Cycles painful menstrual periods: causes and treatments of dysmenorrhea

Dysmenorrhea è il dolore che precede, accompagna o segue le mestruazioni. La causa di questo dolore non è ben nota. L’esame clinico e ginecologico deve essere accurato, vengono richiesti esami aggiuntivi a seconda dei casi e dell’orientamento diagnostico, ma nella maggior parte dei casi questa sensazione non è così invalidante da richiedere un intervento invasivo. Spesso ci si reca in pharmacy looking for a cure that can relieve this dull and sharp pain, and the answer lies in the classicanti-inflammatories|| |106 non steroidei che agiscono nella ricaptazione dell’accumulo di ciclossigenasi infiammatorie (prostaglandine). 

In fact, among the most accredited causes in the scientific world, it seems that dysmenorrhea is caused byexcessive concentrations of prostaglandins, hormones that cause contraction of the uterus during menstruation and childbirth. The pain is explained by a release of these hormones during the shedding of the endometrium (the membrane that lines the uterus) during menstruation, causing the uterus to contract and reduce its blood supply.

Factors that may further aggravate the pain associated with primary dysmenorrhea include tilting of the uterus backward (retroversion of the uterus) rather than forward, more intense or irregular periods, lack of exercise, psychological stress or society, smoking, alcohol consumption, overweight, family history of dysmenorrhea, and onset of menstruation before the age of 12.

Secondary dysmenorrheamay result from a number of conditions, including the following:

  • adenomyosis: the tissue lining the uterus (called the endometrium) begins to grow inside its muscular walls;
  • endometriosis: fragments of the endometrial wall leave the uterus and implant themselves on other organs i of the pelvis;
  • fibroids – benign tumors that appear on or are attached to the uterine wall;
  • sexually transmitted infection (STI);
  • the use of an intrauterine device (method of contraception);
  • salpingitis – an infection that mainly affects the fallopian tubes but can also affect the ovaries, uterus and cervix;
  • cancer ovarian or cyst.

Symptoms of dysmenorrhea

The main symptom of dysmenorrhea ispresence of pain, which appears in the lower part of the abdomen during menstruation and may also be felt in the hips, lower back or thighs. Other symptoms may appear, including nausea, vomiting, diarrhea, dizziness, headache, or fatigue.

For most women, pain usually begins shortly before or at the beginning of the period, reaches peak about 24 hours after bleeding begins and begins to disappear after 2 to 3 days. Bloody clots or pieces of tissue from the lining of the uterus may be pushed out of the uterus, causing pain.

The pain of dysmenorrhea can be spasmodic (severe pelvic cramps that occur at the onset of menstruation) or congestive (dull and persistent pain). Symptoms of secondary dysmenorrhea often appear earlier than those of primary dysmenorrhea in the menstrual cycle and usually persist for longer.

In 5-15% of cases, the pain experienced by women with primary dysmenorrhea is severe enough to interfere with their daily activities and may be the cause of an absence from school or work.

Treatment and prevention

Your doctor may prescribe medications or other remedies depending on the cause of dysmenorrhea.

Primary dysmenorrhea is usually treated with pain medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Buscofen) and naproxen provide relief for many women.

Some doctors may prescribe supplements hormonal. Oral contraceptives can help reduce the severity of symptoms. Nausea and vomiting can be treated with anti-nausea (antiemetic) drugs, but these symptoms usually go away without treatment when the cramps are gone. Implantable contraceptives and progesterone-based intrauterine devices that release a small amount of the hormone progesterone have also been shown to be very helpful in relieving pain.

Other non-medical measures can help relieve pain caused by dysmenorrhea:

  • Do light exercise, such as stretching, walking, or cycling (exercise can improve blood flow and reduce pelvic pain);
  • yoga;
  • place a hot water bottle on your abdomen or lower back;
  • get plenty of rest and avoid situations stressful when your period approaches;
  • take a hot bath.

Endometriosis and painful periods

Menstrual pains are common for many women, however, in some cases, they can hide other problems. If pain persists and no treatment, even medication, seems to be able to relieve it, you should speak to a doctor. In fact, it can be a sign of a condition such as endometriosis. This gynecological disease is characterized by the presence of fragments of the uterine lining located outside the uterus (rectum, bladder, intestine, ovary).

These lesions, called endometriotic lesions, become inflamed during menstrual cycles, which can cause severe pelvic pain. Diagnosing endometriosis is not straightforward, leading some patients to discover the disease by accident. Today it affects 1 in 10 women. 

As soon as disabling dysmenorrhea occurs, it is always necessary to go to the doctor, so that endometriosis can be thought of in order to be able to diagnose it as soon as possible and implement a cure early.

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