Primary Dysmenorrhea Basics for Women
Primary dysmenorrhea is such a common problem that many women do not report it during medical interviews.
This article presents simple, easy to grasp medical information covering
what primary menstrual cramps are, how they come about and most
especially predisposing factors and treatment guidelines.
What Is Primary Dysmenorrhea?
in general are lower abdominal or pelvic pain that occurs during the
period of menses. It usually originates from the uterus. The medical
term for this pain is dysmenorrhea. It could either be termed primary or
secondary depending on the underlying cause.
cramps are cramps not associated with any identifiable underlying cause.
Hey, not that there is really nothing wrong. There is simply no known
identifiable cause associated with it. They often begin within 6 to 12
months of the first menstrual flow (menarche).
or secondary menstruation cramps are period pains associated with
diseases such as pelvic infections, ovarian cysts or endometriosis.
An Important Problem
Primary dysmenorrhea is a very common problem among adolescents. Some
surveys have reported that as many as 90% of adolescents suffer from
such menstrual cramps.
It is known that many young women tend
to consider it as almost “normal” such that they do not even report it
when they are being interviewed by a doctor. For this reason, the
problem remains under-diagnosed and under-treated. In fact cramps only
meet the doctor in special cases!
A report indicated that about 14
percent of females between the ages of 20 to 35 experience symptoms so
severe that they are unable to go to school or work.
If there is no underlying cause, where then do primary cramps come from?
Note that the word “primary” means no definite cause can be identified
and not that nothing is really abnormal.Two important mechanisms causing
primary cramps are
- Normal menstruation is regulated by
substances called prostaglandins which are produced from the inner
lining of the uterus as the cells break down. Prostaglandins and some
other substances cause the uterine muscle to contract and provide the
gentle force needed to push the menstrual blood through the cervix.
These uterine contractions caused by prostaglandins are thought to be
the major mechanism underlying menstrual cramps.
Research has indicated that another mechanism underlying primary
dysmenorrhea is a disturbed balance between anti-inflammatory chemicals
called eicosanoids derived from omega-3 fatty acids, and
proinflammatory eicosanoids derived from omega-6 fatty acids. This is
the logic behind the use of omega-3 fatty acids in the treatment of
There are some features which increase the likelihood of a woman developing primary menstrual cramps.These risk factors are
- Early age at menarche (<12 years)
- Nulliparity( never been pregnant)
- Heavy or prolonged menstrual flow
- Positive family history
- Iron deficiency has also been suggested
Primary or Secondary Cramp?
Differentiating primary from secondary cramps is often not difficult.
These are some characteristic features of primary dysmenorrhea such as
often starts within 6 to 12 months of the first menses (
menarche).Suspect a secondary cause if the first episode occurs after 20
years of age. After 25 years, the likelihood of a secondary type is
- The pain begins with the onset
of menstruation (or just shortly before) and persists throughout the
first 1-2 days. The secondary type may persist throughout the flow.
- It may be associated with symptoms such as malaise, fatigue, nausea and vomiting, diarrhea, lower backache, and headache. Secondary dysmenorrhea may be associated with symptoms such as heavy bleeding, painful intercourse or fever depending on the underlying cause.
has a usual duration of 48-72 hours (often starting several hours
before or just after the menstrual flow).Secondary pain will last longer
and even continues as persistent pelvic pain after menses depending on
the specific cause.
- There could be extension of the pain to the back or the thigh.
- It often respond to common menstrual cramp relief
therapies such as antiinflammatory drugs or heat therapy. If there is
persistentl little or no response to usual therapies, a secondary cause
should be excluded.
Women with typical symptoms and no risk factors for secondary dysmenorrhea do not generally need lab or radiological evaluation.
Note these points as you fully review the different options for menstrual cramp relief.
- Home care is often the rule! Good therefore to start off right with right info and options.
- Menstrual cramp relief is a possibility for many women.
- Many options exist. Finding what works for you is the key.
- Seek medical care when it is necessary.
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