends on the underlying cause and its type.

In the case of primary dysmenorrhea, methods such as taking medications, making lifestyle and diet changes, and following alternative treatments are very effective.

In the case of secondary dysmenorrhea, treatment depends on the specific cause of the condition and usually includes hormone therapy or surgery.

**What is the first-line treatment for dysmenorrhea?**

First-line treatment for dysmenorrhea includes taking NSAIDs such as flurbiprofen and ibuprofen. These medications inhibit the production of prostaglandins, which significantly reduces the severity of pain.

**What are the types of dysmenorrhea?**

Dysmenorrhea is classified into two types based on whether it is caused by a specific health condition or not, and we will explain the difference between them below:

**Primary dysmenorrhea**

Primary dysmenorrhea is defined as pain that occurs during the menstrual cycle without a specific health condition. Its symptoms may appear before or during the first days of the period. This type occurs as a result of increased production of prostaglandins, which are chemicals naturally secreted in the body that cause the muscles of the uterus and blood vessels to contract. The prostaglandin level is high on the first day of the period, then decreases as the bleeding continues, leading to less pain after the first few days.

**Secondary dysmenorrhea**

 

Secondary dysmenorrhea is caused by problems with the reproductive organs, such as uterine fibroids or endometriosis, which are the most common cause of this type. The pain usually increases over time, often lasting longer than normal menstrual cramps. For example, the pain may start several days before your period starts, get worse during it, and may not go away after it ends.

Secondary dysmenorrhea is more common in older women, who are more likely to have uterine problems that can cause pain during menstruation.

What are the causes of dysmenorrhea in women?

The causes of dysmenorrhea vary between being primary or secondary. As explained previously, primary dysmenorrhea is caused by an increased level of a hormone known as prostaglandin, which causes contractions of the uterus.

Secondary dysmenorrhea occurs as a result of other health conditions, such as:

- Endometriosis (endometriosis).

- Pelvic inflammatory disease (PID).

- Uterine fibroids.

- Abnormal pregnancy (such as an ectopic pregnancy).

- Infection, tumors, or any other growths in the pelvic cavity.

- Cervical stenosis.

- Uterine abnormalities.

- Ovarian cysts.

- Crohn's disease.

- Urinary tract disorders.

The likelihood of developing dysmenorrhea increases with the presence of certain risk factors, including:

- Age: Dysmenorrhea cases increase among girls under twenty years of age.

- Premenstrual syndrome (PMS).

- Smoking.

- Heavy bleeding during menstruation.

- Irregular menstrual cycle.

- Not having children previously.

- Early puberty in females (under 11 years).

**Causes of dysmenorrhea after the age of forty*

Usually weakenedMenstrual symptoms after reaching forty, but dysmenorrhea may appear at this stage as a result of other health problems, which makes it classified as secondary dysmenorrhea. Endometriosis is one of the most common causes of secondary dysmenorrhea, in addition to a host of other causes mentioned previously.

Stress is also considered one of the factors contributing to dysmenorrhea after forty, as nervousness and mood changes increase in women at this age.

**Causes of dysmenorrhea**

There are many factors that lead to dysmenorrhea, and the causes vary depending on its type, as shown below:

**Causes of primary dysmenorrhea**

Primary dysmenorrhea occurs as a result of uterine contractions that occur to empty its lining during the menstrual cycle. Research suggests that a hormone-like chemical known as prostaglandin stimulates these contractions.

Before menstruation begins, the level of progesterone decreases, which leads to an increase in the level of prostaglandins, and thus the muscles of the uterus contract stronger during menstruation. These intense contractions can put pressure on surrounding blood vessels, blocking the flow of oxygen to muscle tissue. When your muscles run out of oxygen for a short time, you may feel severe pain (primary dysmenorrhea).

**Causes of secondary dysmenorrhea**

Secondary dysmenorrhea is mainly caused by certain reproductive disorders and diseases, such as:

- **Endometriosis**: Where tissues similar to the lining of the uterus grow outside the uterus, such as the fallopian tubes, pelvis, and ovaries. This tissue bleeds during menstruation, causing severe pain, excessive bleeding, and inflammation.

- **Adenomyosis**: In this condition, the tissue surrounding the uterus begins to fuse with the muscular uterine wall, which increases the size of the uterus and causes severe abdominal pain and bleeding.

- **Fibroids**: They are benign tumors that form in the uterus, causing inflammation and pressure on the spine, leading to severe pain.

- **Cervical stenosis**: Where the opening of the uterus is very narrow, which obstructs menstrual flow and increases pressure inside the uterus, leading to severe pain.

