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By Syed Talha : Dysmenorrhea

In simple words, dysmenorrhea is pain with your menstrual periods. This pain entails aching pain in the stomach, a sensation of pressure on the stomach and pain that spreads to the hips, lower back and inner thighs. This pain is typically felt before or during menstruation. Other symptoms such as nausea and vomiting or vaginal discharge may also present simultaneously.

However, some pain, discomfort and cramps are considered normal. This is because the uterus must contract in order to push out a buildup of uterine tissue, which all menstruating women see in the form of bleeding.

So how do you know whether the pain you’re experiencing is normal or abnormal? Here is a checklist you can use:
1) The pain, cramps and discomfort interfere with different aspects of daily life
2) Symptoms are getting worse and more severe
3) Pain medication does not provide any relief
4) Pain and cramps last for more than 3 days or they continue after menstruation has stopped
5) Painful bleeding
6) Heavy and irregular bleeding
If some or all of these points apply to your situation, we would recommend that you book an appointment with a gynecologist.

The physician will likely perform a physical examination and/or require further testing in the form of a CT scan, MRI or ultrasound amongst others. This will be required to accurately evaluate the case and determine whether the dysmenorrhea is “Primary” or “Secondary”. Primary dysmenorrhea is painful bleeding that happens monthly corresponding with the dates of menstruation in the absence of any other disease or pathology. Secondary dysmenorrhea is menstrual pain that stems from problems and medical conditions of the reproductive organs. Some common conditions experienced by women include: Endometriosis, pelvic inflammatory disease and fibroids.

There are a range of symptomatic treatment options for primary dysmenorrhea. A healthcare provider will be able to determine the best feasible combination for any individual from the following:
• Use of NSAIDs such as ibuprofen when the bleeding or cramping starts. Alternatively, use of another pain reliever like acetaminophen if the use of an NSAID is not possible
• Placing a heating pad or hot water bottle on your lower back or abdomen
• Resting when needed
• Eating a balanced diet and avoiding foods with caffeine
• Avoiding smoking and drinking alcohol
• Massaging your lower back and abdomen
• Incorporating exercise into the weekly routine
• Suggesting the use of oral contraceptives

Secondary dysmenorrhea requires treatment of the underlying condition causing the pain. This is accomplished through the use of medication such as oral contraceptives, or in more severe conditions, surgery.

Menstrual health is important and often changing eating, sleeping and exercise habits can play a big role in improving the severity of menstruation symptoms. Approaching a healthcare provider about symptoms like period pains can go a long way to improving your menstrual and general health.

About The Author:
I am a 5th year medical student at Dow Medical College, Karachi, Pakistan. My career interests include general surgery and cardiology. I am passionate about improving community health as well as uplifting medical standards and practices in developing areas. As a future healthcare provider, I believe in pursuing quality education to be able to bring about positive change.