There are two kinds of painful mensesprimary and secondary
dysmenorrheaand it is very important to distinguish between them so both
are treated properly, Debrovner stresses.
Primary dysmenorrhea usually starts within three years of the onset of
menstruation and lasts one or two days each month. While this type of
menstrual pain may lessen for some women as they grow older or after the
birth of children, it also can continue until menopause.
Secondary dysmenorrhea is menstrual pain caused by disease such as pelvic
inflammatory disease, endometriosis (abnormalities in the lining of the
uterus), or uterine fibroids (nonmalignant growths). Endometriosis is a
major cause of secondary dysmenorrhea. Pain from it usually starts later in
life and worsens with time, according to Debrovner. Another hint that
disease might be the cause of menstrual pain is if pain also occurs during
intercourse or during other parts of the cycle.
Primary dysmenorrhea is a result of the normal production of
prostaglandinschemical substances that are made by cells in the lining of
the uterus. (Prostaglandins are also produced elsewhere throughout the
body.) The lining of the uteruswhich has built up and thickened during the
early stages of the menstrual cyclebreaks up and is sloughed off at the
end of the cycle and releases prostaglandins, explains Lisa Rarick, M.D.,
medical officer in FDAs division of metabolism and endocrine drug products.
The prostaglandins, in turn, make the uterus contract more strongly than at
any other time of the cycle. They can even cause it to contract so much that
the blood supply is cut off temporarily, depriving the uterine muscle of
oxygen and thus causing pain. Women who suffer painful contractions may be
producing excessive amounts of prostaglandins. Or, it may be that some women
are just more sensitive to them, says Rarick.
The cramps themselves help push out the menstrual discharge. Because the
cervical opening is often widened after childbirth or years of menstruation,
cramps may lessen in severity later in life.
Most women describe their menstrual cramps as a dull aching or a pressure
low in the abdomen. The pains may wax and wane, remain constant, or be so
severe that they cause nausea, vomiting, diarrhea, backache, sweating, and
an achiness that spreads to the hips, lower back, and thighs.
Hilton Johani is a leading expert on period pains,Tinnitus, hyperacusis and Menieres disease and has been assisting John Currie in running his tinnitus related website since 1999.
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