- **Pelvic inflammatory disease (PID)**: Refers to an infection caused by bacteria or sexually transmitted diseases, which begins in the uterus and spreads to other reproductive parts, causing scarring of the uterine lining and leading to secondary dysmenorrhea

- **Intrauterine device (IUD)**: A contraceptive method that prevents implantation by irritating the uterine lining, which increases the risk of pelvic inflammatory disease and secondary dysmenorrhea.

- **Uterine abnormalities**: Refers to any abnormalities in the uterus that may cause severe pain during menstruation

**Who is most at risk of developing dysmenorrhea?**

A person may be more likely to develop dysmenorrhea if:

- The first menstrual period began before the age of 12 years.

- She was under 20 years old.

- Her menstrual cycle was heavy or lasted more than seven days.

- She was smoking.

- One of the biological parents suffered from dysmenorrhea.

**What is the difference between normal menstrual cramps and dysmenorrhea?**

Both conditions refer to cramps associated with the menstrual cycle, but dysmenorrhea includes additional symptoms, and the severity of the symptoms lasts longer and is more severe compared to regular menstrual cramps. Sometimes, symptoms may be so severe that they prevent a woman from performing her daily tasks.

**Primary symptoms of dysmenorrhea:**

- Pain in the lower back and pelvis.

- Pain in the thighs and hips.

- Headache and fatigue.

- nausea.

- Diarrhea.

- Vomiting.

- Irritability and anxiety.

- The appearance of acne.

**Normal menstrual pain**

The nature of menstrual pain varies from one woman to another, as some women may not feel any pain, while others suffer from severe pain. The pain can be continuous or come and go intermittently. This diversity of experiences leads many women to wonder how normal pain during menstruation is.

Here are some characteristics associated with normal menstrual pain

- The pain usually begins a few days before the start of the period, and may continue for a day or two afterward.

- The severity of the pain ranges from mild to moderate.

- The pain can be dull, continuous or severe that appears intermittently.

- Pain and cramps can often be relieved with over-the-counter pain relievers.

- The pain usually occurs in the lower abdomen or lower back, and may extend to the thighs.

- The pain may be accompanied by other symptoms such as nausea, bloating, diarrhea, or fatigue.

- The pain usually decreases with age and after the birth of the first child.

**Abnormal menstrual pain**

Some women suffer from a condition known as dysmenorrhea, in which they feel cramps and severe pain some time before their period that lasts longer than normal pain. Dysmenorrhea can be divided into two types:

- **Primary dysmenorrhea**: refers to the normal pain associated with the menstrual cycle.

- **Secondary dysmenorrhea**: Refers to pain associated with certain health problems.

Severe and abnormal pain can indicate health conditions such as:

- Endometriosis.

- Fibroids.

- Adenomyosis.

- Pelvic inflammatory disease, which involves infection of the uterus, fallopian tubes, and ovaries.

- Polycystic ovary syndrome.

Placing an IUD inside the uterus can also be a cause of abnormal pain, as a woman may suffer from pain during the first three to six months after its placement.

**When should a woman see a doctor because of menstrual pain?**

 

Menstrual pain is something that most women face, and can often be dealt with with home remedies. However, there are cases that require a visit to the doctor, including:

- Severe pain that affects daily activities.

- Pain does not improve with over-the-counter pain relievers.

- The pain worsens over time.

- The pain persists for more than two days.

- Pain occurs outside the menstrual period.

- Other severe symptoms appear, such as severe bleeding, severe vomiting, or fever

**Treatment of dysmenorrhea**

 

Although dysmenorrhea may be painful, it can be treated. If you want to learn more about methods of treating dysmenorrhea, read on, as the treatments are divided into two main types.

**Treatment of primary dysmenorrhea**

If you suffer from primary dysmenorrhea, you can follow one of the following methods to relieve menstrual pain:

**pharmaceutical**

Studies show that nonsteroidal anti-inflammatory drugs (NSAIDs) such as flurbiprofen, ibuprofen, and tiaprofenic acid are effective in relieving primary dysmenorrhea, as they work to reduce prostaglandin production.

Another study also showed that birth control pills can relieve severe pain during menstruation by reducing endometrial growth, reducing prostaglandin production, and inhibiting ovulation.

You can take these medications at the beginning of your menstrual cycle, but it is preferable to consult a doctor first.

**Lifestyle and diet modifications**

 

To relieve dysmenorrhea, you can make the following changes to your lifestyle and diet:

- Follow a balanced diet rich in vitamins such as vitamin E and minerals.

- Exercise regularly and maintain a healthy lifestyle.

- Avoid alcohol, sugar, and caffeine.

- Stay away from dairy products and smoking.

- Take a warm bath during menstruation.

