DYSMENORRHEA-DIFFICULTIES IN MENSTRUAL FLOW 2012

DYSMENORRHEA

INTRODUCTION
From time immemorial, the days of menstruation, for many a woman, are misery. These women who are suffering as result of menstruation, suffer from a condition known as dysmenorrhea. Dysmenorrhea refers to the syndrome of painful menstruation. The word, ‘dysmenorrhea,’ is derived from Greek word that means difficult monthly flow, otherwise known as painful menstruation. Although it’s not life threatening, dysmenorrhea can be debilitating and psychologically tasking for many women.

Definition

Dysmenorrhea refers to the pain or discomfort associated with menstruation. Although not a serious medical problem, the term describes a woman adolescent girl with menstrual symptoms severe enough to keep her from functioning for a day or two each month.

Description

Menstrual cramps are Primary dysmenorrhea usually presents during adolescence, Affected young women experience sharp, intermittent spasms of pain, usually centered in the suprapubic area. Pain may radiate to the back of the legs or the lower back. Systemic symptoms of nausea, vomiting, diarrhea, fatigue, fever and headache. Pain usually develops within hours of the start of menstruation and peaks as the flow becomes heaviest during the first day or two of the cycle. Some women notice that painful periods disappear after having their first child. This could be due to the stretching of the opening of the uterus or the fact that birth improves the uterine blood supply and muscle activity.

GENERALLY THERE TWO TYPES OF DYSMENORRHEA

PRIMARY AND SECONDARY
 

Primary dysmenorrhea

  is the most common type of dysmenorrhea and is due to the production of uterus and other parts of the body. Those made in the uterus make the uterine muscles contract and help the uterus to shed the lining that has built up during the menstrual cycle. It appears, however, that the level of prostaglandins has nothing to do with how strong a woman's cramps are. Some women have high levels of prostaglandins and no cramps, whereas other women with low levels have severe cramps. Thus cramps must also be related to something other than prostaglandins, such as genetics, stress, and different body types. The first year or two of a girl's periods are not usually very painful; however, once ovulation begins, the blood levels of the prostaglandins rise, leading to stronger contractions during menstruation Prostaglandins can also cause headaches, nausea, vomiting, and diarrhea. The likelihood that a woman will have cramps increases if the following apply to her:

• She has a family history of painful periods.
• She leads a stressful life.
• She does not get enough exercise.
• She uses caffeine.
• She has pelvic inflammatory disease

SECONDARY DYSMENORRHEA  

is  a pain that is caused  by disorder in the woman’s reproductive organs such as endometriosis[ a condition in which the tissue lining the uterus{the endometrium}is found outside the uterus.,    Adenomyosis{a condition were the lining of the uterus grows into the muscle of the uterus } pelvic inflammation disease-caused by bacteria which start in the uterus and can spread to other reproductive organs. pains from secondary  dysmenorrheal usually begins earlier in the menstrual cycle and last longer than  common menstrual cramps .the pain is not typically accompanied by nausea, vomiting, fatigue, or diarrhea

WHAT CAUSES DYSMENORRHEA:

In recent years, researchers have found that women who have complex chemicals known as prostaglandins, which cause contractions within female.  Prostaglandins rise before a period, increasing the movement of the uterus to help in the removal of the lining of the womb that occurs during menstruation. Women suffering from dysmenorrhea have extremely high levels of
prostaglandins, two to ten times the normal amount with the onset of menstrual flow. This already high concentration rises even higher and causes the uterus to contract painfully.

Symptoms of Dysmenorrhea:

 The main symptom of dysmenorrhea is pain concentrated in the lower abdomen in the umbilical region; it is also commonly felt in the right or left abdomen and it may radiate to the
thighs and lower back. Symptoms after co-occurring with menstrual pain include nausea, vomiting, diarrhea, headache, dizziness, disorientation, hypersensitivity to sound, light, smell and touch. Since many women expect certain discomfort, they tend to be reluctant
to bother doctor with their complaints about menstrual pains. You should contact your doctor for help to determine whether your monthly pains are due to underlying organic problems (secondary dysmenorrhea) or whether they are due to causes of primary dysmenorrhea.
Who Is Most Affected By Dysmenorrhea?
Millions of female from every conceivable walk of life in all corners of the world experience dysmenorrhea. It particularly affects women in their teens and early 20s. It often starts within the first year or two of menstrual period and May persists into the 30s and beyond. Fifty per cent of females have dysmenorrhea and some 10% lose one or two days of work or school every month. And are unable to care for their  families.
Why Is Dysmenorrhea Such A Major Problem?

 Twenty-six per cent of the estimated 13.4 million Nigerian dysmenorrheaic women miss work or school for at least one day due to the severity of dysmenorrhea. In addition, many people think
dysmenorrhea is a psychological problem, that this, they consider it a condition women must bear rather than one that is indeed medical and can be simply and easily treated. Eighty-four per cent of Nigerian women who suffer from dysmenorrhea do not even know its cause.

What To Do If You Have Dysmenorrhea:
Don’t be embarrassed to talk about it. Dysmenorrhea is a medical problem that can be treated with safe and effective medication. Seek help. Contact your doctor to determine whether your monthly pains are due to primary or secondary dysmenorrhea, by describing all your symptoms. Cramps are one of the major discomforts that can be associated with dysmenorrhea. Keep track of all kinds of pains where and when they occur.

Diagnosis

A focused history and physical examination are usually sufficient to make the diagnosis of primary dysmenorrhea. The history reveals the typical cramping pain with menstruation, and the physical examination is completely normal. A doctor should perform a thorough pelvic exam and take a patient history to rule out an underlying condition that could cause cramps. It is usually possible to differentiate dysmenorrhea from premenstrual syndrome (PMS) based on the patient's history. The pain associated with PMS is generally related to breast tenderness and abdominal bloating, rather than a lower abdominal cramping pain. PMS symptoms begin before the menstrual cycle and resolve shortly after menstrual flow begins.
Treatment Of Dysmenorrhea:
Women tend to use home remedies such as heat application, hot bath, bed resting  to relief discomfort. Some women take over-the-counter drugs that act to block the production of prostaglandins and have be convey successful in the treatment of dysmenorrhea. These  over-the- counter drugs are called no steroidal ,anti-inflammatory drugs
(NSIAD), typical examples are aspirin, ibuprofen, piroxicam,etc. These drugs inhabit synthesis of prostaglandins, lessen the contraction of uterus and reduce the menstrual flow.

Treatment of secondary dysmenorrhea

 This Depend on the cause. Endometriosis is the most common cause of secondary dysmenorrhea, depending on the stage of this disease and women’s age and desire to have children. The treatment method varies from conservation drug therapy (androgens progestin oral contraceptives and gonads tropic-releasing hormone agonists) to surgical procedures. If the problem is adenomyosis, hysterectomy may be necessary. Pelvic inflammatory disease may be treated with antibiotic. Uterine fibroids, fibroid tumuors and pelvic tumours are often treated surgically. Cervical narrowing can be corrected with grocery as well occasionally an Iud (Intra-uterine device) may be the cause  and if so, doctor should prescribe anti-prostaglandin drugs and suggest removing the device and using another form of birth control

By Maya  Salmat Salisu Musah

Fb id  maya Salisu OR maya salmah

Email:salmat_salisu@Yahoo.com OR salmatmaya@gmail.com

Phone number:08155509092,08037498259.