An article on Dysmenorrhoea

Dysmenorrhoea actually means painful menstruation.

Types:

1.Primary Dysmenorrhoea ( spasmodic, instinctive, essential functional)

2.Secondary Dysmenorrhoea ( Congestive, extrinsic,organic)

Primary: It is one where there is no identifiable pelvic pathology. Actual cause is unknown of this disease.

Incidence:

5-10% girls may face in their teen ages.

Causes of pain :

The mechanisms of initiation of uterine pain in primary Dysmenorrhoea is difficult to establish.But the following are too often related.

It is mostly confined to adolescents.
It is almost always confined to ovulatory cycle.
Sometimes pain is usually cared following pregnancy and vaginal delivery.

Psychometric factors:
Due to tension and anxiety during adolescents pain thresh hold is often attributed as an aggravating factor in pain perception.
Abnormal functioning of uterus: Stenosis at the internal OS and narrowing of cervical canal and it is difficult for the menstrual blood to escape and it creates strong uterine contraction and ultimately it creates pain.

Role of vasopressor:

There is increased vasopressor release during menstruation in women with primary Dysmenorrhoea. It increases prostaglandin synthesis and it also creates myometrical activity directly. It creates uterine hyper activiting and dysthymias contractions and it creates ischemia and hypoxia and it creates pain.

Role of prostaglandin :

In ovulatory cycles under of progesterone, prostaglandin are synthesized from the secretory endometrium is a strong vasoconstrictor which causes ischemia of myometrium.

Others :

Primary Dysmenorrhoea is predominantly confined to adolescents girls ,appears within 2 yrs of menarche.

Clinical features:

Pain begins a few hours before and just with the onset of menstruation. It may last for few hours and extend upto 24-48 hours.
Pain is mainly confined to lower abdomen of the patient.
It may radiate to back and medical aspect of through the patient.
It may creates nausea, vomiting, fatigue, diarrhoea and headache and backache
It may be accompanied by vasomotor changes pallor ,cold sweat,occasional fainting and fatigue.

Diagnosis:

In the diagnosis, abdominal and pelvic examination does not reveal any abnormal findings of Dysmenorrhoea.

Treatment:

In general measure include in improvement of general health of the patient.
Psychotherapy may be treated as a treatment in terms of explanation and assurance.
During menses ,bowel should be kept ready always
Mild analgesic and spasmodic may be used.
Encourage normal activities of the patient.
In severe cases indomethacin 25 mcg , prostaglandin synthesis inhibitor
Ibuprofen 400 mgs may be used in this treatment.