Menstrual pain

DEFINITION AND INCIDENCE OF MENSTRUAL PAIN OR DYSMENORRHEA

Menstrual pain or dysmenorrhea is a common gynecological disorder that affects between 20 and 90% of girls and women of reproductive age.

Dysmenorrhea is the severe pelvic pain, abdominal pain, and cramps that can occur before and/or during the period.

Pain is difficult to measure and objectify, but on a scale of 0 to 10, where 0 is no pain and 10 is the worst pain imaginable, from 4 menstrual pain should not be considered normal.

Period pain is not a disease, but a symptom of a disease that must be diagnosed and treated.

• If menstrual pain prevents a woman from leading a comfortable work, family, academic or social life, it is necessary to go to her gynecologist so that he can proceed with the tests that allow diagnosing the disease that causes the pain and starting treatment. most appropriate treatment.

SYMPTOM

About 30% of girls and women with menstrual pain suffer from severe symptoms that condition and limit their work, academic and family life.

Depending on the disease that causes menstrual pain, in addition to intense cramps and pelvic and abdominal pain, the symptoms that may appear most frequently are the following:

• Lumbar pain
• Headache
• dizziness
• Colic
• Nausea and vomiting
• Weakness and fatigue
• Heavy bleeding and/or prolonged bleeding

WHEN TO GO TO THE GYNECOLOGIST

The period can cause abdominal discomfort or mild pain, but when menstruation is painful and prevents following the daily routine or does not allow a comfortable life, it is necessary to go to the gynecologist.

On a scale of 0 to 10, if a woman describes her pain as a 4 or higher, it is necessary to investigate and perform diagnostic tests to discover and treat the cause of the pain.

It is advisable to consult with the gynecologist if any of the following circumstances occur:

• Pain and cramps appear for the first time.
• Menstrual pain is accompanied by fever.
• You feel pain even when you don't have your period.
• Menstrual pain worsens and becomes more intense or unbearable.
• Menstrual pain and other symptoms prevent normal academic, work, social or family life.

If the woman suffers from any of the symptoms mentioned, it is very important that she go to her trusted specialist so that tests are carried out to allow the design of an individualized treatment that is adapted to the circumstances, needs and wishes of the patient.

DIAGNOSIS

To find out the cause of menstrual pain, the gynecologist performs a physical examination and a clinical interview with the patient in order to know in detail the history, symptoms and characteristics of the pain.

The gynecologist may request complementary diagnostic tests such as an ultrasound, an MRI, blood tests or cultures to confirm the diagnosis.

The clinical interview, physical examination and diagnostic tests will allow the gynecologist to discover the disease causing the pain and start treatment.

CAUSES OF MENSTRUAL PAIN

The causes of menstrual pain are numerous, but the most common are endometriosis, adenomyosis, prolapse and uterine fibroids, all diseases that once properly diagnosed can be treated effectively.

• ENDOMETRIOSIS

Endometriosis is a chronic disease that usually affects women of reproductive age, although a small percentage of cases maintain symptoms during menopause.

It is a disease that causes a lot of pain during menstruation and ovulation, often continuous pelvic pain, discomfort during sexual intercourse and, on some occasions, makes it difficult or prevents pregnancy.

In endometriosis, the endometrium (the inner lining of the uterus) implants outside of its usual place and from that place prepares itself every month for a possible pregnancy.

As the endometrium is not in its usual place, the period has no way out and remains inside the body. These remains of menstruation are responsible for the pain that women with endometriosis present.

• ADENOMYOSES

Adenomyosis is a common chronic gynecological disease that usually affects women of reproductive age and can cause severe pain during menstruation, abundant uterine bleeding and infertility problems.

Adenomyosis consists of cells of the endometrium moving from their natural place and penetrating the interior of the muscular wall of the uterus.

These displaced endometrial cells (in their new location in the muscle wall) continue to function just as they would if they had not been displaced from their natural location.

With each new menstrual cycle, the displaced cells thicken, degrade and end up causing the patient from mild discomfort to intense pain and profuse and prolonged bleeding.

• UTERINE PROLAPSE

Uterine prolapse or pelvic floor prolapse is the descent of the pelvic organs (bladder, uterus or rectum) through the vaginal wall, as a result of failure or rupture of the suspension elements of these organs.

Uterine prolapse occurs when the muscles and ligaments of the pelvic floor weaken, no longer provide adequate support for the uterus, and the uterus descends into or protrudes from the vagina.

Among the causes of pelvic floor prolapse are vaginal delivery, chronic constipation, sports practices that require abdominal pressure, obesity, smoking, pelvic radiotherapy and radical surgeries for treatment of gynecological cancer.

• FIBROIDS

Uterine fibroids, also called uterine fibroids, are benign (non-cancerous) tumors that are very common during the reproductive age of women that develop in or on the muscular walls of the uterus.

Fibroids can cause symptoms such as heavy menstrual bleeding, painful periods, abdominal pain, discomfort during sexual intercourse, lower back pain, a feeling of weight in the lower abdomen, increased urinary frequency, constipation, and in some cases, pregnancy loss or infertility. .

TREATMENT OF MENSTRUAL PAIN

The treatment of menstrual pain must be very individualized, depending on the profile and circumstances of the patient, and varies depending on the intensity, duration and, especially, the cause of the pain.

If the pain is mild, depending on the cause and the context of each patient, the gynecologist may only recommend treating the symptoms with measures that modulate and relieve pain:

• Diet changes.
• Limitation in the consumption of alcohol and caffeine.
• Frequent and moderate physical exercise.
• Relaxation exercises
• Anti-inflammatory pain relievers such as ibuprofen.
• Natural drugs such as turmeric or cannabidol.
• Local heat in, for example, the lower abdomen.

If the pain associated with menstruation is intense and long-lasting and prevents the woman from continuing her daily life normally, it is necessary to go to the gynecologist as soon as possible in order to find out the cause and treat it appropriately.

Due to social influence, many women assume that they should consider menstrual pain to be "normal", even though it is incapacitating, undermines their personal well-being and does not allow them to lead a comfortable and peaceful life.

But incapacitating period pain is not an inevitable circumstance: it is a symptom of a disease that can and should be diagnosed and treated individually by expert gynecologists.