Recognizing Secondary Dysmenorrhea
Secondary dysmenorrhea or secondary menstrual cramps must be promptly
identified, and most especially must not be erroneously treated by home
self-care as primary cramps.A woman with cramps must not miss this.
Menstrual pain that starts after an initial period of pain-free menses
is usually associated with genital disease and is called secondary
dysmenorrhea or secondary menstrual pain. The term “secondary” implies
it occurs secondary to an underlying disease. The advent of secondary
menstrual cramps therefore warrants medical evaluation.
Identifying Secondary Cramps
Secondary dysmenorrhea should be highly suspected if there is one or more of the markers listed below
- Onset of pains in the 20s or 30s, after relatively painless menstrual cycles in the past
- Heavy menstrual flow or irregular bleeding
- Dyspareunia( painful sexual intercourse)
- Vaginal discharge
- Pain may not be relieved by nonsteroidal anti-inflammatory drugs (NSAIDs)
- Sudden change of severity and/or location of the usual menstrual pain
The following diseases may cause secondary dysmenorrhea
are benign( non-cancerous) growths of the uterine muscle layer, about
10 times more common in black women than whites. Other symptoms may
include prolonged bleeding, frequent urination, feeling of pelvic
fullness or abdominal pressure.
is the presence of endometrial tissue outside the uterus like in the
ovaries or the rectum. Other possible symptoms are back pain, pelvic
pain and dyspareunia. A rare condition similar to endometriosis is
adenomyosis which results from the presence of endometrial tissue in the
uterine muscle layer where it is not supposed to be found.
Pelvic inflammatory disease (PID)
is an infection of the uterus, fallopian tubes and the ovaries and
surrounding tissues in some cases. It is an infection that usually
occurs just after menses as the cervix opens up and thus allows
infectious organisms to ascend through the cervix to the tubes and
ovaries. The two most frequent causes are Chlamydia and gonorrheal
infections though other bacteria like those within the vagina and
intestines could also be responsible. Other symptoms besides
dysmenorrhea may include fever and vaginal discharge. Proper and prompt
treatment is required to prevent complications like abscess development,
infertility or inflammation around the liver.
is pus collection within the fallopian tubes or the ovaries. It is
usually caused by PID. Fever, vaginal discharge, nausea or vomiting may
These are fluid
containing cavities within the ovaries lined by a thin layer. There are
different types like the follicular cysts or dermoid cysts. Follicular
cysts occur when the usual egg-containing follicles enlarge beyond the
normal range. They can become complicated by twisted around themselves(
cyst torsion) or bleeding within( cyst hemorrhage). Pelvic ultrasound is
often sufficient for diagnosis.
may cause menstrual pains especially when they cause a complication
like uterine perforation. Consult your gynecologist if you suspect
unusual menstrual cramps may be due to an IUD.
is now called premenstrual dysmorphic disorder. It is a condition is
associated with menstrual cramps, bloating, body aches, migraine
headaches, breast tenderness, and emotional complaints.
Evaluation and Treatment
Each of these conditions has to be evaluated medically and appropriate treatment given.
is most important is that every woman with menstrual cramps learns to
identify the markers of a secondary cause and seek prompt medical care
for thorough evaluation to confirm or rule out an underlying disease.
Return From Secondary Dysmenorrhea to Menstrual Cramp Relief
Return From Secondary Dysmenorrhea To Menstruation Home