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Menstrual Cramps (Dysmenorrhoea)


Menstrual Cramps (Dysmenorrhoea)

Having your periods can be one of the most physically and emotionally exhausting times of the month if it is associated with pain, discomfort and cramping. Pain is usually felt in the lower abdomen, lower back and in some lower limbs. It’s normal for 50 – 55% of women to have mild abdominal cramps on the first day or two of their period, about 10% of women experience severe pain.

There are two types of dysmenorrhea:

  • Primary dysmenorrhea is menstrual pain that is not a symptom of an underlying gynecologic disorder but is related to the normal process of menstruation. Primary dysmenorrhea is the most common type of dysmenorrhea, affecting more than 50% of women, and quite severe in about 10%. Primary dysmenorrhea is more likely to affect girls during adolescence. Fortunately for many women, the problem eases as they mature, particularly after a pregnancy. Although it may be painful and sometimes debilitating for brief periods of time, it is not harmful.
  • Secondary dysmenorrhea a Menstrual pain that is generally related to some kind of gynecologic disorder. Most of these disorders can be easily treated with medications or surgery. Secondary dysmenorrhea is more likely to affect women during adulthood.


Primary dysmenorrheal – caused by excessive levels of prostaglandins that make your uterus contract during menstruation. Lack of exercise, psychological or social stress, smoking, drinking alcohol, being overweight increases the levels of prostaglandins. Secondary dysmenorrhea may be caused by a number of conditions:
  • Fibroids –benign tumours that develop within the uterine wall or are attached to it.
  • Adenomyosis –the tissue that lines the uterus (called the endometrium) begins to grow within its muscular walls.
  • A sexually transmitted infection (STI).
  • Endometriosis– fragments of the endometrial lining that is found on other pelvic organs.
  • Pelvic inflammatory disease (PID), which is primarily an infection of the fallopian tubes, but can also affect the ovaries, uterus, and cervix.
  • The use of an intrauterine device (IUD), a birth control method.

Symptoms of dysmenorrheal – Main symptom is usually a sharp cramp in the lower abdomen during menstruation and may also be felt in the lower back, or thighs or lower limbs. Other associated symptoms are nausea, vomiting, diarrhoea, lightheadedness, or general achiness.

For most women, the pain usually starts before or during their menstrual period, peaks within 24 hours, and subsides after 2 to 3 days. Sometimes clots or pieces of bloody tissue from the lining of the uterus are expelled from the uterus, causing pain.

Dysmenorrhea pain may be spasmodic (sharp pelvic cramps at the start of menstrual flow) or congestive (deep, dull ache). The symptoms of secondary dysmenorrhea often start sooner in the menstrual cycle than those of primary dysmenorrhea and usually last longer.

Management of Menstrual Cramps(Dysmenorrhoea): And they need some kind of treatment so that their work does not suffer.

  • Rest -lying on your back, supporting your knees with a pillow.
  • Avoid strenuous physical activity.
  • Holding a heating p1ad or hot water bottle on your abdomen or lower back.
  • Taking a warm bath.
  • Gently massaging your abdomen.
  • Doing mild exercises like stretching, walking, or biking – exercise may improve blood flow and reduce pelvic pain.
  • Getting plenty of rest and avoiding stressful situations as your period approaches.
  • Yoga, Accupressure and Accupuncture.
  • Pain killers- Are effective in relieving the pain like Ibuprofen, ibuprofen and paracetamol combination, aceclofenac alone or in combination with paracetamol. To relieve the pain, painkillers should be taken as soon as the pain starts and mild in nature. If one starts when pain has become very severe then it takes time to give relief. It is recommended that one should use hot fomentation also along with painkillers once the pain becomes very severe. They should always be taken full stomach. If taken empty stomach they can have side effects of nausea, dyspepsia, peptic ulcer