- Use a heating pad to relax or massage the abdomen.

-Practice yoga and breathing techniques.

- Get enough rest during the menstrual cycle.

**Alternative treatments**

In addition to the methods mentioned above, you can try some alternative treatments to relieve primary dysmenorrhea.

One study suggests that high-frequency transcutaneous electrical nerve stimulation (TENS) can be effective in reducing the severity of dysmenorrhea. It sends electrical currents that interfere with the pain signals sent by the nerves to the brain.

Acupuncture and acupressure are also helpful options. These treatments include pressure on specific nerve points, which helps reduce the severity of pain associated with dysmenorrhea.

**Treatment of dysmenorrhea**

**Drug treatment**

There are several medications that can be used to relieve the symptoms of dysmenorrhea, including:

- **Pain relievers**: Taking over-the-counter pain relievers can help relieve dysmenorrhea pain. It is preferable to take it before the start of menstruation or when symptoms appear. Examples of these medications include ibuprofen and naproxen.

- **Hormonal contraceptives**: These methods are available in several forms, such as oral pills, injections, flexible rings that are placed in the vagina, or the intrauterine device. These methods contain hormones that prevent ovulation and relieve dysmenorrhea pain

**Surgeries**

Surgical procedures can help relieve symptoms of dysmenorrhea caused by endometriosis or uterine fibroids. For example, a hysterectomy may be an option to relieve symptoms, especially after other treatments have failed and if the woman does not want to have children.

**Treatment of secondary dysmenorrhea**

Treatment for secondary dysmenorrhea depends on the underlying cause. In general, treatment involves the use of hormones. For example, if the cause is endometriosis, studies have shown that progestin-alone pills are effective in treatment, as they weaken the uterine lining and inhibit ovulation, leading to fewer menstrual periods.

In addition, surgery is commonly used to treat secondary dysmenorrhea, often involving laparoscopic procedures, hysterectomy, and various types of hysterectomy. Surgery may also include repair of abnormalities in the uterus.

**Treatment of dysmenorrhea**

Primary dysmenorrhea usually does not require medical treatment, unless the pain is severe and unbearable, in which case the doctor may prescribe some painkillers to relieve the pain. In the case of secondary dysmenorrhea resulting from a health problem, it is necessary to consult a gynecologist to determine the cause and obtain appropriate treatment.

Here are some natural ways that may help relieve symptoms:

- **Using a heating pad**: It can be placed on cramping areas such as the pelvis, back, or lower abdomen.

**Abdominal massage**: Massaging in circular motions may help relieve pain, and aromatic oils can be used during the massage.

- **Taking a warm bath**: It is a good option when feeling severe pain.

**Avoid fatty foods**: They can cause digestive disorders that increase the feeling of pain in the abdomen.

- **Practice relaxation techniques or yoga**: These practices help relieve pain.

- **Reduce your intake of salt, caffeine, and sugar**: to avoid bloating.

**Drinks that relieve menstrual pain**

Here are the most prominent drinks that help reduce menstrual pain:

1. **Chamomile tea**

Chamomile tea is considered beneficial for increasing levels of glycine in the body, an amino acid that contributes to the relaxation of muscles and nerves, which may help relieve menstrual cramps. To get the best results, it is recommended to drink it daily during the week before menstruation, and the benefit increases when consumed regularly every month.

2. **Fennel seed tea**

Fennel seed tea can relieve menstrual cramps, as it works similarly to some painkillers such as ibuprofen, reducing the feeling of pain and bloating associated with menstruation. To prepare it, add a teaspoon of dried fennel seeds to a cup of boiling water and leave for 5 minutes before consuming it.

3. **Cinnamon drink**

Cinnamon helps relieve menstrual pain and associated symptoms such as nausea, and may also contribute to reducing menstrual bleeding. To obtain its benefits, it is preferable to consume mDrink cinnamon daily during the first three days of the cycle.

4. **Ginger drink**

Ginger can relieve menstrual pain, and has an effect similar to some painkillers such as ibuprofen. It is recommended to take it 4 times daily during the first three days of the cycle, and it can be combined with fennel seeds to achieve better results.

5. **Peppermint tea**

Peppermint drink is considered an effective option for relieving menstrual pain, as it helps relax the muscles thanks to the compounds found in it, which reduces cramps and abdominal pain. It is recommended to take it to relieve premenstrual syndrome and during the menstrual cycle.

6. **Water**

In addition to the above herbal drinks, it is important to drink sufficient amounts of water daily, especially before and during menstruation. It is preferable to drink warm water, as it helps reduce cramps, as warm liquids enhance blood flow to the skin and contribute to relaxing tense muscles.